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

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, β=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, β=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, β=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, β=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, β=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.

Tobacco Dependence Treatment: Examining Cessation Effectiveness in Oncology Settings

The Wilmot Cancer Institute launched the Tobacco Dependence Treatment Program in 2015. Formal program evaluation consisted of 324 patients who presented for at least one visit to assess quit rates. The secondary aim was to ascertain the effectiveness of guideline recommendations that four or more visits would be beneficial in an outpatient oncology tobacco treatment program to promote success in smoking cessation. The first 32 months of program data revealed that there were significantly improved quit rates for those who were seen for four or more visits compared to those seen for three or fewer visits.

Improving children's fundamental movement skills through a family-based physical activity program: results from the "Active 1 + FUN" randomized controlled trial

Background

Physical activity is related to many positive health outcomes, yet activity levels of many children are low. Researchers have suggested that family-based interventions may improve physical activity behaviors of both children and their parents. In this study, we evaluated the “Active 1 + FUN” program, which was designed based on tenets of self-determination theory. Intervention components included free sporting equipment, ten coach-led workshops and activity sessions, and one booster session.

Methods

We evaluated the intervention program using a randomized controlled trial. One hundred seventy-one families were randomly allocated to either an experimental group or a wait-list control group. Participants were exposed to program contents over a nine-month period, while families in the control did not receive any form of intervention. Measured constructs included moderate-to-vigorous physical activity, co-physical activity behaviors, fundamental movement skills, BMI, and several self-reported questionnaire outcomes. Hierarchical linear modeling was used to compare changes in measured outcomes across the two groups.

Results

No significant intervention effects were found for children’s and parents’ accelerometer-measured moderate-to-vigorous physical activity, or their co-physical activity. However, in terms of children’s fundamental movement skills, a significant Time*Group interaction (B = 0.52, 95% CI [0.07, 0.96] for Times 1 to 2; B = 0.24, 95% CI [0.01, 0.48] for Times 1 to 3) in favor of the experimental group was found.

Conclusions

Results suggested that the “Active 1 + FUN” program was effective in improving children’s fundamental movement skills. Additional research is needed to examine how family-based initiatives could effectively improve physical activity behaviors too.

Trial registration

ANZCTR, ACTRN12618001524280. Registered 11 September 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375660.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12966-021-01160-5.

Associations between previous sport and exercise experience and physical literacy elements among physically inactive Danes

Background

Physical inactivity is recognized as a leading global public health threat. Physical Literacy, a concept describing an individual’s prerequisites to participate in and adhere to physical activities, has been suggested to be a key concept in understanding physical activity in various populations. The aim of this study was to describe the prerequisites for physical activity among inactive adults in terms of their physical literacy and previous experience with sport and exercise and how these are interrelated.

Methods

Sample: 1033 physical inactive Danes. Measures: BREQ-3, ESES, the Levels of knowledge questionnaire and the physical self-confidence scale.

Results

Inactive Danish adult’s physical literacy scores are generally low compared to samples in other studies. Inactive adults with no or little previous experience with sport and exercise had lower levels of competences, self-efficacy and autonomous motivation for exercise and sport than the inactive with more experience. Previous sport and exercise experience was positively associated to the physical and affective domain of PL.

Conclusion

Previous experience with sport and exercise is very important to consider when developing sport and exercise activities for currently inactive adults as individuals with low previous experience have lower competences and autonomous motivation and therefore need lower challenges and other important attention to the motivational climate in order to ensure that the activities are motivating enough to secure continued engagement.

Integrating needs-supportive delivery into a laboratory-based randomised controlled trial for adolescent girls with overweight and obesity: Theoretical underpinning and 12-week psychological outcomes

When designing efficacy trials, researchers have a responsibility to "do no harm" and to "do good". Given the psychological vulnerability of adolescent girls with overweight and obesity, it is important to consider the implications of participating in weight-related research studies. We investigated psychological outcomes from a 12-week laboratory-based randomised controlled trial aimed at improving body composition and bone health in adolescent girls with overweight and obesity. Sixty-three participants were randomised to three groups (Recommended dairy diet plus exercise (RDa, n = 24); Low dairy diet plus exercise (LDa, n = 25); no-intervention control (n = 14)). Self-Determination Theory-informed strategies were applied in both intervention groups to foster motivation and enhance psychological wellbeing. Motivation, perceived competence and self-perceptions were measured at 0 and 12 weeks. Fifty-four participants (24 RDa, 23 LDa, 7 Control) provided complete psychological data. There were no between group differences in 0- to 12-week change in motivation, perceived competence or global self-worth. Both intervention groups showed significant improvements in physical self-worth (p = 0.001), body satisfaction (p = 0.002) and perceived physical conditioning (p = 0.002), compared with the control group. A theory-informed, laboratory-based diet and exercise intervention produced favourable psychological outcomes for adolescent girls with overweight and obesity.

Did You Enjoy It? The Role of Intensity-Trait Preference/Tolerance in Basic Psychological Needs and Exercise Enjoyment

Promoting exercise regimens that aim at enhancing the quality of individuals’ subjective exercise experience can be challenging. Given the recent theoretical contributions regarding the possible interaction of exercise intensity-traits and several motivational variables, as well as their potential value for exercise adherence, the objective of this study was to examine the mediation role of basic psychological needs in the relationship between preference for and tolerance of exercise intensity and enjoyment. This cross-sectional study comprised a total of 160 exercisers (Mage = 34.12, SD = 9.23, 73 males) enrolled in several health clubs. All analyses were performed using SPSS v. 23.0/PROCESS v. 3.4. The results indicate that intensity-traits presented positive associations with enjoyment, and negative associations with all of needs frustration variables. A mediation role of needs frustration emerged in the intensity-traits and enjoyment associations that was analyzed according to relatable theoretical considerations.

Effects of Nurse-Led Intervention Programs Based on Goal Attainment Theory: A Systematic Review and Meta-Analysis

This study aimed to evaluate the effects of the goal attainment theory-based nurse-led intervention programs using a systematic review and meta-analysis. Randomized and non-randomized controlled trials, published from January 2001 to December 2020, were examined using four international databases and four domestic databases. The search, selection, and coding were performed independently by two researchers. R version 4.0.3 and Review Manager (version 5.3) were employed for meta-analysis and quality assessment, respectively. Of the 7529 articles retrieved, 18 were selected for analysis. The random overall effect size of the programs was 0.77 (95% CI = 0.61-0.94). Effect size by dependent variables were 2.36 (95% CI = 0.91-3.82), 1.25 (95% CI = 0.66-1.83), 0.83 (95% CI = 0.55-1.10), 0.64 (95% CI = 0.39-0.89), and 0.58 (95% CI = 0.30-0.85) for interpersonal, cognitive, health behavior, psychological, and indicators of physical health, respectively. Effect size by independent variables were 1.25 (95% CI = 0.86-1.64), 0.76 (95% CI = 0.48-1.03), 0.72 (95% CI = 0.37-1.06), 0.35 (95% CI = 0.21-0.49), and 1.35 (95% CI = -0.15-2.85) for prevention, health promotion, counseling and education, goal-setting and health contract, and parent participation programs, respectively. The effect size by control variables was 1.72 (95% CI = 0.88-2.56) at age ≤17, 0.85 (95% CI = 0.54-1.15) at time (min) 61-90, 1.04 (95% CI = 0.76-1.32) at sessions seven to eight, and 0.93 (95% CI = 0.66-1.19) at duration (weeks) five to eight. Thus, these programs were effective in improving various health aspects. Additionally, they can be recommended in various settings. Because efficacy is also influenced by control variables, considering treatment designs based on intervention characteristics and methodological approaches is warranted.

