Self-determination Theory-based Intervention Research Articles

Effectiveness of a self-determination theory-based smoking cessation intervention plus instant messaging via mobile application for smokers with cancer: Protocol for a pragmatic randomized controlled trial.

Despite evidence that patients living with cancer who continue to smoke after diagnosis are at higher risk for all-cause mortality and reduced treatment efficacy, many cancer patients continue to smoke. This protocol is for a study to test the effectiveness of a self-determination theory-based intervention (quit immediately or progressively) plus instant messaging (WhatsApp or WeChat) to help smokers with cancer to quit smoking. This will be a multi-centre, two-arm (1:1), single-blind, pragmatic, individually randomized controlled trial. Taking part will be specialist outpatient clinics in five major hospitals in different location-based clusters in Hong Kong. The sample will include 1448 Chinese smokers living with cancer attending medical follow-ups at outpatient clinics. The intervention group will receive brief advice (approximately 5-8 minutes) from research nurses in the outpatient clinics and then be invited to choose their own quit schedules (immediate or progressive). During the first 6-month follow-up period they will receive instant messaging with smoking cessation advice once per week for the first 3months, and thereafter approximately once per month. They will also receive four videos, and those opting to quit progressively will receive a smoking reduction leaflet. The control group will also receive brief advice but be advised to quit immediately, and instant messaging with general health advice during the first 6-month follow-up period using the same schedule as the intervention group. Participants in both groups will receive smoking cessation leaflets. The primary outcome is biochemically validated smoking abstinence at 6months, as confirmed by saliva cotinine level and carbon monoxide level in expired air. Secondary outcomes include biochemically validated smoking abstinence at 12 months, self-reported 7-day point prevalence of smoking abstinence at 6 and 12 months, self-reported ≥ 50% reduction of cigarette consumption at 6 and 12 months and quality of life at 6 and 12 months. All time-points for outcomes measures are set after randomization. The results could inform research, policymaking and health-care professionals regarding smoking cessation for patients living with cancer, and therefore have important implications for clinical practice and health enhancement.

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

BackgroundAutonomy-supporting interventions, such as self-determination theory and guided self-determination interventions, may improve self-management and clinical and psychosocial outcomes in people with diabetes. Such interventions have never been systematically reviewed assessing both benefits and harms and concurrently controlling the risks of random errors using trial sequential analysis methodology. This systematic review investigates the benefits and harms of self-determination theory-based interventions compared to usual care in people with diabetes.MethodsWe used the Cochrane methodology. Randomized clinical trials assessing interventions theoretically based on guided self-determination or self-determination theory in any setting were eligible. A comprehensive search (latest search April 2022) was undertaken in CENTRAL, MEDLINE, Embase, LILACS, PsycINFO, SCI-EXPANDED, CINAHL, SSCI, CPCI-S, and CPCI-SSH to identify relevant trials. Two authors independently screened, extracted data, and performed risk-of-bias assessment of included trials using the Cochrane risk-of-bias tool 1.0. Our primary outcomes were quality of life, all-cause mortality, and serious adverse events. Our secondary outcomes were diabetes distress, depressive symptoms, and nonserious adverse events not considered serious. Exploratory outcomes were glycated hemoglobin and motivation (autonomy, controlled, amotivation). Outcomes were assessed at the end of the intervention (primary time point) and at maximum follow-up. The analyses were conducted using Review Manager 5.4 and Trial Sequential Analysis 0.9.5.10. Certainty of the evidence was assessed by GRADE.ResultsOur search identified 5578 potentially eligible studies of which 11 randomized trials (6059 participants) were included. All trials were assessed at overall high risk of bias. We found no effect of self-determination theory-based interventions compared with usual care on quality of life (mean difference 0.00 points, 95% CI −4.85, 4.86, I2 = 0%; 225 participants, 3 trials, TSA-adjusted CI −11.83, 11.83), all-cause mortality, serious adverse events, diabetes distress, depressive symptoms, adverse events, glycated hemoglobulin A1c, or motivation (controlled). The certainty of the evidence was low to very low for all outcomes. We found beneficial effect on motivation (autonomous and amotivation; low certainty evidence).ConclusionsWe found no effect of self-determination-based interventions on our primary or secondary outcomes. The evidence was of very low certainty.Systematic review registrationPROSPERO CRD42020181144

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

BackgroundExisting 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/designWe 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.DiscussionSelf-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 registrationPROSPERO CRD42020181144

A classification of motivation and behavior change techniques used in self-determination theory-based interventions in health contexts.

