A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health

What drives Chinese youth to use fitness-related health information on social media? An analysis of intrinsic needs, social media algorithms, and source credibility

Introduction

The role of social media in providing fitness-related health information has been widely discussed; however, there is a notable lack of research on fitness-related health information behaviors among youth within the social media context. This study aims to address this gap by integrating Self-Determination Theory (SDT)-based internal factors and external factors (social media algorithms and source credibility).

Methods

A voluntary sample of 600 participants, aged 15 to 29, was recruited. Data were analyzed using Partial Least Squares-Structural Equation Modeling (PLS-SEM) to examine the relationships between variables.

Results

The analysis revealed that all three intrinsic needs-competence, autonomy, and relatedness-along with social media algorithms and source credibility, positively correlated with fitness-related health information use behaviors among youth. Additionally, social media algorithms moderated the relationship between the need for relatedness and fitness-related health information behavior.

Discussion

These findings provide new insights into developing health communication strategies on social media, particularly targeted toward the youth demographic, enhancing our understanding of effective health information dissemination in digital environments.

Impact of professional identity on learner well-being of undergraduate nursing students of "double tops" universities: Mediating effect of self-regulated learning

OBJECTIVES

The pressure of internal competition at the college level has increased in recent years in China with an impact on nursing students' learning and well-being. This study aimed to investigate the current situation and factors affecting professional identity, learner well-being and self-regulated learning of undergraduate nursing students in the Neijuan ecology of the "double tops" universities, and to explore the relationships between these three variables.

METHODS

A cross-sectional design was adopted to conduct an online survey of 322 Chinese undergraduate nursing students from seven "double tops" universities. The survey included socio-demographics characteristics, students' professional identity, learner well-being, and self-regulated learning.

RESULTS

Results of Pearson correlation analysis showed that professional identity was significantly and positively correlated with learner well-being (R = 0.795, p < 0.001); professional identity was significantly and positively correlated with self-regulated learning (R = 0.843, p < 0.001); and, self-regulated learning was significantly and positively correlated with learner well-being (R = 0.852, p < 0.001). After mediation effect testing, self-regulated learning had a mediating effect between professional identity and learner well-being (95 % CI 0.366-0.548, p < 0.001). Professional identity had a positive predictive effect on self-regulated learning (a = 0.570, p < 0.001), and self-regulated learning also had a positive predictive effect on learner well-being (b = 0.798, p < 0.001). The direct effect of professional identity on learner well-being (0.225) and its mediating effect (0.455) account for 33.1 % and 66.9 % of the total effect (0.680), respectively.

CONCLUSIONS

The learner well-being of undergraduate Chinese nursing students is in the middle to upper range, and it is crucial to enhance professional identity and develop students' self-regulated learning to improve their learner well-being. This study provides empirical evidence to support the mediating effect of self-regulated learning on the relationship between professional identity and learner well-being among undergraduate nursing students in "double tops" universities. Universities are expected to strengthen career planning guidance and professional competence training for students as early as possible in order to develop quality nursing education programs that produce graduates who enter and remain in the workforce.

Beyond health: exploring women's socio-cultural motivations for HPV vaccination

PURPOSE

Autonomous motivation is critical to motivating individuals to adopt healthy behaviours. While many studies have explored the medical factors that influence women's autonomous motivation to receive HPV vaccination, sociocultural factors have received less attention. Therefore, this study analyses women's autonomous motivation for HPV vaccination from a sociocultural perspective to gain insight into the generation of women's health decisions.

METHODS

This study conducted in-depth interviews with 19 women at their peak age of infection who had been vaccinated against HPV to examine the socio-cultural factors that drove them to receive HPV vaccination. It used NVivo12 to analyse qualitative data obtained from interviews.

RESULTS

The results showed that (1) Demonstrating Personal Independence, (2) Asserting Reproductive Autonomy, (3) Acknowledging Sexual Needs, and (4) Showcasing Health Literacy, Economic Power, and Social Connections were autonomous motivations for women to receive HPV vaccination.

CONCLUSIONS

Based on these motivations, future vaccine promotion programmes should demonstrate the role of the HPV vaccine for women to become autonomous individuals, as well as clear up misconceptions between the HPV vaccine and sexual shame and reduce the monetary burden of the vaccine to build a friendly and egalitarian vaccination environment.

Development of the social dimensions of health behaviour framework

Despite rapid theoretical expansion in conceptualising individual and environmental processes, the examination of social processes associated with health behaviours has a less cohesive theoretical landscape. The purpose of this mapping review and content analysis was to develop a taxonomy of social dimensions applicable to health behaviours. Michie et al. (2014) 'ABC of Theories of Behaviour Change' text, which includes 83 behaviour change theories, was used as the data-set, whereby an iterative concurrent content analysis was undertaken with respect to all relational/interpersonal psychological dimensions. The analysis resulted in a social dimensions of health behaviour (SDHB) framework of 10 dimensions, including seven sub-types of social appraisal dimensions and three-sub-types of social identification dimensions. The SDHB revealed that specific dimensions, such as descriptive norm, are prevalent in behavioural theories, while other dimensions have seen less attention. Further, while most social constructs in behavioural theories are represented by only one social dimension in the SDHB, other constructs have complex representation. This version 1.0 of the SDHB framework should assist in specifying the core social dimensions in health behaviour, provide a common lexicon to discuss relational constructs in psychological theories, amalgamate the disparate social constructs literature and identify opportunities for further research to advance theory development and interventions.

Developing a Training in Motivational Counselling to Promote Return to Work: An Intervention Mapping Approach

PURPOSE

Due to the Belgian health insurance system's controlling nature, work-disabled claimants can feel forced to return to work (RTW), increasing their risk of relapse. RTW out of interest or importance is considered more sustainable. Such autonomous motivation for RTW can be promoted through 'motivational counselling', an integration of self-determination theory and motivational interviewing. To adopt this, health insurance practitioners need training, which can be designed through intervention mapping as an evidence-based planning tool. This paper reports on the development of a motivational counselling training for health insurance practitioners.

METHODS

Intervention mapping's six steps guided the formulation of programme goals and learning outcomes, matching the context. We then identified change methods which were translated into practical components. Together with the health insurances' input, this resulted in a concrete training programme with an implementation and evaluation plan.

RESULTS

The training was designed to increase practitioners' knowledge, skills, and beliefs relevant for learning motivational counselling, which also requires solution-focused strategies. Methods like guided practice were translated into built-in exercises, feedback, and information, which were implemented through an online training format of five sessions including one follow-up.

CONCLUSION

Reporting about training development increases understanding of its effectiveness and implementation, which will be evaluated via pre- and post-training data collection amongst practitioners. Future trainings can benefit from this by accounting for health insurances' organizational barriers or building on the training's evidence-based backbone whilst only requiring specific adaptations for other stakeholders and contexts. Further research should evaluate motivational counselling's impact on claimants' RTW trajectories.

Training effectiveness evaluation: Advancing a Kirkpatrick model based composite framework

The present study aims at ideating a quantitative protocol to evaluate effectiveness of training programmes especially meant for farmers, farm women, and rural youth. The specific objective was to develop a robust framework for measuring the effectiveness of rural training programmes organized by the Farmers Training Centres (FTCs) of India. Kirkpatrick's training evaluation model provides us the foundation to design a four-dimensional composite framework based on range-based indicator normalization, principal component analysis based indicator weight estimation, and rank correlation based framework sensitivity testing. We used cross-sectional primary data generated through household survey and personal interviews with randomly selected one thousand trainees to test and validate our proposed protocol. Applying it on our evaluation target we find that the degree of effectiveness of the training programmes varies; one in every four training programmes may not be effective. Trainees' reactions on various aspects of the training programmes may have positive and significant influence on learning. Training outcomes may be linked with the trainees' post-training changes in behaviour. A sensitivity test confirms that the proposed framework is not susceptible to changes in weighting schemes, implying robustness of indicator selection. The findings offer dissection of individual training programmes guiding policy decisions for a training organization. The proposed framework enriches the Kirkpatrick's training evaluation model by offering standardized indicators for training effectiveness evaluation.

The help-seeking process and predictors of mental health care use among individuals with depressive symptoms: a machine learning approach

Purpose

The goal of the study was to identify the most important influences on professional healthcare use of people with depressive symptoms. We incorporated findings from research areas of health behaviors, stigma, and motivation to predict the help-seeking process variables from a wide range of personal factors and attitudes.

Methods

A sample of 1,368 adults with untreated depressive symptoms participated in an online survey with three-and six-month follow-ups. We conducted multiple linear regressions for (a) help-seeking attitudes, and (b) help-seeking intentions, and logistic regression for (c) help-seeking behavior with machine learning methods.

Results

While self-stigma and treatment experience are important influences on help-seeking attitudes, complaint perception is relevant for intention. The best predictor for healthcare use remains the intention. Along the help-seeking process, we detected a shift of relevant factors from broader perceptions of mental illness and help-seeking to concrete suffering, i.e., subjective symptom perception.