Using self-determination theory to predict self-management and HRQoL in moderate-to-severe COPD

Objective: Chronic Obstructive Pulmonary Disease (COPD) is a long-term condition that detrimentally affects health-related quality of life (HRQoL), with self-management proposed as an effective treatment. Using self-determination theory (SDT), this research explored psychological need satisfaction, frustration, and behavioural regulation to explain indicators of self-management.

Design and Main Outcome Measures: Cross-sectional, questionnaire-based methods in people on a pulmonary rehabilitation waiting-list. 72 participants completed SDT, HRQoL, and self-management knowledge questionnaires. Path analyses investigated the ability of SDT concepts to predict self-management knowledge and HRQoL.

Results: Chi-square tests found no significant differences (χ²(13, N=72) = 16.7, p > 0.05) between the just – and over-identified models, and multiple measures suggested an acceptable fit to the data. Relatedness frustration positively predicted controlled regulation and autonomy and relatedness satisfaction positively predicted autonomous regulation. The associations between the other needs and the different regulation types were not statistically significant. Both regulation types strongly predicted HRQoL (35% variance explained) and self-management knowledge (22% variance explained).

Conclusion: SDT concepts can predict more self-determined self-management regulation, self-management knowledge, and HRQoL and provide a framework for researchers and healthcare professionals to develop future health interventions for people with COPD. Greater research is needed to understand basic psychological need frustration in health contexts.

Reducing occupational sitting time in adults with type 2 diabetes: Qualitative experiences of an office-adapted mHealth intervention

AIM

Understanding barriers and facilitators for limiting occupational sitting and what impact it has on health on those with type 2 diabetes is essential for future trials and intervention development in primary healthcare settings. This study aimed to explore the feasibility and acceptability of an intervention using mobile health (mHealth) technology, together with counselling by a diabetes specialist nurse, to reduce occupational sitting in adults with type 2 diabetes.

METHODS

Individual semi-structured interviews were conducted in 15 participants with type 2 diabetes who completed a 3-month intervention including mHealth; activity tracker (Garmin Vivofit3) and SMS reminders, one initial face-to-face patient-centred counselling session and three telephone follow-up calls by a diabetes specialist nurse within the primary healthcare system in Sweden. The interviews were recorded, transcribed verbatim and analysed using qualitative content analysis.

RESULTS

Two themes were identified: (1) 'From baby steps to milestones' reflecting three categories; 'Small changes make it easier to reduce sitting', 'Encouraged by trustworthy coaching', 'Physical and mental rewards matter' and (2) 'Tailoring strategies that fit me and my workplace' reflecting four categories; 'It's up to me', 'Taking advantage of the support', 'Using creativity to find practical solutions for interrupting sitting' and 'Living up to expectations'.

CONCLUSION

The intervention was perceived as feasible and acceptable in different office workplaces, and led to increased awareness of sedentary behaviour in adults with type 2 diabetes. Stepwise goal setting together with personalization of the mHealth intervention should be emphasized in individual type 2 diabetes programmes aiming to reduce workplace sitting.

Identifying goals in patients with chronic pain: A European survey

BACKGROUND

Chronic pain is a major healthcare issue that often requires an interdisciplinary treatment approach. Defining relevant treatment goals is one of the crucial steps in creating successful rehabilitation schemes. Therefore, the first aim was to explore goals that patients suffering from chronic pain aim to achieve. The second aim was to translate those goals into measurable functional outcome variables which can be used to measure treatment success.

METHODS

An online survey was developed and spread through local pain alliances in six European countries. Participants, patients suffering from chronic pain, were asked to report their most important goals, combined with a rank to denote the importance of each goal. For the highest ranked goals, participants were asked to decompose their goal into functional postures and the number of minutes per posture to achieve this goal.

RESULTS

We approached 1,494 persons, of which 487 effectively completed this survey. The highest ranked goals were taking part in family and social activities (72.55%), pain reduction (91.18%) and household tasks (68.14%). Obtaining pain reduction was most often ranked first (55.75%), followed by improving sleep (12.25%) and taking part in family or social activities (11.00%). For all goals, walking was a crucial component.

CONCLUSIONS

The goals of chronic pain patients are in line with previously explored expectations, denoting the importance of achieving pain relief combined with improvements on the level of activities and participation. This survey indicates that rehabilitation programs should definitely focus on improving walking ability, due to its importance in underpinning overall goal achievement.

SIGNIFICANCE

Goals and expectations of chronic pain patients are in line with each other. Obtaining pain relief remains the highest ranked goal, however, goals on the level of activities and participation were also highly ranked. Walking seems to be the overall crucial component for goal achievement.

Building MedVenture - A mobile health application to improve adolescent medication adherence - Using a multidisciplinary approach and academic-industry collaboration

Objective

Mobile health (mHealth) tools are increasingly used to support medication adherence yet few have been designed specifically for the pediatric population. This paper describes the development of a medication adherence application (MedVenture) using the integration of patient and healthcare provider input, health behavior theory, and user engagement strategies for adolescents with chronic gastrointestinal disease.

Methods

MedVenture was created by a multidisciplinary research team consisting of a gastroenterologist, a social health psychologist, software developers, and digital health researchers. Healthcare providers and adolescent patients were interviewed to identify barriers to medication adherence, explore ways that technologies could best support medication adherence for both patients and providers, and determine user requirements and core design features for a digital health tool. Intervention mapping was used to match themes from qualitative content analysis to known efficacious adherence strategies, according to a conceptual framework based on self-determination theory. Iterative design with review by the research team and two rounds of user testing informed the final prototype.

Results

Three themes were identified from content analysis: 1) lack of routine contributes to nonadherence, 2) adolescents sometimes purposefully forgo medications, and 3) healthcare providers would prefer a tool that promotes patient self-management rather than one that involves patient-provider interaction. These findings, combined with evidence-based adherence and user engagement strategies, resulted in the development of MedVenture – a game-based application to improve planning and habit formation.

