Development of the PRACTIC Goal Setting Interview (PGSI) for Frail Community-Dwelling Patients. Feasibility, Interrater Reliability and Content validity—a Mixed Methods Study

Anette Væringstad,1,2 Øyvind Kirkevold,1– 3 Ellen Thea Gjelseth Dalbak,1,2 Janne Myhre,4,5 Ingvild Hjorth Feiring,1 Sverre Bergh,1,3 Bjørn Lichtwarck1 1The Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway; 2Faculty of Medicine NTNU, Department of Health, Care and Nursing, Norwegian University of Science and Technology, Gjovik, Norway; 3The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Vestfold, Norway; 4Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences (INN University), Elverum, Norway; 5Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, NorwayCorrespondence: Anette Væringstad, The Research Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway, Tel +47 995 40 470, Email [email protected]; [email protected]: Goal-setting interviews in randomised controlled trials (RCTs), such as the Bangor Goal-Setting Interview (BGSI), provide personalised, measurable outcomes that are meaningful to participants because they reflect their unique needs. The PRACTIC (PReventing and Approaching Crises for frail community-dwelling patients Through Innovative Care) RCT (2023– 2024) evaluates a biopsychosocial intervention to approach and prevent crises for frail community-dwelling patients. The PRACTIC Goal Setting Interview (PGSI), adapted from the BGSI, focuses on individual goal attainment and readiness to change and was chosen as the primary outcome in the PRACTIC RCT. This study aimed to translate and develop the PGSI, exploring its feasibility, content validity and interrater reliability.Design and Methods: This study used a convergent mixed-method design; quantitative and qualitative data were collected with equal priority, analysed separately, and compiled for the results and discussion. Two substudies are included: 1) translation and development of the BGSI towards the PGSI and 2) feasibility, content validity and interrater reliability of the PGSI. Substudy 1 comprised field notes from meetings with municipal staff (n=7) across two municipalities. Substudy 2 included data from 28 municipalities participating in the PRACTIC RCT; patient (n=126), next of kin (n=72), and data from focus groups with staff members (n=13) and data collectors (n=5), as well as individual interviews; patients (n=8) and next of kin (n=4).Results: The PGSI was well received in the home care services and helped strengthen patient involvement. However, there were challenges in using the PGSI, such as time pressure and workload for the staff. After 12 weeks, participants with high motivation showed a significant increase in PGSI compared with those with low motivation (p = 0.010). Analyses also revealed strong positive correlations between participants and staff members assessments of goal attainment at 12 weeks (Spearman’s ρ = 0.87– 0.92, p < 0.001). The results indicate that the PGSI is a valid and reliable tool for improving patient care through structured goal setting and the active involvement of patients and their next of kin.Conclusion: The PGSI appears to be a useful and feasible tool for goal setting in home care services. The tool strengthens patient engagement and goal attainment with high content validity and interrater reliability.Trial Registration: ClinicalTrials.gov identifier: NCT05651659. Registration date: 07.12.22.Keywords: frailty, crises, home care services, health services for the aged, goal setting, PRACTIC goal setting interview, PGSI