Conclusion

The results suggest a spectrum of influencing factors ranging from personal, self-determined factors to socially normalized factors. We discuss social influences on professional help-seeking and the use of combined public health programs and tailored help-seeking interventions.

Clinical trial registration

German Clinical Trials Register (https://drks.de/search/en): Identifier DRKS00023557.

Social Media Use and Fear of Missing out: An Exploratory Cross-Sectional Study in Junior High Students from Western Mexico

BACKGROUND/OBJECTIVES

The increased use of social media in Mexico has given rise to the "fear of missing out" (FoMO) phenomenon, especially among adolescents. This study aimed to measure the extent of FoMO among junior high school students in the metropolitan area of Guadalajara, Mexico, during the COVID-19 pandemic. Additionally, this study explored the association between FoMO levels and demographic characteristics, as well as the type and frequency of social media use.

METHODS

A cross-sectional survey was conducted from November 2021 to January 2022 in four junior high schools. A total of 1264 students (656 females and 608 males) aged 11-16 years completed the Fear of Missing Out Scale, adapted to the Mexican context. Data on demographics, social media usage, and school shifts were collected. Statistical analyses were performed using t-tests, ANOVA, and correlation coefficients.

RESULTS

The mean FoMO score was 1.79 ± 0.64, with higher scores observed in females (p < 0.001) and students attending morning shifts (p = 0.001). Significant associations were found between higher FoMO scores and the use of social media platforms like Instagram, TikTok, and Pinterest (p < 0.001 for each). The most frequently used social media platforms were WhatsApp (1093), TikTok (828), and Instagram (583). Participants who used social media all week exhibited significantly higher FoMO scores than those who used it only on weekends (p < 0.001).

CONCLUSIONS

FoMO is a significant phenomenon among junior high school students in Guadalajara, Mexico, particularly among females and those who use multiple social media platforms. The findings suggest a need for interventions to manage social media use and mitigate FoMO-related negative health outcomes in this population.

Examining the link between exercise motivation and preferred exercise setting in college students

Introduction: This study examined differences in self-determined motivation between those who prefer to exercise outdoors vs indoors. These differences could foster targeted applications of Self-Determination Theory to develop intrinsic exercise motivation. Participants: n = 506 students attending a mid-size four-year university in the southeastern United States participated. Methods: This was a cross-sectional study using a modified version of the Exercise Motivations Inventory (EMI-2). Results: Using exploratory and confirmatory factor analysis, three exercise motivations were identified: intrinsic, extrinsic, and social. Using structural equation modeling, we found higher extrinsic motivation was associated with indoor exercise preference, whereas higher social motivation was associated with outdoor exercise preference. Discussion: This study revealed exercise setting as a possible contributing factor for self-determined motivation. Those who prefer to exercise indoors may be at higher risk of strengthening external regulation. Interventions that support psychological needs may help foster self-determined exercise motivation among college students.

Detailed statistical analysis plan for a guided self-determination intervention versus an attention control for outpatients with type 2 diabetes in the randomised OVERCOME trial

BACKGROUND

Autonomy-supporting interventions may be a prerequisite to achieve better long-term management of type 2 diabetes. Evidence suggests that the guided self-determination (GSD) method might improve haemoglobin A1c and diabetes distress in people with type 1 diabetes. The evidence of an effect of a GSD intervention compared with an attention control group in adults with type 2 diabetes is unknown.

METHODS/DESIGN

The trial is designed as a pragmatic, investigator-initiated, dual-centre, randomised, parallel-group, assessor-blinded, superiority clinical trial of persons with type 2 diabetes. A nurse will administer GSD intervention versus an attention control. The primary outcome is diabetes distress, and secondary outcomes are quality of life, depressive symptoms, and non-serious adverse events. Exploratory outcomes are haemoglobin A1c, motivation, and serious adverse events. Participants are assessed at baseline, 5-, and 12-month follow-up. Here, we present a detailed, comprehensive plan of all statistical analyses, including methods to handle missing data, and assessments of the underlying statistical assumptions. The statistical analyses will be conducted independently by two statisticians following the present plan.

DISCUSSION

To mitigate the risk of analysis bias and increase the validity of the OVEROME trial, this statistical analysis plan was developed prior to unblinding of the trial results in concordance with the Declaration of Helsinki and the Conference on Harmonization of Good Clinical Practice Guidelines.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04601311. Registered on October 2020.

Mindfulness improves psychological health and supports health behaviour cognitions: Evidence from a pragmatic RCT of a digital mindfulness-based intervention

BACKGROUND

Mindfulness-based interventions can improve psychological health; yet the mechanisms of change are underexplored. This pre-registered remote RCT evaluated a freely accessible digital mindfulness programme aiming to improve well-being, mental health and sleep quality. Health behaviour cognitions were explored as possible mediators.

METHODS

Participants from 91 countries (N = 1247, Mage = 27.03 [9.04]) were randomized to 30 days of mindfulness practice or attention-matched control condition. Measures of well-being, depression, anxiety, stress, sleep quality, barriers self-efficacy, self-regulation and behavioural predictors (e.g., attitudes and behavioural intentions) were taken at baseline, 1-month (post-intervention) and 2-months (follow-up). Linear regression examined intervention effects between and within groups. Longitudinal mediation analyses explored indirect effects through health behaviour cognitions.

RESULTS

Three hundred participants completed post-intervention measures. Those receiving mindfulness training reported significantly better well-being (Mdifference = 2.34, 95%CIs .45-4.24, p = .016), lower depression (Mdifference = -1.47, 95%CIs -2.38 to -.56, p = .002) and anxiety symptoms (Mdifference = -.77, 95%CIs -1.51 to -.02, p = .045) than controls. Improvements in well-being and depression were maintained at follow-up. Intervention effects on primary outcomes were mediated by attitudes towards health maintenance and behavioural intentions. Mediating effects of attitudes remained when controlling for prior scores in models of depression and well-being.

CONCLUSIONS

Digital, self-administered mindfulness practice for 30 days meaningfully improved psychological health, at least partially due to improved attitudes towards health behaviours and stronger behavioural intentions. This trial found that digital mindfulness is a promising and scalable well-being tool for the general population, and highlighted its role in supporting health behaviours.

Meeting people where they are: Crowdsourcing goal-specific personalized wellness practices

OBJECTIVES

Despite the development of efficacious wellness interventions, sustainable wellness behavior change remains challenging. To optimize engagement, initiating small behaviors that build upon existing practices congruent with individuals' lifestyles may promote sustainable wellness behavior change. In this study, we crowd-sourced helpful, flexible, and engaging wellness practices to identify a list of those commonly used for improving sleep, productivity, and physical, emotional, and social wellness from participants who felt they had been successful in these dimensions.

METHOD

We recruited a representative sample of 992 U.S. residents to survey the wellness dimensions in which they had achieved success and their specific wellness practices.

RESULTS

Responses were aggregated across demographic, health, lifestyle factors, and wellness dimension. Exploration of these data revealed that there was little overlap in preferred practices across wellness dimensions. Within wellness dimensions, preferred practices were similar across demographic factors, especially within the top 3-4 most selected practices. Interestingly, daily wellness practices differ from those typically recommended as efficacious by research studies and seem to be impacted by health status (e.g., depression, cardiovascular disease). Additionally, we developed and provide for public use a web dashboard that visualizes and enables exploration of the study results.

CONCLUSIONS

Findings identify personalized, sustainable wellness practices targeted at specific wellness dimensions. Future studies could leverage tailored practices as recommendations for optimizing the development of healthier behaviors.

The role of motivation in clinical presentation, treatment engagement and response in schizophrenia-spectrum disorders: A systematic review

Schizophrenia, a debilitating psychiatric disorder, has a long-term impact on social and occupational functioning. While negative symptoms, notably amotivation, are recognized as poor prognostic factors, the positive force of patient motivation (autonomous motivation) remains underexplored. This systematic review, guided by Self-Determination Theory (SDT), investigated the impact of motivation on clinical presentation, and treatment engagement and response in schizophrenia-spectrum disorders. Fifty-five independent studies (N = 6897), using 23 different motivation scales, met inclusion criteria. Results were categorized into cross-sectional and longitudinal correlates of autonomous motivation, and the effects of motivational interventions. Cross-sectionally, autonomous motivation was positively associated with social/occupational functioning, and negatively associated with negative and positive symptom severity. In longitudinal studies, baseline autonomous motivation predicted engagement in and response to social/occupational treatments, with mixed results in cognitive interventions. In the 16 randomized controlled trials (RCTs), the most common motivational interventions were individualized goal setting and goal attainment support, followed by increasing sense of competence by challenging defeatist beliefs, and enhancing relatedness by increasing contact time. Motivational interventions consistently increased autonomous motivation, treatment engagement and response. More studies are needed, particularly studies that monitor motivation during treatment: proximal assessments could facilitate the identification of treatment elements that impact motivation and engagement and inform treatment modifications to enhance the patient experience and improve treatment efficacy.