Conclusions

Academic-industry collaboration incorporating stakeholders can facilitate the development of mobile health tools designed specifically for adolescents with chronic disease.

Examination of Weight-Loss Motivators and Family Factors in Relation to Weight Management Strategies and Dietary Behaviors among Adolescents with Obesity

The study aim was to test hypotheses informed by self-determination theory (SDT) regarding associations of adolescent motivators for weight loss and family feeding practices on understanding adolescent weight management and dietary behaviors. Adolescents (n = 71) with obesity were recruited from a large medical center in the Midwest USA and completed questionnaire assessments via an online survey. Results supported hypotheses that endorsement of health motivators for weight loss, conceptualized as autonomous (intrinsic) motivation, and positive family support would be associated with healthier weight management practices and dietary behaviors. Nuanced findings related to social- and self-esteem-related motivators for weight loss indicated a need for further understanding of these weight-loss motivators in the context of SDT. The current study findings highlight the importance of addressing motivational factors and family influences in research and practice related to promoting healthy dietary habits and weight management strategies among adolescents with obesity.

Motivation for Physical Activity: Validation of the Dutch Version of the Physical Activity and Leisure Motivation Scale (PALMS)

Understanding motivation for exercise can be helpful in improving levels of physical activity. The Physical Activity and Leisure Motivation Scale (PALMS) measures distinct goal-oriented motivations. In this study selected measurement properties of the Dutch version (PALMS-D) are determined. Forward-backward translation was used for cross-cultural adaptation. Construct validity of the PALMS-D was assessed in five subsamples completing the PALMS-D and the Behavioral Regulation in Exercise Questionnaire (BREQ-3). The study population consisted of five samples recruited from different populations; samples consisted of runners, hockey players, soccer players, participants in medical fitness, and a sedentary group of young adults with low activity. A total of 733 participants completed the questionnaire: 562 athletes and 171 non-athletes. Exploratory for Analysis confirmed the original eight factors. Internal consistency of the subscales was high, except for Others’ expectations. The a priori determined hypotheses related to differences between athletes participating in different sports were confirmed, as well as the hypothesis related to differences between amateur athletes, patients in medical fitness, and non-active participants. It was concluded that the Dutch version of the PALMS is an acceptable questionnaire with which to evaluate the individual motivation of athletes in the Netherlands, and discriminates between different leisure athletes, patients in medical fitness, and non-active youths.

Postnatal Exercise Partners Study (PEEPS): a pilot randomized trial of a dyadic physical activity intervention for postpartum mothers and a significant other

Background: Research suggests dyadic interventions can increase physical activity; such interventions are untested within postpartum parent couples. Methods: A three-armed pilot randomized trial addressed this gap and tested which type of dyadic intervention is most effective. Inactive postpartum mothers and a significant other were recruited in Australia (n = 143 assessed for eligibility) and randomised in a single-blinded fashion (i.e. participants were blinded) to 1 of 3 dyadic conditions involving a single face-to-face session with access to web-based group support: a minimal treatment control (n = 34), collaborative planning group (n = 38), or collaborative planning + need supportive communication group (n = 30). Participants were asked to wear their accelerometers for 8 days and completed self-report measures at baseline, end of intervention (week 4), and follow-up (week 12). We expected dyads in the collaborative planning + need supportive communication group would have the greatest increases in Physical Activity (PA), autonomous motivation, and partners' need supportive behaviours; and decreases in controlled motivation and controlling partner behaviours. Results: Results from 51 dyads using Bayesian actor-partner interdependence models provided some evidence for a small positive effect on total PA at follow-up for postpartum mothers in the collaborative planning group and for partners in the collaborative planning + need supportive communication group. Furthermore, partners in the collaborative planning + need supportive communication group were more likely to engage in some vigorous PA. At follow-up, postpartum mothers in the collaborative planning + need supportive communication group scored lower on personal autonomous reasons. Conclusions: The impact of prior specification mean intervention effects need to be interpreted with caution. Progression to a full trial is warranted.

Evolution of physical activity habits after a context change: The case of COVID-19 lockdown

Objective

Habits, defined as well‐learned associations between cues and behaviours, are essential for health‐related behaviours, including physical activity (PA). Despite the sensitivity of habits to context changes, little remains known about the influence of a context change on the interplay between PA habits and behaviours. We investigated the evolution of PA habits amidst the spring COVID‐19 lockdown, a major context change. Moreover, we examined the association of PA behaviours and autonomous motivation with this evolution.

Design

Three‐wave observational longitudinal design.

Methods

PA habits, behaviours, and autonomous motivation were collected through online surveys in 283 French and Swiss participants. Variables were self‐reported with reference to three time‐points: before‐, mid‐, and end‐lockdown.

Results

Mixed effect modelling revealed a decrease in PA habits from before‐ to mid‐lockdown, especially among individuals with strong before‐lockdown habits. Path analysis showed that before‐lockdown PA habits were not associated with mid‐lockdown PA behaviours (β = −.02, p = .837), while mid‐lockdown PA habits were positively related to end‐lockdown PA behaviours (β = .23, p = .021). Autonomous motivation was directly associated with PA habits (ps < .001) and withto before‐ and mid‐lockdown PA behaviours (ps < .001) (but not with end‐lockdown PA behaviours) and did not moderate the relations between PA behaviours and habits (ps > .072).

Conclusion

PA habits were altered, and their influence on PA behaviours was impeded during the COVID‐19 lockdown. Engagement in PA behaviours and autonomous motivation helped in counteracting PA habits disruption.

Physical Activity and Resilience among College Students: The Mediating Effects of Basic Psychological Needs

Considering the significance of resilience in coping with adversity, how to improve college students' resilience is worthy of attention. Previous studies have revealed that physical activity can promote resilience; however, few studies examined the mediating factors between them. The purpose of this study was to investigate the effect of physical activity on resilience, as well as the mediating effects of competence need, autonomy need, and relatedness need between physical activity and resilience. The study involved 2375 college students (1110 males and 1265 females), with an average age of 20.25 years (SD = 2.04). Participants completed the International Physical Activity Questionnaire Short Form, Basic Needs Satisfaction in General Scale, and Connor-Davidson Resilience Scale. Results showed that physical activity was positively associated with resilience, and the three basic needs played significant mediating roles between physical activity and resilience. The indirect effect of competence need was significantly greater than that of autonomy need and relatedness need. To conclude, physical activity plays an important role in resilience among college students, and the satisfaction of competence, autonomy, and relatedness needs mediates the relationship between physical activity and resilience, among which, competence need appears as the strongest mediator.

