# How is goal setting used in interventions for chronic disease prevention and management in sub-Saharan Africa? A systematic review and narrative synthesis

## TL;DR

This review explores how goal setting is used in chronic disease interventions in sub-Saharan Africa, highlighting its usefulness and challenges.

## Contribution

The study provides a comprehensive synthesis of goal setting approaches and their application in chronic disease management in sub-Saharan Africa.

## Key findings

- Goal setting was used in 18 interventions for chronic disease prevention and management in sub-Saharan Africa.
- Participants and facilitators found goal setting useful for translating self-management advice into practice.

## Abstract

Non-communicable diseases are increasingly prevalent in sub-Saharan Africa, and goal setting is often used to promote healthy self-management behaviours. In this review, we aimed to synthesise literature around how goal setting is used, for application in future interventions in the region. A systematic search was conducted in six databases and results screened for eligibility. Study characteristics, intervention details, goal setting components, feedback from participants and facilitators were extracted. Data were analysed using narrative synthesis and thematic analysis. The Mixed Methods Appraisal Tool was used to assess study quality. We included 24 publications describing 18 unique interventions. Included studies were of high to moderate methodological quality. Goal setting intervention components were informed by a variety of frameworks and involved a range of tasks. Interventions were often facilitator-led; many were conducted in group settings. Participants reported goal setting as useful for putting self-management into practice but encountered challenges related to language and literacy levels. Adequate detail on goal setting intervention components was not always present. Through this review, we provide a comprehensive picture of the variability of goal setting approaches in chronic disease prevention and management in sub-Saharan Africa and recommend more standardised use and reporting of goal setting intervention components.

Main findings: Goal setting was used in 18 interventions for chronic disease prevention and management in sub-Saharan Africa. Participants and facilitators found goal setting useful for translating self-management advice into practice, however challenges included delivering structured goal setting activities, language barriers and literacy levels.Added knowledge: This review provides a comprehensive picture of the different ways that goal setting has been used for chronic disease prevention and management in sub-Saharan Africa and highlights participants’ and intervention facilitators’ experiences, barriers and facilitators to using goal setting.Global health impact for policy and action: The findings and recommendations can be used to design interventions that make better use of goal setting techniques, adapt them to the sub-Saharan African context and reporting guidelines for interventions that contain goal setting components have been provided.

Main findings: Goal setting was used in 18 interventions for chronic disease prevention and management in sub-Saharan Africa. Participants and facilitators found goal setting useful for translating self-management advice into practice, however challenges included delivering structured goal setting activities, language barriers and literacy levels.

Added knowledge: This review provides a comprehensive picture of the different ways that goal setting has been used for chronic disease prevention and management in sub-Saharan Africa and highlights participants’ and intervention facilitators’ experiences, barriers and facilitators to using goal setting.

Global health impact for policy and action: The findings and recommendations can be used to design interventions that make better use of goal setting techniques, adapt them to the sub-Saharan African context and reporting guidelines for interventions that contain goal setting components have been provided.