Decoding the Influence of eHealth on Autonomy, Competence, and Relatedness in Older Adults: Qualitative Analysis of Self-Determination Through the Motivational Technology Model

BACKGROUND

Older adults adopt and use eHealth systems to build autonomy, competence, and relatedness and engage in healthy behaviors. The motivational technology model posits that technology features, such as those on websites, smart displays, and mobile phones, must allow for navigability, interactivity, and customizability, which spur feelings of self-determination and intrinsic motivation. We studied ElderTree, an online system for older adults that provides on-demand videos of healthy living content, self-monitoring, and weekly researcher-hosted video meetings.

OBJECTIVE

We aimed to understand the theoretical crossover between the motivational technology model and self-determination theory using features of ElderTree to understand the usability of the technology and how it may support older adults' autonomy, competence, and relatedness.

METHODS

Drawing participants from a randomized controlled trial of a mobile health app for older adults with multiple chronic conditions, we conducted qualitative interviews with 22 older adults about their use of the app; the interviews were coded using qualitative thematic analysis.

RESULTS

Older adults did find that features within ElderTree such as content available on demand, good navigation, and weekly researcher-led video calls supported feelings of autonomy, competence, and relatedness, respectively. Individual differences such as a background using computers also influenced participants' experiences with the smart displays.

CONCLUSIONS

Participants confirmed the features that increased internal motivation, such as interactivity correlating with feelings of relatedness, but they also found other ways to support autonomous health behavior change beyond narrow views of navigability, interactivity, and customization.

The use of dance to improve the health and wellbeing of older adults: A global scoping review of research trials

BACKGROUND

Dance is a promising health resource for older adults, but empirical evidence remains inconsistent. The lack of synthesised evidence regarding program design, dose, and delivery limits understanding of factors influencing participation and health outcomes. This scoping review aimed to map the scope, range, and effectiveness of dance programs for older people, and identify gaps and opportunities for future research and practice.

METHODS

Searches across five databases (September 2023) identified 148 studies evaluating 116 dance programs (≥4 weeks) for older adults (≥55 years, N = 8060), Dance interventions delivered to clinical groups were excluded. Intervention design and delivery were charted against the TIDieR reporting checklist. Program outcomes including adherence, safety, and positive tests were charted into established taxonomies.

RESULTS

Demographic information, program details, and implementation were often insufficiently reported. Participant groups differed by age range, with underserved communities underrepresented. Programs varied extensively in key factors including dose, prospective 'active ingredients', delivery approach, facilitator expertise, and class size. While dance was physically safe, adherence rates in older adults are comparable to other community exercise programs. Less than 40% of health assessments showed positive change, with more consistent benefits to physical endurance, strength, and function, moderate impacts on psychosocial health, and limited benefits to cognitive and brain health, and falls and falls risk.

CONCLUSION

Dance is a meaningful, safe, adaptable, and low-cost health resource for older adults. Key opportunities for advancing research include improved access for underserved groups, program suitability assessments, strategies to support adherence and engagement including theory-informed approaches, and incorporation of participant and practitioner insights. Identification of key 'active ingredients' and dance program factors may improve understanding of causal pathways and mechanisms to optimise engagement and health impacts. Stronger reporting practices will facilitate comparisons across studies and more robust evidence synthesis. This review provides a critical knowledge foundation to guide future approaches in dance for health and offers reporting recommendations.

Technology-Supported Physical Activity and Its Potential as a Tool to Promote Young Women's Physical Activity and Physical Literacy: Systematic Review

BACKGROUND

Despite the known benefits of physical activity (PA), rates of engagement in PA remain low globally. Low engagement in PA among young women can impact their health. Technology-supported PA may increase PA and physical literacy (PL; skills that can support PA) among young women.

OBJECTIVE

This systematic review aims to investigate the (1) associations between technology-supported PA and PA levels, (2) associations between technology-supported PA and PL levels, and (3) types of technology-supported PA that are associated with higher levels of PA engagement among young women aged 13 to 24 years. This age range was chosen as it includes two transitional periods characterized by decreases in PA.

METHODS

We searched 6 databases: Applied Science and Technology Source, Education Source, Embase, MEDLINE Complete, Global Health, and SPORTDiscus. Eligible studies were original research published in English between January 1, 2010, and April 24, 2024; focused on young women; and involving either technology-supported PA interventions or research exploring the correlation between technology and PA and PL. The findings of the review were presented descriptively. Study quality was assessed using the JBI Critical Appraisal tools. There were no deviations from the registered protocol.

RESULTS

In total, 23 (0.1%) studies (10,233 participants) from 23,609 records were included: randomized controlled trials (n=9, 39%), nonrandomized or retrospective observational studies (n=9, 39%), and cross-sectional studies (n=5, 22%). Of the 23 studies, 12 (52%) focused on young adults (aged ≥19 y), 9 (39%) involved adolescents (aged <19 y), and 2 (9%) focused on both groups. Nine studies (39%) were theory based. Common types of technology-supported PA were interactive websites or social media platforms (10/23, 43%), wearable fitness trackers (4/23, 17%), and mobile apps (4/23, 17%). PA or PL were predominantly self-reported (18/23, 78%). A total of 53 PA outcomes were measured: 36% (19/53) reported a positive impact on PA from mobile apps (9/15; 60% of analyses), interactive websites or social media platforms (8/27; 30% of analyses) and wearable fitness trackers (2/11; 18% of analyses). The impact on PL was weak (2/7; 29% of analyses). Eight studies (35%) were rated high, 7 (30%) medium, and 8 (35%) low in quality.

CONCLUSIONS

There was limited evidence that technology-supported PA improved young women's PA or PL. The evidence was limited by poor study quality and a lack of theoretical frameworks. In addition, little information was provided on the designs of the technology used. Future interventions seeking to improve young women's PA and PL should focus on the development of mobile apps underpinned by behavior change theory and addressing whole domains of PL rather than specific elements. Given that technology continues to rapidly advance, further studies are needed to demonstrate the impact of technology-supported PA in improving PA and PL among young women.

Analysing the Relation between Passion, Motivation, and Subjective Well-Being in Sport: A Systematic Review

Both the Dualistic Model of Passion and Self-Determination Theory suggest that the persistence of a behaviour over time derives from the internalisation of the passion or motivation that the individual feels about the activity. However, the integration of these theoretical assumptions may lead to a better understanding of related outcomes, in particular on subjective well-being (SWB). In this context, this study aimed at systematically reviewing the relation between passion, behaviour regulation (i.e., self-determined motivation), and SWB in sport. The PRISMA 2020 protocol was used to guide the systematic review. Electronic searches were conducted in the Web of Science database and Pubmed. The following descriptors were used: SWB; passion; motivation; behavioural regulation; and sport. After the search, 12 studies were retrieved for analysis that show us the following results tendencies: harmonious passion (HP) and autonomous motivation (AM) (i.e., more self-determined forms of behaviour regulation) are positively related to SWB (i.e., life satisfaction and positive affect), while obsessive passion (OP) and controlled motivation (CM) (i.e., less self-determined forms of behaviour regulation) are negatively associated with SWB. However, no studies were found to simultaneously analyse the three theoretical constructs. These results show us the importance of developing conditions in sport contexts that promote positive feelings that take into account athletes' development of harmonious passion and self-determined behaviour regulation, in order to achieve higher levels of well-being. Nevertheless, these results also lead us to the necessity for more studies to highlight the theoretical link between passion and motivation in the context of sport, especially regarding the mediating role of motivation in the relationship between passion and well-being.

A randomized controlled trial of a "Small Changes" behavioral weight loss treatment delivered in cardiac rehabilitation for patients with atrial fibrillation and obesity: study protocol for the BE-WEL in CR-AF study

BACKGROUND

Atrial fibrillation (AF) represents a global epidemic. Although international AF practice guidelines indicate weight loss for patients with AF and comorbid obesity (BMI ≥ 30 kg/m2) to alleviate symptom burden and improve prognosis, few cardiac rehabilitation (CR) programs include targeted weight loss treatment.

AIMS

This RCT protocol will evaluate the efficacy of a "Small Changes" behavioral weight loss treatment (BWLT) to produce clinically relevant (≥ 10%) weight loss among patients with AF and obesity undergoing CR, relative to CR alone. Secondary aims are to establish efficacy of CR + BWLT for improving AF symptoms, AF risk factors, and health-related quality of life.

METHODS

Adults (18 +) with AF and obesity will be recruited and randomized to receive CR + BWLT (intervention) or CR-only (control). Controls will receive CR consisting of supervised exercise and risk factor self-management for 12 weeks. The intervention group will receive CR plus BWLT (12 weekly, group-based virtual sessions, followed by 12 weeks of follow-up support). Weight and AF-risk factors will be assessed at pre-randomization, 12 weeks, 24 weeks, and 52 weeks. AF burden will be assessed using 30-s ECGs recorded bidaily and with AF symptoms. The primary endpoint of weight loss will be calculated from baseline to 52 weeks as a percentage of starting weight. Intention-to-treat analyses will compare the proportion in each group achieving ≥ 10% weight loss. Assuming success rates of 5% and 30% among controls and intervention groups, respectively, and a 30% loss to follow-up, 120 patients (60 per group) will provide 80% power to detect a difference using a two-sided independent test of proportions (alpha = 5%).