Motivation for Learning among Students Undertaking Basic Vocational Training and University Studies within the Context of COVID-19

The main aim of the present study is to adapt the academic motivation scale (AMS) for use within basic vocational training and university students. Another aim was to analyze the characteristics of the different dimensions of motivation, whilst also examining existing significant differences between the two studied educational stages. For this, we conducted exploratory and confirmatory factor analysis, alongside descriptive and inferential analysis of student responses. One of the main findings was that a reduced version of the AMS, made up of five dimensions and 21 items, demonstrated good internal consistency and fit. Further, we observed that intrinsic motivation is higher in university students, whilst extrinsic motivation is higher during the basic vocational training stage. In addition, we uncovered significant differences between both educational stages with regards to the pleasure felt by students when they better themselves, learn new things and attend the educational center. Differences also emerged in relation to the importance attributed by students to achieving a good and well-paid job. With regards to amotivation, significant differences only exist in relation to the motives students have for attending classes and decision making about whether to continue studying the course they are enrolled on. Finally, we have analyzed how the variables sex, age, prior work experience and volunteering experience, and average grade influence the motivation of students undertaking basic vocational training and university students.

Personalized hypertension management based on serial assessment and telemedicine (PHMA): a cluster randomize controlled trial protocol in Anhui, China

BACKGROUND

Despite tremendous investment worldwide, hypertension treatment and control rates remain low. The complexity and long-term dynamics of influencing factors make personalized management inevitable and challenging. This protocol describes Personalized Hypertension Management in Anhui, China (PHMA), a project that uses a package of innovative approaches in tailoring interventions to individual patient's dynamic complications and contexts.

METHODS/DESIGN

PHMA strives to reduce hypertension harms by eight "objective behaviors" (e.g., self-monitoring and reporting, healthy diet, physical exercise/activities). These objective behaviors are promoted through five intervention measures: support for self- monitoring, supervised machine communications, daily education or reminder messages, weekly blood pressure notification, and quarterly signed feedback. PHMA uses ten categories and over 300 variables in selecting and refining intervention procedures and content for individual patients. Efficacy of the intervention package is evaluated using a cluster randomized controlled trial design involving a total of 60 site communities and 3352 hypertension patients. Primary measure for the evaluation is systolic and diastolic blood pressure; while secondary evaluation measures include quality of life (EQ5D-5L), occurrence of hypertension-related complications (such as cerebral hemorrhage, coronary heart disease, myocardial or cerebral infarction), healthcare utilization and scores of objective behaviors.

DISCUSSION

PHMA uses novel, low cost and sustainable approaches to tailor interventions to the dynamic conditions and contexts of individual patients. Unlike contemporary approaches to hypertension management which are mainly population based, each participant patient in PHMA applies a unique intervention package and all messages, feedbacks and other materials sent out to individual patients are different from each other. PHMA is the first project that adopts comprehensive tailoring and if proved effective, it should have important implications for future research, practice and policy-making. Trial registration ISRCTN10999269. July 17, 2020; https://doi.org/10.1186/ISRCTN10999269 .

Keep on running - a randomized controlled trial to test a digital evidence-based intervention for sustained adoption of recreational running: rationale, design and pilot feasibility study

BACKGROUND

This paper describes the rationale, intervention development, study design and results from the pilot feasibility study of the Keep On Running (KOR) trial. KOR aims to test a web-based brief theory-based intervention, targeting maintenance of recreational running behavior over time (i.e. relapse preventing).

METHODS

Intervention development was based both on Self-Determination Theory and on Self-Regulation Theory. As part of it, a pilot study was implemented (n=18) to measure intervention adherence and participant satisfaction in order to establish the feasibility and acceptability of the intervention toolkit. Furthermore, this pilot study was also used to test the feasibility and acceptability of the questionnaires selected to be part of the later RCT.

RESULTS

Pilot intervention acceptability was good, but overall adherence was low. Features such as feedback and social sharing should be added to the toolkit. The main trial should lessen questionnaire length and include data from usual monitoring gadgets and apps (APIs). The protocol of the RCT was adjusted to test the efficacy of the refined final version of the intervention, and the RCT that will test it, contributing to the understanding of recreational running sustainability, allowing the optimization of future interventions aimed at physical activity promotion.

A School-Based Randomized Controlled Trial to Promote Cycling to School in Adolescents: The PACO Study

This manuscript describes the rationale and protocol of a school-based randomized controlled trial called “Cycling and Walk to School” (PACO, by its Spanish acronym) that aims to promote cycling to and from school and physical activity (PA) in adolescents. This study will examine the effects of this intervention in cycling and active commuting to and from school (ACS), PA and several ACS-related factors based on self-determination theory (SDT) and a social-ecological model (SEM). A total of 360 adolescents attending six high schools (three experimental and three control) from three Spanish cities will participate in this randomized controlled trial. The intervention (four cycling sessions; 1–2 h per session, one session per week) will be conducted by the research staff; the control group will continue their usual activities. PA levels will be measured by accelerometers, whereas ACS and the other study variables will be self-reported using questionnaires at baseline and post-intervention. The primary outcomes will be: rates of cycling to school, ACS and PA levels. In addition, SDT-related variables and individual, interpersonal, community, and environment variables relevant to ACS will be based on SEM. The findings will provide a comprehensive understanding of the short-term effects of this school-based intervention on cycling to school behaviour, ACS and PA levels in Spanish adolescents.

The Co-Occurrence of Satisfaction and Frustration of Basic Psychological Needs and Its Relationship with Exercisers' Motivation

Although the relationship between both need frustration and, particularly, need satisfaction and different motivational regulations for exercise has been widely examined in the literature, little is known about the co-occurrence of both need satisfaction and need frustration in the exercise context. Grounded in self-determination theory, the present study aimed to examine the effects of both need satisfaction and frustration on motivational regulations for exercise, by applying a response surface analysis approach. In total, 477 regular exercisers aged 18-54 years participated in this study. The interaction between needs (high on both need satisfaction and frustration) displayed a positive and significant association with amotivation, integrated regulation, and intrinsic motivation. Considering the direction of the discrepancy (high vs. low levels of need satisfaction and frustration) related to the behavioral regulations, results showed that higher need satisfaction relative to need frustration was associated with more self-determined regulations of motivation. Contrarily, higher need satisfaction relative to need frustration was associated with lower scores on amotivation, external, introjected, and identified regulation. Overall, these findings extend previous literature, suggesting that need satisfaction and frustration are distinct factors that can be experienced simultaneously in individuals during exercise and that different degrees of both needs have different associations with behavioral regulations.

Barriers and facilitators of physical activity participation in adults living with type 1 diabetes: a systematic scoping review

To identify and map barriers and facilitators of physical activity (PA) in adults living with type 1 diabetes (T1D) in any care setting or environment. A scoping review was conducted in accordance with the PRISMA-ScR guidelines to address the aim of this review. Exclusion/inclusion criteria were determined a priori. Articles captured in the search were subject to title and abstract screening before full-text articles were assessed for eligibility against the exclusion/inclusion criteria. Included articles underwent critical appraisal before being charted, mapped, and discussed. Forty-six articles were included in the final synthesis. Most commonly, articles reported cross-sectional survey studies (46%), then qualitative designs (17%), and opinion or text (17%). Experimental studies accounted for 13% of included articles. Hypoglycaemia/fear of hypoglycaemia was the most commonly reported barrier and patient education the most commonly discussed facilitator. Quality appraisal revealed methodological issues among included articles. Higher quality research with theoretically sound behaviour-change interventions combined with targeted patient education is needed to address hypoglycaemia/fear of hypoglycaemia as a barrier to PA. Novelty: Hypoglycaemia and fear of hypoglycaemia were the most commonly reported barriers to PA in adults with T1D. Powered randomised controlled trials are required to establish efficacy of behaviour change interventions targeting these barriers to PA.

Satisfied or Frustrated? A Qualitative Analysis of Need Satisfying and Need Frustrating Experiences of Engaging With Digital Health Technology in Chronic Care

Introduction: Digital health technologies such as self-monitoring devices and apps are becoming increasingly important as tools to promote healthy habits and support individuals in their self-care. There is still a scarcity of research that builds on motivational theory to better understand the functioning of digital health technologies. The self-determination theory (SDT) is a macro theory of motivation that delineates three basic psychological needs that are linked to different types of motivation and lead to well-being when satisfied and illbeing when frustrated.

Objective: To explore how the use of a digital tool for self-monitoring and communication with healthcare satisfies or frustrates basic psychological needs across four spheres of user experience: interface, task, behavior, and life.

Methods: The study was conducted in a Swedish primary care setting with individuals who participated in a pilot study of a digital health intervention for self-monitoring in chronic care management. Data from a follow-up survey with participants 7 months after recruitment were analyzed using a thematic approach mixing inductive and deductive analysis. The unit of analysis is based on a total of 642 individual answers to seven open-ended questions, from 121 respondents.

Results: The analysis identified positive and negative influences of self-monitoring and digital communication with healthcare on all three psychological needs. Three main findings are that: (1) data covered all four spheres of user experiences, but most user experiences concerned the behavior and task spheres; (2) satisfaction and frustration of competence needs was more prominent than influences on other needs; (3) the same experience may be perceived as both need frustrating and need satisfying, which suggests a tension that reflects individual differences.

Conclusion: Designers of digital health technologies need to take into account basic psychological needs within all spheres of user experience, from interface to life in general. Because some features may be simultaneously experienced as satisfying and frustrating by different users, these types of tools need to be flexible to accommodate for variation of user experiences. Careful design considerations that take motivational theory into account would contribute to the transformation of care for individuals with chronic conditions.

Enhancing the translation of health behaviour change research into practice: a selective conceptual review of the synergy between implementation science and health psychology

Health psychology is at the forefront of developing and disseminating evidence, theories, and methods that have improved the understanding of health behaviour change. However, current dissemination approaches may be insufficient for promoting broader application and impact of this evidence to benefit the health of patients and the public. Nevertheless, behaviour change theory/methods typically directed towards health behaviours are now used in implementation science to understand and support behaviour change in individuals at different health system levels whose own behaviour impacts delivering evidence-based health behaviour change interventions. Despite contributing to implementation science, health psychology is perhaps doing less to draw from it. A redoubled focus on implementation science in health psychology could provide novel prospects for enhancing the impact of health behaviour change evidence. We report a Health Psychology Review-specific review-of-reviews of trials of health behaviour change interventions published from inception to April 2020. We identified 34 reviews and assessed whether implementation readiness of behaviour change interventions was discussed. We then narratively review how implementation science has integrated theory/methods from health psychology and related discipline. Finally, we demonstrate how greater synergy between implementation science and health psychology could promote greater follow-through on advances made in the science of health behaviour change.

Running prevalence in Portugal: Socio-demographic, behavioral and psychosocial characteristics

The purpose of this study was to cross-sectionally estimate the prevalence of recreational running in Portugal and describe characteristics of adult recreational runners. A random representative sample of 1068 Portuguese adults was selected. Socio-demographic information, physical activity habits and running behavior were assessed. Recreational runners’ training habits, motivations, barriers, vitality and flow were also assessed. The prevalence of recreational running in Portugal was 10.6%. It was higher in men (14.6% vs. 6.6%, p = .024) and in younger runners (13.6% vs. 7.7%, p = .026). Participants ran on average 3 times, 20 kilometers and 3 hours per week. General health orientation (88%), self-esteem (63%), and life meaning (57%) were the most predominant motives for running, while time was the most prevalent barrier (43%). This first Portuguese running prevalence representative study, indicates that almost 11% of adults ran regularly, and describes correlates of running, which can inform future running promotion interventions.

Development and feasibility of a mobile phone application designed to support physically inactive employees to increase walking

Background

Physical inactivity is a global health concern. mHealth interventions have become increasingly popular, but to date, principles of effective communication from Self-Determination Theory have not been integrated with behavior change techniques to optimize app effectiveness. We outline the development of the START app, an app combining SDT principles and 17 purposefully chosen BCTs to support inactive office employees to increase their walking during a 16-week randomized controlled trial. We also explored acceptability, engagement with, associations between app usage and behavioral engagement, and perceived impact of the app in supporting behavior change.

Methods

Following development, fifty insufficiently physically active employees (M age = 44.21 ± 10.95 years; BMI = 29.02 ± 5.65) were provided access and instructions on use of the app. A mixed methods design was used to examine feasibility of the app, including the User Mobile App Rating Scale, app engagement data, step counts, and individual interviews. Linear mixed modeling and inductive thematic analysis were used to analyze quantitative and qualitative data, respectively.

Results

Walkers rated the app quality favorably (M = 3.68 out of 5). Frequency of entering step counts (i.e., frequency of self-monitoring) on a weekly basis positively predicted weekly step counts measured via Fitbits at both the between-and within-individual levels. App features (entering daily step counts, reminders, and motivational messages) were perceived to assist walkers in fostering goal achievement by building competence and via self-monitoring.

Conclusions

The START app may be a useful component of walking interventions designed to increase walking in the workplace. Apps designed to promote walking behavior may be effective if they target users’ competence and integrate BCTs.

Trial Registration: This study was part of a pilot larger randomized controlled trial, in which a component of the intervention involved the use of the mobile app. The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618000807257) on 11 May 2018 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375049&isReview=true.

Mobilising people as assets for active ageing promotion: a multi-stakeholder perspective on peer volunteering initiatives

BACKGROUND

Successful peer volunteering is central to many community-based, active ageing initiatives. This study synthesises the perspectives of a range of stakeholders involved in peer volunteering initiatives and provides recommendations as to how peer volunteers can be effectively mobilised as community assets.