IMPACT

This clinical trial will be the first to demonstrate that adding BWLT to CR promotes clinically meaningful weight loss among patients with AF and comorbid obesity. Findings will inform design and execution of a large efficacy trial of long-term (e.g., 5-year) clinical endpoints (e.g., AF severity, mortality). Implementing weight control interventions designed to target the AF substrate in CR could dramatically reduce morbidity and enhance quality of life among patients living with AF in Canada.

TRIAL REGISTRATION

ClinicalTrials.gov registration number: NCT05600829. Registered October 31, 2022.

Living together-does it help or hinder the pursuit of a healthful diet, physical activity, and weight loss among cancer survivors and their chosen partners?

PURPOSE

Parental or spousal cohabitating relationships are often targeted in behavioral interventions, but the contribution of cohabitation is poorly understood. This study explored whether cohabitation status moderated the impact of social cognitive theory constructs on adiposity, diet, and exercise in a dyadic, web-based weight loss intervention among cancer survivors and their chosen partners.

METHODS

The 24-week weight loss intervention was conducted among 56 dyads, comprised of a cancer survivor and their chosen partner (n = 112). Baseline and 6-month data on social cognitive theory constructs (self-efficacy, social support, and perceived barriers), and study outcomes of adiposity (weight and waist circumference), diet (calories and diet quality), and moderate-to-vigorous physical activity (MVPA) were used to perform moderated-mediation analyses among cohabitating (n = 25) versus non-cohabitating (n = 31) dyads.

RESULTS

The intervention was positively associated with dietary social support (path a1: 0.36, 95% CI [0.083, 0.659]) and inversely associated with perceived dietary barriers (path a1: - 10.57, 95% CI [- 19.109, - 3.091]) and perceived exercise barriers (path a1: - 11.29, 95% CI [- 22.098, - 3.500]) among those who did not cohabitate (effects not observed among cohabitating pairs). The intervention's mediating effects through perceived barriers on weight (indirect effect (ab): - 2.21, 95% CI [- 4.794, - 0.548]), waist circumference (ab: - 1.13, 95% CI [- 2.452, - 0.171]), caloric intake (ab: - 5.09 (2.86), 95% CI [- 12.602, - 0.709]), and self-reported MVPA (ab: 0.29 (0.18), 95% CI [0.019, 0.754]) also were stronger among non-cohabitating pairs.

CONCLUSIONS

These findings suggest that social support partners outside the home substantially enhance intervention impact, though relationship quality and gender dynamics warrant further exploration.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04132219.

Exercise intensity agreement, need satisfaction, and exercise behavior: A sex-moderated mediation model

Several theoretical frameworks have been used to understand exercise adherence. Basic psychological needs (BPN), grounded on self-determination theory, have received large attention for this purpose. More recently, the hedonic theory and the assumptions related to the exercise characteristics (e.g., intensity) that can bolster positive affective responses have been revitalized. This study aimed to explore the associations between the agreement of current exercise intensity and the one individually preferred, BPN satisfaction/frustration, enjoyment, the intention to continue exercise, and exercise frequency. Additionally, an exploration of the direct and indirect effects while testing sex as a moderator was performed. A sample of 369 exercisers (Mage = 43.6, standard deviation = 12.96; 214 females) enrolled in 26 health clubs participated in this study voluntarily. Data were received in a first-approach descriptive and correlational analyses. Next, a moderated mediation was performed using model 15 (PROCESS v.4.2). As a result, agreement in preference for exercise intensity was positively associated with enjoyment (r = 0.35), intention (r = 0.43), and all needs satisfaction (ranging from r = 0.12 to r = 0.45) and negatively associated with all needs frustration (ranging from r = -0.15 to r = -0.31). In the moderated mediation analysis, the same pattern of results emerged in direct effects. Indirect effects were significant for autonomy in the enjoyment and frequency models. Findings suggest that promoting an individually adjusted training intensity may foster BPN satisfaction. It appears to be present an independent (of needs) and positive association with exercise enjoyment and intention to continue exercising.

Self-efficacy and autonomous motivation are associated with lower sugar-sweetened beverage consumption in low-income overweight and obese mothers of young children

Sugar-sweetened beverage (SSB) consumption is strongly associated with obesity. Autonomous motivation and self-efficacy, key concepts of self-determination theory, may influence SSB consumption. Low-income mothers of young children experience disproportionate rates of obesity. Whether autonomous motivation and self-efficacy are associated with SSB consumption in low-income mothers of young children is unknown. This exploratory secondary data analysis explored whether autonomous motivation or self-efficacy were associated with SBB consumption using data from a lifestyle intervention for low-income, overweight or obese mothers with young children. Participants (N = 311) completed surveys assessing autonomous motivation, self-efficacy, and SSB consumption at baseline, after the 16-week intervention, and at 3-month follow-up. Using baseline data, we performed linear regression models to explore associations of self-efficacy and autonomous motivation with SSB consumption. We also performed mixed effects models to explore whether autonomous motivation or self-efficacy were associated with SSB consumption over time. At baseline, a one-point increase in autonomous motivation and self-efficacy were associated with 4.36 (p < 0.001) and 6.43 (p = 0.025) fewer ounces of SSB consumption per day, respectively. In longitudinal models, SSB consumption decreased over time. Change in SSB consumption was associated with self-efficacy (B = -4.88; p = 0.015) and autonomous motivation (B = -2.29; p = 0.008). Our findings suggest self-efficacy and autonomous motivation may influence SSB consumption among mothers of young children with overweight and obesity. Further investigation should explore if self-efficacy and autonomous motivation have long-term effects on SSB consumption.

"I Refuse to Wear a Mask!" Examining the Relationship Between Grit and Preventative Behaviors and Well-Being: Mediating Role of Motivation

Despite government mandates to wear face masks in some public locations, why do some people still refuse to wear a face mask in public? This paper examines the relationship between grit, COVID-19 preventative health measure, and distress. Further, the mediating role of COVID-19 autonomous and controlled motivation is also investigated. The results suggest that grit is directly related to decreased distress and increased preventative behaviors. COVID-19 autonomous and controlled motivated mediated the relationship between grit, distress and preventive behaviors, such that COVID-19 autonomous motivation mediated the association between grit and preventive behaviors; while COVID-19 controlled motivation mediated the relationship between grit and psychological distress. These findings suggest that grit can be an important growth mindset in increasing preventative behaviors and individual well-being during the pandemic. Implications for human resource managers in attempting to help employees cope effectively during the pandemic are discussed.

Motivational profiles for eating behavior and their associations with intuitive eating

Intuitive eating is an adaptive eating approach shown to have positive psychological and physical health outcomes. Understanding the motivation behind eating behavior can provide valuable information for why some women eat intuitively and others do not. Using self-determination theory (SDT), this study aimed to identify motivational profiles for eating behavior and examine differences in intuitive eating across these motivational profiles. A nationally representative sample of New Zealand women (n = 1447) aged 40-50 years (M = 45.4; SD = 3.2) completed questionnaires assessing motivation and intuitive eating. Latent profile analysis identified five profiles characterized by varying levels of the global and specific forms of behavioral regulation described by SDT. The self-determined profile, characterized by high levels of global self-determination, had higher intuitive eating scores. The internalized profile, characterized by high levels of identified and integrated regulation, had average intuitive eating scores. The conflicted profile, characterized by high levels on most forms of behavioral regulation, and the unmotivated profile, characterized low levels on all forms of behavioral regulation, had a mix of high and low intuitive eating subscale scores. The amotivated profile, characterized by very high levels of amotivation, had lower intuitive eating scores. A motivational profile characterized by higher levels of self-determination and lower levels of the extrinsic forms of behavioral regulation appears to be beneficial for intuitive eating. Therefore, SDT-informed eating behavior interventions that enhance women's self-determined motivation should be created to facilitate intuitive eating in midlife women.

Motivation to participate in structured physical activity for autistic youth: A systematic scoping review

LAY ABSTRACT

Autistic youth participate less in physical education classes and organised sport than their neurotypical peers. We conducted a review of existing studies to investigate what is known about what motivates (and does not motivate) autistic youth to take part in structured physical activities. We systematically searched electronic databases and found 18 publications that met the criteria to be included in this review. Data from these studies were extracted and mapped to the self-determination theory to identify factors that support (or undermine) motivation for autistic youth. We also discussed the findings with autistic individuals and other relevant stakeholders to discover how the review related to their experiences. Our results found competence (youth feeling competent in their athletic and social skills and abilities) to be the most reported psychological need impacting motivation for autistic youth. Intrinsic motivation (participating for enjoyment and satisfaction) was the most common facilitator of motivation. Autism-specific themes outside of the self-determination theory were mapped inductively, and we found that the sensory environment was a prominent theme reported to influence the motivation of autistic youth not covered by the self-determination theory. The findings of this review suggest that supporting the psychological needs of autistic youth can foster motivation to engage in physical activity, although how these needs are met can differ from their neurotypical peers. Future research should examine motivational factors that support engagement in structured physical activities through the lens of autistic youth and their experiences.