METHODS

An evidence synthesis of qualitative data from (a) the evaluation of ACE (Active, Connected, Engaged), a feasibility trial of a peer volunteering active ageing intervention, and (b) interviews with volunteers and managers of third sector organisations providing peer volunteering programmes. Data were analysed using directed content analysis.

RESULTS

Ten managers, 22 volunteers and 20 ACE participants were interviewed. The analysis identified six main themes, 33 higher and 22 sub themes. Main themes were: (i) Motives, (ii) Benefits, (iii) Skills and Characteristics, (iv) Challenges, (v) Training Needs, (vi) Recruitment and Retention. Altruism, changes in life circumstances, opportunities to reconnect with the community and personal fulfilment were the main reasons for volunteering. Volunteering was described as being personally rewarding, an avenue to acquire new skills and knowledge, and an opportunity for increased social connections and physical activity. Good peer volunteers are committed, reliable, have a good sense of humour, good interpersonal skills and are able to relate to participants. When pairing volunteers with participants, shared interests and geographical proximity are important to consider. Clarity of role, level of time commitment, regular feedback, recognition of effort and strong networks for on-going support are important strategies to facilitate volunteer retention.

CONCLUSIONS

The findings of this study support the value of peer volunteering as a strategy for mobilising community assets in promoting active ageing. To ensure success and longevity, these schemes require appropriate funding and efficient administrative support.

Causality Orientations and Supportive/Controlled Environment: Understanding Their Influence on Basic Needs, Motivation for Health and Emotions in French Hospitalized Older Adults

Objectives

From a self-determination theory perspective, the purpose of this cross sectional study was to better understand how to motivate hospitalized older adults’ behaviors and test an integrative model of the role of causality orientations and a supportive/controlled environment on basic need satisfaction, motivation for health oriented physical activity, positive and negative affective states, depressive symptoms, apathy, and boredom.

Methods

Older adults (N = 146; M_age = 81.27 years, SD = 7.75, 74.7% female) in French hospital units completed self-report questionnaires and socio-demographic data were also collected.

Results

Partial least squares path modeling results showed that participants’ autonomy orientation positively associated with the perception of a supportive environment was related to need satisfaction, autonomous motivation for health-oriented physical activity, and high scores on positive affective states. Conversely, participants’ impersonal orientation positively associated with the perception of a controlled environment was related to undermining need satisfaction, controlled motivation for health-oriented physical activity, and amotivation, and high scores on both negative affective states, and boredom.

Conclusion

The present results indicate that taking into account personality factors in hospital units can be useful and health professionals should take an interest both in the patients’ causality orientations and the supportive nature of the environment in order to understand better how to motivate patients’ behaviors. The present study points to the need to focus on all motivational dynamics which allow patients’ need satisfaction.

Self-determination theory interventions versus usual care in people with diabetes: a protocol for a systematic review with meta-analysis and trial sequential analysis

BACKGROUND

Existing self-management and behavioural interventions for diabetes vary widely in their content, and their sustained long-term effectiveness is uncertain. Autonomy supporting interventions may be a prerequisite to achieve 'real life' patient engagement and more long-term improvement through shared decision-making and collaborative goal setting. Autonomy supportive interventions aim to promote that the person with diabetes' motivation is autonomous meaning that the person strives for goals they themselves truly believe in and value. This is the goal of self-determination theory and guided self-determination interventions. Self-determination theory has been reviewed but without assessing both benefits and harms and accounting for the risk of random errors using trial sequential analysis. The guided self-determination has not yet been systematically reviewed. The aim of this protocol is to investigate the benefits and harms of self-determination theory-based interventions versus usual care in adults with diabetes.

METHODS/DESIGN

We will conduct the systematic review following The Cochrane Collaboration guidelines. This protocol is reported according to the PRISMA checklist. A comprehensive search will be undertaken in the CENTRAL, MEDLINE, EMBASE, LILACS, PsycINFO, SCI-EXPANDED, CINAHL, SSCI, CPCI-S and CPCI-SSH to identify relevant trials. We will include randomised clinical trials assessing interventions theoretically based on guided self-determination or self-determination theory provided face-to-face or digitally by any healthcare professional in any setting. The primary outcomes will be quality of life, mortality, and serious adverse events. The secondary will be diabetes distress, depressive symptoms and adverse events not considered serious. Exploratory outcomes will be glycated haemoglobin and motivation. Outcomes will be assessed at the end of the intervention and at maximum follow-up. The analyses will be performed using Stata version 16 and trial sequential analysis. Two authors will independently screen, extract data from and perform risk of bias assessment of included studies using the Cochrane risk of bias tool. Certainty of the evidence will be assessed by GRADE.

DISCUSSION

Self-determination theory interventions aim to promote a more autonomous patient engagement and are commonly used. It is therefore needed to evaluate the benefit and harms according to existing trials.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020181144.

Information Safety Assurances Increase Intentions to Use COVID-19 Contact Tracing Applications, Regardless of Autonomy-Supportive or Controlling Message Framing

Promoting the use of contact tracing technology will be an important step in global recovery from the COVID-19 pandemic. Across two studies, we assessed two messaging strategies as motivators of intended contact tracing uptake. In one sample of 1117 Australian adults and one sample of 888 American adults, we examined autonomy-supportive and controlling message framing and the presence or absence of information safety as predictors of intended contact tracing application uptake, using an online randomized 2 × 2 experimental design. The results suggested that the provision of data safety assurances may be key in affecting people’s intentions to use contact tracing technology, an effect we found in both samples regardless of whether messages were framed as autonomy-supportive or controlling. Those in high information safety conditions consistently reported higher intended uptake and more positive perceptions of the application than those in low information safety conditions. In Study 2, we also found that perceptions of government legitimacy related positively to intended application uptake, as did political affiliation. In sum, individuals appeared more willing to assent to authority regarding contact tracing insofar as their data safety can be assured. Yet, public messaging strategies alone may be insufficient to initiate intentions to change behavior, even in these unprecedented circumstances.

An exercise trial for adults undergoing neoadjuvant chemoradiotherapy for rectal cancer proves not feasible: recommendations for future trials

Background

The aim of this paper is to share the methodological problems of an unsuccessful prospective single-arm feasibility trial conducted to evaluate the safety and feasibility of a 12-week progressive exercise intervention for adults undergoing neoadjuvant chemoradiotherapy for rectal cancer, as well as offer recommendations for future trials.