Basic Psychological Need Satisfaction as Correlates of Physical Activity Trajectories During Adolescence

This analysis aimed to (1) identify longitudinal joint trajectories of participation in organized and unorganized physical activity contexts, and level of daily moderate-to-vigorous physical activity (MVPA) and (2) assess whether basic psychological need satisfaction during adolescence differentiates between membership in different physical activity trajectories. Participants (n = 888; 56% girls) reported their involvement in 36 different physical activities, level of MVPA, and their perceived satisfaction of competence, autonomy, and relatedness satisfaction in physical activity up to three times per year, over 8 years (from ages 10 to 17 years). Group-based multi-trajectory models were used to identify longitudinal joint trajectories of physical activity participation. We estimated a multinomial logistic regression model for membership in a physical activity trajectory by including individual-level intercepts and slopes for each psychological need obtained using mixed models over the 24 cycles modelized as natural cubic splines. Five longitudinal trajectory groups emerged: Non-participants, Dropouts, Active in unorganized physical activities, Active in organized physical activities, and Active through a variety of activities. Relative to Non-participants, we identify a dose-response relationship in baseline competence and membership in the higher active trajectory groups. In addition, a positive change in competence in early adolescence predicted membership in all three Active trajectory groups.

Psychosocial factors associated with physical activity in people with dementia: A pilot cross-sectional study

Objectives

To understand how psychosocial factors associated with physical activity differ based on disease severity in people with dementia, and how these factors are associated with physical activity participation.

Methods

Eighty-seven people with dementia, alongside their family carer were asked to complete a series of questions related to physical activity participation, including barriers, motivators, and facilitators. Regression models were developed to understand how psychosocial factors were associated with physical activity participation in the cohort.

Results

In the final models, only the absence of intrapersonal barriers was associated with overall physical activity and regular moderate-to-vigorous physical activity. Feelings of relatedness were associated with regular moderate-to-vigorous physical activity only.

Conclusion

Reducing intrapersonal barriers would appear to be a potentially useful strategy to promote physical activity in people with dementia. However, a tailored approach is needed depending on the desired physical activity outcome.

Enhancing career adaptability in college students: a Tai Chi-based sports intervention study

Introduction

This research explores the impact of Tai Chi, a traditional Chinese martial art, on the career adaptability of college students, utilizing a quasi-experimental design. With the increasing complexities in the transition from school to work, effective interventions that address both psychological and vocational needs are essential.

Methods

The study involved 70 senior college students, randomly assigned to either an intervention group that participated in an organized 8-week Tai Chi program based on positive youth development (PYD) or a control group with no intervention.

Results

Results indicated significant improvements in the intervention group in terms of both career adaptability and satisfaction of basic psychological needs, compared to the control group. Mediation analysis revealed that the increase in career adaptability induced by intervention was mediated by the satisfaction of basic psychological needs, underscoring the effectiveness of Tai Chi as a holistic intervention tool.

Discussion

This study contributes to the field by demonstrating that physical activity, particularly one embedded with deep cultural and philosophical significance like Tai Chi, can effectively enhance the career adaptability of college students. It advocates for the inclusion of PYD-based physical practices in developmental interventions aimed at preparing youth for the challenges of the modern workforce.

Self-appreciation is not enough: exercise identity mediates body appreciation and physical activity and the role of perceived stress

Introduction

This study explores the relationship between body appreciation and physical activity, focusing on the mediating role of exercise identity and the moderating effect of perceived stress. While individuals with positive body image are generally thought to engage in proactive physical activity, it remains unclear whether this positive attitude necessarily promotes exercise.

Methods

We conducted a short-term longitudinal survey, recruiting 345 college students 28 (100 females, 245 males; M age = 22.94, SD = 5.99) who completed questionnaires at two-week intervals for a total of three times within four weeks. Body appreciation, exercise identity, perceived stress, and physical activity were measured for the participants separately.

Results

The results demonstrated that body appreciation positively predicted physical activity, exercise identity partially mediated the positive effect of body appreciation on physical activity, and perceived stress played a moderating role in body appreciation and exercise identity.

Discussion

These results highlight the significant role of body appreciation in influencing physical activity through exercise identity, with perceived stress further moderating this relationship. The study underscores the importance of promoting body appreciation and regulating stress to enhance physical activity engagement among college students.

Investigating Correlation between Exercise Participation Motivation and Social Physique Anxiety and Their Differences across Exercise Stages of Change

This study aims to investigate the correlation between exercise participation motivation and social physique anxiety and their differences across the exercise stages of change in individuals. A convenience sampling technique was used to gather data from 374 sedentary individuals aged 18 and over, using a questionnaire that included the Behavioral Regulations in Exercise Questionnaire-2 (BREQ-2), Social Physique Anxiety (SPA) scale, and Exercise Stages of Change Questionnaire (ESOCQ). Welch's ANOVA test was utilized to examine if there were significant differences between the average levels of behavioral regulations in exercise and SPA within exercise stages of change, respectively. Based on Welch's ANOVA results, it has been found that there are significant differences in the total score of SPAS according to exercise stages of change (F = 15.801, p < 0.001). Furthermore, the sub-factors intrinsic regulation, introjected regulation, and external motivation statistically significantly differ according to exercise stages of change (F=6.681, p < 0.001 for IR; F=30.186,p < 0.001 for introjected regulation; F=10.104, p < 0.001 for external motivation, F=0.481,p = 0.750 for AM). Pearson's r correlation coefficients were also computed to determine the relationship between behavioral regulations in exercise and SPA. A significant negative moderate correlation was found between intrinsic regulation and SPA (r = -0.645, p < 0.001). Furthermore, a significant medium positive correlation was found between introjected regulation and SPA (r = 0.534, p < 0.001), external motivation and SPA (r = 0.588, p < 0.001), and amotivation and SPA (r = 0.564, p < 0.001). The findings suggest that being self-motivated for exercise might decrease SPA. On the other hand, exercise motivated by external pressures could lead to increased SPA. The findings also suggest that those who started exercising with intrinsic motivation reached more advanced stages of exercise than those who started exercising with extrinsic factors. Finally, extrinsic motives may help in the first stages of the exercise, but intrinsic motives are required to continue the exercise. Consequently, these findings may guide physical activity specialists, trainers, etc., to develop more effective strategies to motivate exercise participation by considering social physique anxiety among individuals.

Aligning extracurricular school activities with physical literacy: pilot evaluation through self-study of practice

Introduction

Although several important documents of education and health promotion on the international level favor practices geared toward physical literacy (PL), not all countries have yet gained experience with this holistic concept. Therefore, numerous stakeholders and practitioners who intend to align their interventional activities with PL will soon face the situation that there are no recommendations for their specific culture and language for how to design such programs. Given that such recommendations are also lacking for Germany, the goal of the present study within the uncontrolled pilot cycles of the PLACE study was (a) to describe the process of a female pedagogue (27 years old, previously unexperienced with PL) initially familiarizing herself with the PL concept and its implementation opportunities for the school setting, and (b) to retrace the process of developing and refining a PL-driven intervention for extracurricular physical education (60-90 min) of children in grades three and four at primary schools in Bremen.

Methods

Adopting a self-study design, this endeavor emphasized continuous reflexivity involving: (a) session protocols; (b) biweekly discussions with another coach; (c) weekly discussions between scientists and stakeholders of youth development ("multi-perspective panel"); (d) weekly observations and impressions during field work; and (e) summative group interviews with children (n = 17, age range: 8-9 years, 17.6% boys). Written documents underwent qualitative content analysis with inductively generated categories.

Results

Despite explicit links between the theoretical PL domains and the intervention content, the character of how PL informed the intervention level was dominated by the stance and atmosphere implemented by the deliverer (e.g., participatory attitude, open mindset). Accordingly, the team revised the intervention primarily on the levels of organization (temporal schedule and sequences), instruction, and materials. After initial stages of didactically "surviving" within classes, the deliverer could increasingly integrate tasks of cognitive engagement and provide choice for students enabling individual autonomy for nurturing a person-centered approach.

Discussion

This study encourages teachers and stakeholders of physical education to seek exchange with scholars or other practitioners while simultaneously demonstrating patience in comprehensively internalizing PL and efficiently translating the concept into routines in line with individual's quality standards.

Health behavior inventory - short form: a Chinese validation study using classical test theory and item response theory

BACKGROUND

It is imperative to use a validated tool to measure and understand health behavior as it greatly impacts health status. It has been demonstrated that the Health Behavior Inventory - Short Form (HBI-SF) is valid in several countries. The purpose of this study was to translate the HBI-SF into Chinese and test its psychometric properties.

METHODS

This study employed a two-phase methodology. The phase one entailed the cross-cultural adaptation of the HBI-SF, while the subsequent phase evaluated the psychometric properties of the scale. This evaluation encompassed classical test theory (CTT) and item response theory (IRT) tests to assess reliability and validity. It involved 1058 participants, of whom 1036 completed the questionnaire successfully. Out of these, 518 were analyzed for CTT, along with 518 for IRT.

RESULTS

The S-CVI was found to be 0.935, while the I-CVI ranged from 0.889 to 1.000. The results of the confirmatory factor analysis suggested the goodness-of-fit indices for the four-factor model was acceptable. Regarding the subscales, the average variance extracted (AVE) and Heterotrait-Monotrait Ratio of Correlations (HTMT) matrix also met the cutoff values (AVE > 0.5 and HTMI < 0.85). Furthermore, the internal consistency and composite reliability indices of all factors were greater than 0.7. Infit and/or outfit values indicated that all items fitted the Rasch model. The Wright map revealed that the average person measures for the participants (mean = - 0.994, SD = 0.430) were comparatively lower than the average item measures (mean = 0.000, SD = 0.257). The person separation reliability values for the four factors ranged from 0.600 to 0.746, indicating an acceptable level of reliability. Two items showed differential item functioning.

CONCLUSIONS

The findings derived from both CTT and IRT analyses demonstrate favorable levels of reliability and validity for the Chinese version of the HBI-SF.

A mixed-methods longitudinal examination of weight-related self-monitoring and disordered eating among a population-based sample of emerging adults

BACKGROUND

Weight-related self-monitoring (WRSM) apps are used by millions, but the effects of their use remain unclear. This study examined longitudinal relationships between WRSM and disordered eating among a population-based sample of emerging adults.

METHODS

Participants (n = 138) were recruited from EAT 2010-2018 (Eating and Activity over Time study) to participate in a mixed-methods (quantitative and qualitative) longitudinal study to understand the impacts of WRSM. In 2018, participants (Mage=21.7 ± 1.9 years) reported motivations for use and types of WRSM apps used. Dependent variables collected in 2022 (Mage=25.7 ± 1.9 years) included past year total number of disordered weight control behaviors, disordered muscle building behaviors, compulsive exercise, and binge eating. Linear and logistic regressions were used adjusting for sociodemographics, body mass index, and baseline disordered eating. Semi-structured interviews (n = 25) were analyzed using inductive thematic analysis.

RESULTS

Participants using WRSM apps for weight management demonstrated an increase in disordered weight control behaviors over time (β = 0.894, p = .012). Using WRSM apps for "healthy" eating was marginally associated with an increase in disordered weight control behaviors. (β = 0.673, p = .052). Qualitatively, participants reported varied temporality between WRSM and disordered eating, but believed that app use encouraged restriction/binge cycles and normalized disordered eating.

CONCLUSIONS

Findings suggest there may be individual variation in the relationships between WRSM and disordered eating, but that using WRSM apps with the motivation of managing eating or weight may increase disordered eating in some. Additionally, WRSM apps may normalize or encourage disordered eating. Therefore, safeguards, including screening and monitoring, are needed to ensure WRSM does not cause or escalate harm among WRSM users.

The associations of transformational leadership and team cohesion on the psychological health of young football players through basic psychological needs

The present study examined the associations of transformational leadership behaviors and team cohesion with the psychological health (life satisfaction, positive and negative affect, and burnout) of athletes and the indirect relationship of basic psychological needs. The sample consisted of 252 (boys) players aged between 13 and 15. The model data fit was also verified. The results demonstrated that the transformational leadership behaviors of coaches were indirectly related to athletes' psychological health. Team cohesion was related to athletes' psychological health both directly and indirectly. Basic psychological needs played an indirect role in these relationships. Transformational leadership and team cohesion have important implications for the healthy development of young people.

Factors Influencing Autonomy in Middle-Aged and Elderly Women with Urinary Incontinence

INTRODUCTION AND HYPOTHESIS

Urinary incontinence (UI) is relatively common among middle-aged and elderly women and can have significant impacts on patients' physiological, psychological, and quality-of-life aspects. A higher level of autonomy can encourage better health behaviors in patients, so as to promote rehabilitation of the disease and improve their quality of life. The study is aimed at exploring the level of autonomy and influencing factors among middle-aged and elderly women with UI.

METHODS

A cross-sectional study was conducted at a tertiary hospital in Shenzhen, China. Middle-aged and elderly women were asked to complete the Index of Autonomous Functioning scale (IAF), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and the Urinary Incontinence Quality of Life (I-QOL) scale. Data were collected in January 2024 to March 2024. Descriptive statistics, univariate analysis, bivariate correlation and multivariate linear regression were used to analyze data.

RESULTS

A total of 646 women completed the questionnaire. The means and standard deviations (SD) of the IAF section were 45.40 ± 8.92, those of the ICIQ-UI SF section were 11.54 ± 3.67, and those of the I-QOL section were 43.95 ± 9.83. Multivariate linear regression models for the IAF revealed that questionnaire scores were independently associated with family's monthly income, education level, regular exercise, UI severity, and I-QOL score (p < 0.05).

CONCLUSIONS

The factors influencing the level of autonomy among middle-aged and elderly women with UI include family's monthly income, education level, regular exercise, UI severity, and I-QOL score. Higher levels of autonomy were observed among women with high family income, high education level, regular exercise habits, mild to moderate UI, and high quality of life.

A Critical Review of Breastfeeding Instruments Derived From Self-Determination Theory

BACKGROUND

Understanding the motivational factors that influence breastfeeding behavior is critical for addressing suboptimal breastfeeding outcomes. Self-determination theory has been used as a framework to understand these factors.

RESEARCH AIM

The aim of this article is to identify and critically review breastfeeding instruments derived from self-determination theory and their subsequent uses in the literature.

METHOD

This critical review was guided by Grant and Booth's typological description. Eligibility criteria included full-text, peer-reviewed original instrument development and validation articles, written in the English language without limitation to specific years. Articles describing the use of the eligible instruments were also included. There were 164 articles identified initially, and four instruments were included in the final sample. Finally, five articles, including subsequent uses of the instruments were critically analyzed and an overview, assessment of validation, and analysis of subsequent use of each instrument is presented.

RESULTS

All instruments examine the degree of autonomy underlying breastfeeding motivation. The extent and quality of validation varied. Two instruments have been used in subsequent studies; one was adapted and translated into Turkish and used in three other studies, and another was used in full in one subsequent use and in part in another study. Three of four were initially developed for prenatal administration.

CONCLUSIONS

Instruments derived from self-determination theory hold promise in exploring the autonomy underlying breastfeeding motivations. Researchers who wish to use or adapt these instruments should consider the instruments' domains, validity, and administration. New measures are needed to explore other constructs from self-determination theory related to breastfeeding.

Fostering active choice to empower behavioral change to reduce cardiovascular risk: A web-based randomized controlled trial

OBJECTIVE

To investigate the effect of an active choice (AC) intervention based on creating risk and choice awareness-versus a passive choice (PC) control group-on intentions and commitment to cardiovascular disease (CVD) risk-reducing behavior.

METHODS

Adults aged 50-70 (n = 743) without CVD history participated in this web-based randomized controlled trial. The AC intervention included presentation of a hypothetical CVD risk in a heart age format, information about CVD risk and choice options, and a values clarification exercise. The PC group received a hypothetical absolute numerical CVD risk and brief information and advice about lifestyle and medication. Key outcomes were reported degree of active choice, intention strength, and commitment to adopt risk-reducing behavior.

RESULTS

More AC compared to PC participants opted for lifestyle change (OR = 2.86, 95%CI:1.51;5.44), or lifestyle change and medication use (OR = 2.78, 95%CI:1.42;5.46), than 'no change'. No differences were found for intention strength. AC participants made a more active choice than PC participants (β = 0.09, 95%CI:0.01;0.16), which was sequentially mediated by cognitive risk perception and negative affect. AC participants also reported higher commitment to CVD risk-reducing behavior (β = 0.32, 95%CI:0.04;0.60), mediated by reported degree of active choice.

CONCLUSIONS

Fostering active choices increased intentions and commitment towards CVD risk-reducing behavior. Increased cognitive risk perception and negative affect were shown to mediate the effect of the intervention on degree of active choice, which in turn mediated the effect on commitment. Future research should determine whether fostering active choice also improves risk-reducing behaviors in individuals at increased CVD risk in real-life settings.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT05142280. Prospectively registered.