Methods

The initial plan was to recruit adults diagnosed with rectal cancer and scheduled for neoadjuvant chemoradiotherapy over a 12-month period. The exercise intervention was to consist of supervised exercise sessions delivered three times per week by a trained exercise specialist. Feasibility (i.e., recruitment, adherence, and compliance rates) and safety (i.e., adverse events) were to be assessed throughout the trial, and patient-reported and physical health outcomes were to be assessed pre- and post-intervention. After 8 months of open recruitment, we had been unable to successfully enroll patients into our trial. We therefore modified our eligibility criteria to increase the number of patients that could be recruited into our trial, and in turn increase our recruitment rate. We also amended our recruitment procedures to ensure we could reach patients who were either awaiting treatment, receiving treatment, or had completed treatments in the past 5 years. In doing so, we added a research objective, namely to determine the optimal timing of conducting an exercise intervention with adults diagnosed with rectal cancer (i.e., during neoadjuvant treatment, after surgery, during adjuvant treatment, or post-treatment).

Results

Many problems continued to hinder the progress of our trial, particularly the low recruitment rate and the failure to enroll the required sample size that would make our results reliable.

Conclusion

This led us to conclude that our trial was not feasible and that it is advisable to consider some elements carefully (e.g., recruitment strategies, communication, and trial location) before designing and conducting future trials. If one or more of these elements still proves to be problematic, trial results risk being compromised and alternative approaches should be considered.

Trial registration

ClinicalTrials.gov NCT03049124. Registered on 02 September 2017

Using self-determination theory to understand eating behaviors and weight change in emerging adults

INTRODUCTION

College may be a time when emerging adults establish eating patterns that influence future weight trajectories. Self-determination theory (SDT) suggests that satisfaction of basic psychological needs (autonomy, competence, relatedness) supports autonomous regulation of behavior, which is associated with healthier behaviors. When needs are frustrated, individuals feel as though their behaviors are controlled by others, which is associated with unhealthy behaviors. This study used SDT to examine a model for associated body satisfaction, eating/weight control behaviors, and weight change.

METHODS

Using a cross-sectional design, undergraduates (N = 875; 57% women; Age_M = 20 ± 1.4 yrs.; BMI_M = 24.3 ± 4.4) completed measures of need satisfaction and frustration, behavioral regulation of healthy weight, body satisfaction, eating/weight control behaviors, and weight change in their first semester of college.

RESULTS

Structural equation modeling showed that need satisfaction was positively associated with greater autonomous regulation, which was positively associated with greater body satisfaction and fruit/vegetable intake. Conversely, greater need frustration was associated with greater controlled regulation, which was associated with lower body satisfaction. Participants who had greater body satisfaction engaged in fewer unhealthy weight control behaviors. Engaging in more unhealthy behaviors was associated with greater weight gain during the first semester of college, whereas fruit and vegetable intake was not associated with weight change. The associations were stronger for women than men, particularly for the relationships between body satisfaction and unhealthy weight control behaviors and increased weight gain.

CONCLUSIONS

The model was generally supported, suggesting that psychological need satisfaction and autonomous motivation in college students may facilitate greater body satisfaction and healthier eating behaviors. Future longitudinal research is needed to clarify the factors that influence health behaviors and weight gain in college students.

Profiles of motivations for responsible drinking among college students: A self-determination theory perspective

The present study sought to identify motivational profiles for responsible drinking from a self-determination theory (SDT) perspective among college students. We used data from 507 students who reported drinking alcohol at least once in the past 3 months that were recruited from a random sample of undergraduate students at a Southwestern university. Participants completed an online survey that included measures assessing amotivation, external regulation, introjected regulation, and autonomous motivation for responsible drinking as well as other SDT constructs, alcohol protective behavioral strategies (PBS), and alcohol use/problems. A latent profile analysis suggested that a 3-class solution was optimal: a "High Quality" class (i.e., relatively high on introjected regulation and autonomous motivation but relatively low on all other types of motivation), a "High Quantity" class (i.e., relatively high on all types of motivation), and a "Low Quantity" class (i.e., relatively low on all types of motivation). The High Quality class reported the highest level of psychological need satisfaction and dispositional autonomy, followed by the High Quantity class, with the Low Quantity class reporting the lowest levels. The High Quality class reported more frequent use of serious harm reduction PBS than the High Quantity class. Generally, both the High Quality and High Quantity classes reported more frequent use of all types of PBS and less alcohol use/problems than the Low Quantity class. These results provide initial support for different profiles of motivations based on SDT for responsible drinking. Potential implications for alcohol interventions among college students are discussed.

Experiencing Nature to Satisfy Basic Psychological Needs in Parenting: A Quasi-Experiment in Family Shelters

Finding fulfillment of basic psychological needs may be difficult for parents living in shelters after becoming homeless or after escaping violence. This study tested if experiencing nature was associated with the basic psychological needs of parents in shelters. Need satisfaction and need frustration were measured among parents in shelters (N = 160), with one measurement in the standard indoor context of the shelter and one measurement while experiencing nature. Experiencing nature was associated with enhanced need satisfaction (d = 0.28) and reduced need frustration (d = −0.24). The effect was especially pronounced for parents with young children. Our findings suggest that the physical environment matters for parents’ basic psychological need fulfillment as they interact with their children in the context of sheltering. This finding opens a potential avenue for supporting parental functioning and resilience in the face of risk if these effects were to be replicated across settings using controlled experimental designs. At the very least, the findings may be discussed with practitioners and parents in the context of making shelter life and work more conducive to mental health and family functioning.

Autonomy-supportive exercise behaviors promote breast cancer survivors' well-being

Background: Grounded in self-determination theory (SDT), this pilot study aimed to test an autonomy-supportive exercise instructing style to promote hedonic (seeking comfort and pleasure) and eudaimonic (seeking to develop the best within one and pursue excellence)orientations, exercise motivation, and psychological well-being of breast cancer survivors.

Methods: Twenty-four breast cancer survivors were randomized in either autonomy-supportive exercise instructing style (treatment condition) or usual exercise instructing style (control condition). The study consisted of a pre-intervention session followed by 22 exercise sessions and a post-intervention session. Hedonic and eudaimonic orientations, exercise motivation, and psychological well-being (subjective vitality) measured at baseline and post-intervention sessions.

Results: As expected, participants in the treatment condition reported greater eudaimonic and hedonic orientations and subjective vitality compared to the participants in the control condition. The results showed no difference in exercise motivation across conditions.

Conclusion: We concluded that the SDT-based intervention was successful in helping breast cancer survivors increase hedonic and eudaimonic orientations and subjective vitality. Practical and theoretical implications, along with limitations and future research suggestions are discussed inside.