Exercise motivation, physical exercise, and mental health among college students: examining the predictive power of five different types of exercise motivation

Introduction

The mental health (MH) of college students has long been a crucial concern for families, educational institutions, and society. Extensive research has demonstrated the influential role of exercise motivation in shaping MH. However, further investigation is warranted to ascertain which types of exercise motivation may have more influence on the MH of college students. The present study examined the direct effects of five distinct types of exercise motivation, namely health motivation (HM), appearance motivation (APM), fun motivation (FM), ability motivation (ABM), and social motivation (SM) on MH. Additionally, the study explored the potential mediating role of physical exercise (PE) in these relationships.

Methods

An cross-sectional study design was employed. A total of 433 Chinese college students participated in the study and completed our questionnaires, which included the Exercise motivation scale (EM scale), the Physical exercise scale (PE scale), and the Mental health scale (MH scale).

Results

The findings revealed a significant and positive relationship between all five categories of exercise motivation and the MH of college students. Specifically, FM was found to have the most pronounced impact on MH, followed by HM, ABM, SM, and APM, in descending order of influence. Furthermore, the impacts of HM, FM, ABM, and SM on MH were found to be partially mediated by PE. However, the association between APM and MH was entirely mediated by PE.

Discussion

The present study contributes to enhancing the comprehension of the underlying mechanisms behind different exercise motivations in relation to PE and MH. Additionally, it offers practical implications for developing intervention strategies for improving the MH of college students.

Towards a Healthy Diet in an Adolescent Population: The Mediating Role of Motivation and Perceived Barriers between Self-Efficacy and Weight Regulation

(1) Background: Adolescence is a critical period when dietary choices are a major concern. It is therefore important to understand the psychological factors that explain these choices. The objective of this study was to assess the predictive role of perceived self-efficacy for healthy eating and weight regulation on healthy and unhealthy eating behavior through the mediation of autonomous motivation, controlled motivation, amotivation, and perceived barriers to daily mechanisms affecting healthy consumption. (2) Methods: A total of 994 adolescents between 15 and 19 years old from Mexico and Spain participated in the study. The Spanish versions of the healthy eating and weight self-efficacy questionnaire, the behavioral regulation in exercise questionnaire, the barriers to healthy eating scale, and the weight-related behaviors scale questionnaire were used to measure the variables of interest. (3) Results: Mediated serial regression analysis showed that barriers to healthy eating (the daily mechanism of food consumption) reduced healthy eating choices. Healthy eating and weight self-efficacy also showed a positive significant relationship with autonomous motivation and a negative relationship with controlled motivation and amotivation. All the types of motivation showed a positive relationship with barriers to healthy eating. (4) Conclusions: The results point out the need to enhance self-efficacy, promote autonomous motivation, and reduce perceived barriers in young people with respect to healthy eating.

Choosing to learn: The importance of student autonomy in higher education

Despite strong evidence that autonomy enhances motivation and achievement, few interventions for promoting student autonomy in higher education have been developed and empirically tested. Here, we demonstrate how two autonomy-supportive policies effectively increase classroom attendance and subject mastery. First, in a randomized controlled field study, we explored the effect of allowing students to choose whether to make their attendance mandatory (i.e., a component of their course grades). We found that nearly all students used the opportunity as a pre-commitment device and were subsequently more likely to attend class than were students whose attendance had been mandated. Second, in a multi-year cohort study, we explored the effect of allowing students to opt out of a challenging, high-effort assessment stream, finding that students given greater autonomy invested more effort into their assignments and attained greater proficiency with the material. We discuss other opportunities for applying choice architecture to improve learning, motivation, and well-being in higher education.

Behavior Change Techniques Involved in Physical Activity Interventions for Children With Chronic Conditions: A Systematic Review

BACKGROUND

Behavior change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesized their effects.

PURPOSE

The present review aimed to identify the most promising BCTs used in physical activity interventions associated with (i) increased physical activity behavior and (ii) positive psychosocial outcomes in children with chronic conditions.

METHODS

A systematic search of 6 databases identified 61 articles as eligible for inclusion. Data, including BCTs, were extracted from these studies and analyzed descriptively. Due to the heterogeneity of interventions, chronic conditions, and outcome measures, a meta-analysis was not conducted.

RESULTS

Social support (unspecified), graded tasks, generalization of target behavior, and credible source were the most commonly reported and most promising (i.e., present in 2+ studies evidencing significant effects) BCTs across all studies. These BCTs were found to be especially relevant to improving psychosocial outcomes in the short- and long-term and improving physical activity behaviors in the long-term. Meanwhile, to improve short-term physical activity behaviors, in addition to social support (unspecified), action planning, goal setting (behavior), and problem solving were found to be promising BCTs.

CONCLUSIONS

The BCTs identified in this review may be relevant to incorporate when planning future interventions to support physical activity and psychosocial outcomes for children with chronic conditions.

Immunological Insights Into Nutritional Deficiency Disorders

Essential nutrients play a vital role in influencing immune cell development. This chapter explores the crucial relationship between nutrition and the immune system, delving into the profound impact of dietary choices on overall health. Research highlights the benefits of nutrient-rich foods in supporting optimal immune function, while deficiencies in key nutrients (vitamins A, D, zinc, and iron) compromise immune responses, increasing susceptibility to infections. The bidirectional nature of the relationship is emphasized, underscoring the critical role of a balanced diet in supporting immune cell development, activation, and function. Case studies illustrate immunological vulnerabilities linked to inadequate nutritional status, stressing the importance of maintaining optimal nutrient levels for a robust immune system. In summary, an individual's nutritional status significantly influences immune response effectiveness. Addressing deficiencies through supplementation, dietary interventions, and public health initiatives is crucial for improving immune function.

Giving It a Shot with a Different Approach: Prosocial Strategies Moderate the Joint Effects of Agentic and Communal Goals on Bullying

This study uses polynomial regression and response surface analyses to investigate the joint effects of agentic and communal goals on bullying and the moderating role of prosocial strategies. The sample included 917 adolescents (Mage = 13.54, SD = 1.02) from rural, suburban, and urban areas in China. The findings revealed that higher agentic and lower communal goals were associated with a linear rise in bullying. Surprisingly, when both social goals were higher simultaneously, bullying followed an inverted U-shaped pattern. Furthermore, prosocial strategies moderated the joint effects of the two social goals. Adolescents who are more likely to use prosocial strategies do not show significant changes in bullying when both goals are at a higher level. In contrast, those who are less likely to do so show a linear rise in bullying, regardless of changes in social goals. This study improves our understanding and intervention of bullying behavior, emphasizing a non-pathological perspective.

Is culture the key? Emotional intelligence, autonomous motivation and physical activity of student-athletes from China and Russia

Emotional intelligence is considered as an important factor impacting on sports motivation of students-athletes. Meanwhile the role of culture in the development of emotional intelligence is still insufficiently studied in sports psychology. The purpose of the study included comparing the indicators of emotional intelligence of student-athletes in China and Russia, identifying the relationship between emotional intelligence, sports motivation and physical activity, as well as studying the prognostic effect of emotional intelligence on autonomous motivation. The research was done among 474 student- athletes. In Chinese students sample (N = 281), the 163 men and 118 women. In the Russian student sample (N = 193), there were 64 men and 129 women. The following research methods were used: emotional intelligence scale, the sport motivation scale-6, the international physical activity questionnaire. The results of the study have showed that the level of emotional intelligence of Chinese student-athletes is higher than that of Russian students-athletes. Positive correlations between emotional intelligence, autonomous motivation and physical activity were found in both samples. At the same time, the correlation coefficient in the Russian sample was lower. A predictive relationship between emotional intelligence and autonomous motivation has been established; meanwhile the self-assessment of emotions and emotion regulation make the greatest contribution to autonomous motivation in the Chinese sample, while in the Russian sample there is only the use of emotions. Considering the cultural context can contribute to the preparation effective programs for the development of emotional intelligence and autonomous motivation for physical activity.

The effects of Nirvana fitness and functional training on the body appreciation of young women: non-randomized controlled trial

Introduction

Exercise is an important intervention used to improve body image. The present non-randomized controlled trial aimed to examine the effects of Nirvana Fitness (NF) and functional training (FT) on body appreciation and its correlates in young women.

Methods

Twenty-two students participated in FT, 21 in NF, and 47 in the control (CN) group. The mean age of the study participants was 22.79 ± 6.14 years. The FT and NF groups participated in sessions 2 days per week for 8 weeks, and the CN group did not participate in any sessions. All the participants were evaluated at pre- and post-intervention, filling in the Body Appreciation Scale 2 (BAS-2), Mind-Body Connection from the Physical Activity Body Experiences Questionnaire (PABEQ), Body Surveillance from the Objectified Body Consciousness Scale (OBCS), the Functionality Appreciation Scale (FAS), intrinsic exercise motivation from Behavioral Regulation in Exercise Questionnaire 2 (BREQ-2), and perceived physical fitness.

Results

Significant improvements were found in terms of all outcome measures in the FT group, and improvements of body and mind connection and body surveillance in the NF group, while no improvements were observed in the CN group. FT's effect on body appreciation appeared to operate through the improvement of the mind-body connection in the FT and NF groups and via decreased body surveillance in the FT group.