Everything counts in sending the right message: science-based messaging implications from the 2020 WHO guidelines on physical activity and sedentary behaviour

The World Health Organization (WHO) released the 2020 global guidelines on physical activity and sedentary behaviour. The new guidelines contain a significant change from the 2010 guidelines on physical activity for adults and older adults that has important implications for next-generation physical activity messaging: The removal of the need for aerobic activity to occur in bouts of at least 10 min duration. This change in the guidelines provides an opportunity to communicate in new ways that align with behavioural science, permitting physical activity communicators and promoters to better support people's psychological needs, motivation, and ability to fit healthy levels of physical activity into their lives. The frames and messages we use to communicate about the guidelines matter because they influence whether activity is perceived as relevant, meaningful, and feasible - or not. When developing new physical activity communications there are some overarching principles, based on behavioural science, to keep in mind. Using established theory, this commentary aims to support the creation of more strategic frames and messages for increasing the value and integration of physical activity into daily living. Country-specific physical activity campaigns using these ideas will be discussed.

Caring for home-dwelling parents with dementia: A qualitative study of adult-child caregivers' motivation

Aim

To explore adult children's motivation in caregiving for their home-dwelling parents with dementia.

Design

Qualitative design with a phenomenological approach.

Methods

Semi-structured individual interviews with 21 adult sons and daughters who were caregivers for a parent with dementia. Data were analysed using systematic text condensation.

Results

Inspired by self-determination theory, three categories were identified in the empirical data representing the main motivational drivers for adult-child caregivers: relatedness (to the parent with dementia, the parent's spouse, other persons), competence (in handling dementia, in the parent's need) and autonomy (freedom of choice, innate values and tasks). Caregivers report relatedness as their key motivational driver.These results imply that nurses and other health professionals should value the importance of relatedness when interacting with dementia caregivers and establish belonging support structures. Further research should generate more knowledge of the positive motivational drivers, including interventions to improve relatedness, competence and autonomy.

Basic Psychological Need-Satisfying Activities during the COVID-19 Outbreak

BACKGROUND

The rapidly spreading novel coronavirus outbreak (COVID-19) worldwide may increase fear and stress, and has a cost for people's well-being and their motivation toward activities. In this study, we applied principles from Self-Determination Theory to develop and test activities to satisfy basic psychological needs (autonomy, competence, and relatedness) to enhance the experience of need satisfaction, autonomous self-regulation, and subjective vitality, and to decrease the experience of need frustration, controlled self-regulation, amotivation, and perceived stress.

METHOD

Using a 10-day experimental research design among an Iranian sample (N = 208, M_age  = 23.52, SD = 5.00), we randomly allocated participants to either an experimental (basic psychological need-satisfying activities intervention, n = 98) or a control (neutral comparison group, n = 110) condition.

RESULTS

Repeated measure ANCOVA showed that participants in the experimental condition reported greater psychological need satisfaction, autonomous self-regulation, subjective vitality, and lesser psychological need frustration, amotivation, and perceived stress than did participants in the control condition.

CONCLUSION

We conclude that the intervention was successful in helping participants enhance their motives and well-being and reduce their stress when life is surrounded by uncertainty and during social distancing restrictions.

Effects of the “MAMI Deporte®” Family Sports Program on Parents’ Motivation towards Sport Participation: A Randomized Controlled Intervention

As most parents do not meet physical activity (PA) recommendations, new PA promotion strategies need to be developed considering the role of motivation as an essential underlying factor of PA behavior. Recreational sports programs practiced in the family would represent an effective strategy to promote PA for the entire family in general, and for parents in particular. Building upon self-determination theory, the purpose of this study was to examine the effect of the Active Methodology for Improving Sports Initiation (MAMI Deporte®) program on parents’ behavioral regulation. The participants were 58 parents (50% men) and 78 children (48.71% boys), who were randomized into a control group (29 parents and 39 children), which followed its habitual sports activity over 8 months, and an experimental group (29 parents and 39 children), which completed the MAMI Deporte® program. Specifically, the MAMI Deporte® program focused on simultaneous participation between parents and children in multisports activities, including 32 lessons distributed into 2 h/week for 8 months. Pre-and-post-intervention measures were collected. The results showed significant differences in the parents’ level of intrinsic motivation, integrated regulation, identified regulation and introjected regulation in favor of the experimental group. Nonsignificant effects were found for gender. These results were discussed, highlighting the internalization process of the value of sport in the family experienced by parents after the MAMI Deporte® family-based sports program.

"To be there for my family" and "Keep my independence": Metropolitan and Non-Metropolitan Cancer Survivors' Health Behaviour Motives

PURPOSE

Cancer survivors are at risk of comorbidities and mortality, and those living outside of metropolitan areas are particularly susceptible given poorer socioeconomic, health and support resources. As engagement in health behaviours is affected by participants' autonomous motives, investigation of the motives of cancer survivors in metropolitan and non-metropolitan areas could elucidate the values and reasons for practising health behaviours, allowing programs to be tailored to these motives.

METHODS

Metropolitan (n = 103) and non-metropolitan (n = 80) Australian cancer survivors completed a survey item by describing their motives for physical activity and healthy diet change. Inductive thematic analysis of responses was performed to establish themes across health behaviour motives.

RESULTS

Analyses revealed four themes: to be able to, longevity, psychological health and appearance. Survivors primarily referred to being able to enjoy family, leisure activities, travel and staying independent, with these motives often linked to longevity. Motives were similar across locations; however, those in non-metropolitan locations reported continuation of work and pain relief more frequently. Female survivors more often reported weight loss.

CONCLUSIONS

A predominant motive for health behaviour change in cancer survivors across geographical location was the ability to enjoy family and engage in leisure and work activities. Programs aiming to promote health behaviours in cancer survivors might consider framing interventions accordingly by emphasizing benefits of longevity and maintaining independence.

A Preliminary Investigation of the Relationship between Motivation for Physical Activity and Emotional and Behavioural Difficulties in Children Aged 8-12 Years: The Role of Autonomous Motivation

While motivation for physical activity (PA) and PA participation have been linked, research on the relationship between motivation for PA and mental health outcomes is scant, with studies involving children largely underrepresented. Grounded in self-determination theory, this cross-sectional study aimed to determine whether autonomous motivation versus external motivation (a form of controlled motivation) for PA is associated with fewer emotional and behavioural difficulties and higher levels of PA in children. A sample of 87 children (aged 8–12 years) were recruited from five primary schools in Victoria, Australia. An adapted version of the Behavioural Regulation in Exercise Questionnaire (BREQ) was used to measure motivation for PA and structured parent-report questions were used to assess moderate-to-vigorous PA (MVPA) levels. Parents also completed the Strengths and Difficulties Questionnaire (SDQ) to measure children’s emotional and behavioural difficulties. Children’s autonomous motivation was associated with fewer emotional and behavioural difficulties (β = −0.25, p = 0.038) and higher levels of MVPA (β = 0.24, p = 0.014). These results indicate autonomous motivation is associated with improved mental health outcomes and higher levels of PA in children. Thus, PA interventions that promote autonomous motivation may enhance children’s mental health compared to interventions that promote mainly controlled forms of motivation.