Conclusion

These findings support the developmental theory of embodiment and provide initial evidence that professionally delivered FT and NF might be used as effective strategies for the promotion of positive body image in young women.

The effectiveness of health-related quality of life (HRQOL) model in people with HIV: A cross sectional study

Background and Aims

Acquired immune deficiency syndrome (AIDS) are a chronic and disabling disease that has a significant impact on quality of life due to weakening of physical health, financial problems and social stigma. This study aims to validate the Health-related quality of life (HRQOL) model in people with human immunodeficiency viruses (HIV) in Iran.

Methods

Four hundred and fifty-two people with HIV from Imam Khomeini Hospital between the age of 18 and 65 years (men: 308, women: 144) participated in the research. anonymously completed a battery of questionnaires, namely the Persian basic psychological need satisfaction and frustration scale, SF-36, PSQI and mindful attention awareness scale. The method of the present study was the structural equation model.

Results

Current findings indicated there is a significant positive between mindfulness and need satisfaction, physical and mental health and, significant negative between mindfulness and quality and quantity of sleep. Mindfulness and need satisfaction are significant positive predictors of quality of life in people with HIV. Quality and quantity of sleep are significant negative predictors of quality of life in people with HIV. There is a positive significance between need satisfaction and physical and mental health but there is a negative significance between need satisfaction and quality and quantity. there is a negative significant between the quality and quantity of sleep with physical and mental health. Mindfulness facilitates the satisfaction of more psychological needs and improves the quality of sleep. The quality of sleep is a negative significant predictor for physical and mental health but the quantity of sleep is a negative significant predictor for physical health.

Conclusion

The HRQOL model can explain 18% of physical health and 16% of mental health in people with HIV in Iran. The elements of this model can be useful in evaluating and treating people with HIV in the Iranian Population. They also can use the models to plan for better services.

An exercise and patient education intervention to reduce pain and physical limitations in adults with acetabular dysplasia: study protocol for a process evaluation integrated within a randomised controlled trial (the MovetheHip trial)

BACKGROUND

The Movethehip trial investigates the effectiveness of an exercise and patient education intervention for adults with acetabular dysplasia. The intervention involves eight tailored one-to-one sessions with trained providers who employ supportive feedback tools. The present protocol reports a planned process evaluation, which aims to determine how the intervention functions by examining the implementation of the intervention (process, dose and reach), its acceptability, mechanisms of change and the influence of contextual factors.

METHODS

Two hundred trial participants aged 18-50 years will be recruited from a University Hospital in Denmark and randomised to the intervention or control group. Approximately ten providers will deliver the intervention. The process evaluation adopts a concurrent mixed-methods design. The implementation will be assessed using self-report questionnaires (at baseline and 6-month follow-up), training records and semi-structured focus group interviews with intervention providers (n = 10) and healthcare managers (n = 4-6). The mechanisms of change will be explored through semi-structured one-to-one interviews (at baseline and 6-month follow-up) with 15-20 purposefully sampled participants and by measuring changes in health outcomes (self-reported pain, physical functioning and quality of life completed at baseline and at 3- and 6-month follow-up). Additionally, change will be measured through an explorative examination of associations between dose and change in health outcomes, applying simple linear regression models. The acceptability of the intervention and the influence of contextual factors will be explored through one-to-one participant interviews and focus group interviews with 4-6 healthcare managers. The interviews will focus on expectations, experiences, events, personal understandings and interaction with interpersonal and organisational aspects. Interview data will be analysed using theoretical thematic analyses, and findings will be merged with quantitative data and reported jointly on a theme-by-theme basis.

DISCUSSION

The process evaluation conducted as part of the MovetheHip trial will illuminate how the intervention functions, and if the intervention is proven effective, the findings of the evaluation will contribute to pinpoint how the intervention may be optimised to facilitate future up-scaling and implementation.

TRIAL REGISTRATION

The MovetheHip protocol was approved by the Committee on Health Research Ethics in the Central Denmark Region. ClinicalTrials, NCT04795843. Registered on 20 March 2021.

Autonomy support in an exercise intervention with colorectal cancer patients during chemotherapy: a qualitative perspective

OBJECTIVE

Physical activity (PA) has emerged as an important element of supportive care for cancer patients, but few patients engage with exercise. Considering that autonomy support is associated with healthy lifestyles, it would be useful to know the specific autonomy-supportive techniques that can help to encourage PA in colorectal cancer (CRC) patients. This study aims to qualitatively explore autonomy support perceptions through a self-determination-theory-based exercise program (FIT-CANCER) with CRC patients during chemotherapy treatment.

METHODS AND MEASURES

A total of 27 participants were included, 16 CRC patients, six relatives, and five healthcare professionals. Qualitative data from semi-structured interviews and observational field notes were analyzed with thematic analysis.

RESULTS

Three main themes were identified: Healthcare professionals encouraging enrollment in the exercise program, Relatives supporting attendance to the exercise sessions, Exercise instructor favoring adherence to the exercise program. The different subthemes showed autonomy-supportive techniques from these social agents to promote CRC patients' participation in the exercise program.

CONCLUSION

The present research showed the importance of autonomy support from healthcare professionals, relatives and the exercise instructor to promote the initiation and maintenance of CRC patients' PA behavior and improve their quality of life, health and well-being.

Predicting vaccination hesitancy: The role of basic needs satisfaction and institutional trust

Autonomous motivation is considered a powerful driver of health behaviour, but less is known about the specific roles played by basic needs. Drawing on the context of the COVID-19 pandemic, this research examined basic needs as a motivational determinant of vaccination. We hypothesized that satisfaction of basic needs (autonomy, competence, relatedness) has both a direct and an indirect effect (through trust in science and government) on vaccine hesitancy. Two studies (Study 1: N = 968 French and British; Study 2, pre-registered: N = 716 Americans) tested our hypotheses and compared vaccinated and non-vaccinated individuals using multigroup structural equation models. We found positive direct (in both studies) and indirect (in Study 1) effects of autonomy satisfaction on vaccine acceptance. In contrast, competence satisfaction was directly and indirectly, via science mistrust, related to vaccine hesitancy, particularly among non-vaccinated people. Competence satisfaction also indirectly reduced the intention to vaccinate in both studies. We found no impact of relatedness. Complementing previous work on self-determination theory, our research demonstrates the importance of considering the distinct roles of basic needs. Moreover, we highlight that increasing autonomy and science trust may be an efficient strategy to improve vaccine acceptance and vaccination, even among reluctant individuals.

Free to be Healthy? Free Will Beliefs are Positively Associated With Health Behavior

Previous research has demonstrated that a stronger belief in free will contributes to a variety of socially desirable behaviors. We assessed the correlation between free will beliefs and health behaviors. Four studies (N = 1172) provide evidence that belief in free will is positively associated with health protective behaviors (e.g., physical activity, fruit and vegetable consumption, low fat diet) and negatively associated with health risk behaviors (e.g., alcohol consumption, smoking, unhealthy snacking). In relation to the respective health protective and health risk behaviors, we found free will beliefs were more strongly correlated with physical activity and alcohol consumption, respectively. We also found free will beliefs were associated with key social cognition determinants (e.g., attitude, subjective norm, perceived behavioral control, and intention). Overall, our results suggest that belief in free will can have important consequences for health behavior. This contributes to current theorizing about the implications of believing in free will.

A study on the influence of academic passion on PhD students' research engagement-The role of ambidextrous learning and academic climate

The engagement in research, as the primary form of learning engagement for PhD students, is crucial for enhancing their competitive edge. Academic passion, a key determinant of learning engagement, plays a significant role in driving the research enthusiasm of PhD students. However, the "black box" concerning whether and how academic passion influences PhD students' research engagement remains to be explored. Addressing this gap, the present study draws upon self-determination theory, adopts the "motivation-behavior-effect" analytical framework, and incorporates ambidextrous learning as a mediator to elucidate the specific pathway through which academic passion impacts PhD students' engagement in research activities. Furthermore, it examines the facilitating role of the academic climate in this process. From December 2022 to March 2023, a questionnaire survey was conducted, collecting 522 responses from PhD students across 25 universities in China. The survey primarily assessed the PhD students' academic passion, ambidextrous learning behaviors (including tendencies towards exploratory and exploitative learning), and their perceived academic climate, investigating how these factors collectively influence their engagement in research activities. The questionnaire data were analyzed using a combination of SEM and bootstrapping with SPSS 26.0 and Mplus 8.3 software. The findings reveal that academic passion significantly positively affects PhD students' research engagement; ambidextrous learning (exploratory and exploitative learning) mediates the relationship between academic passion and PhD students' research engagement; and the academic climate effectively facilitates the transformation of PhD students' academic passion into ambidextrous learning (exploratory and exploitative learning). The study's conclusions not only foster PhD students' enthusiasm for research but also enhance learning effectiveness and innovation vitality, providing a theoretical basis for reforming the doctoral training system.