While evidence suggests that interventions based on self-determination theory have efficacy in motivating adoption and maintenance of health-related behaviors, and in promoting adaptive psychological outcomes, the motivational techniques that comprise the content of these interventions have not been comprehensively identified or described. The aim of the present study was to develop a classification system of the techniques that comprise self-determination theory interventions, with satisfaction of psychological needs as an organizing principle. Candidate techniques were identified through a comprehensive review of self-determination theory interventions and nomination by experts. The study team developed a preliminary list of candidate techniques accompanied by labels, definitions, and function descriptions of each. Each technique was aligned with the most closely related psychological need satisfaction construct (autonomy, competence, or relatedness). Using an iterative expert consensus procedure, participating experts (N = 18) judged each technique on the preliminary list for redundancy, essentiality, uniqueness, and the proposed link between the technique and basic psychological need. The procedure produced a final classification of 21 motivation and behavior change techniques (MBCTs). Redundancies between final MBCTs against techniques from existing behavior change technique taxonomies were also checked. The classification system is the first formal attempt to systematize self-determination theory intervention techniques. The classification is expected to enhance consistency in descriptions of self-determination theory-based interventions in health contexts, and assist in facilitating synthesis of evidence on interventions based on the theory. The classification is also expected to guide future efforts to identify, describe, and classify the techniques that comprise self-determination theory-based interventions in multiple domains.

Effect of Health Promotion Model and Self-Determination Theory Based Intervention on Preeclampsia Prevention among Pregnant Women at Beni-Suef Governorate

Pre-eclampsia is the greatest common hypertensive disorder of pregnancy, It is a major cause of maternal mortality and morbidity, preterm birth, intrauterine growth restriction, and perinatal death worldwide. It has been predictable that preeclampsia complicates 2-8% of pregnancies globally, and is considered to be the third cause of maternal death. Aim of this study was to determine the effect of the health promotion model and self-determination theory-based intervention on preeclampsia prevention among pregnant women. Subjects and method: A quasi-experimental design was conducted at the antenatal clinic at Beni-Suef University Hospital, Egypt. A purposive sample of 60 pregnant women was included in the study, they were divided into study and control groups from June 2019, until December 2019. Tools: Data were collected through three main tools: A Structured interviewing questionnaire, The questions about pre-eclampsia prevention knowledge, and the health promotion model. Results: The results of this study revealed there was a significant difference (p < 0.05) in all variables after the implementation of an intervention and the average score of the various variables in the intervention group was greater than that of the control group (p < 0.05). Conclusion: The application of the health promotion model and self-determination theory-based intervention on preeclampsia prevention in pregnant women had an effective improvement of pregnant women's knowledge change behavior, and dietary practices were also improved in the study group compared to the control group. Recommendations: The intervention of management of PE with the pregnancy based on HPM and self-determination theory should be integrated into the ANC program at the study setting and similar ones

Bariatric Outcomes: Self-Management for Sustained Surgical Success: A Multicomponent Treatment for Dysregulated Overeating in Bariatric Surgery Patients.

Binge eating disorder, food addiction, and dysregulated overeating are common among people with severe obesity and prevalent among bariatric surgery populations. These problematic eating habits share commonalities with other addictions. Effective, holistic self-management is needed to promote long-term weight loss and psychosocial adjustment among patients who are severely obese who undergo surgery, especially those with clinically remarkable levels of binge eating, food addiction, or dysregulated overeating.This article aims to briefly review binge eating disorder, food addiction, and obesity-as well as issues surrounding surgery for individuals who are severely obese-and introduce the Bariatric Outcomes: Self-management for Sustained Surgical Success (BOSSSS) program. The BOSSSS program is holistic, skill based, and designed to promote weight loss, prevent weight regain, and improve well-being in patients with severe obesity with a history of bariatric surgery.Preliminary survey data suggest that bariatric surgery patients report a lack of skill-based emotional and behavioral support designed to help them over the long term. The BOSSSS program is rooted in self-determination theory, integrating mobile health technology across program components. Self-determination theory-based interventions are personalized and encourage autonomy, competence, and social support among participating patients and providers. The behavioral self-regulation training within BOSSSS is energy balance self-monitoring and titration. Emotional self-regulation is addressed via a specialized version of dialectical behavior skills therapy, emphasizing promotion of coping skills and use of adaptive, healthy substances in immediate environments. The BOSSSS program has been well received by patients and could be implemented by nurses and other health professionals with minimal support.

A Systematic Review of Psychosocial Interventions to Cancer Caregivers.

Objective: To systematically review the effect of psychosocial interventions on improving QoL, depression and anxiety of cancer caregivers.Methods: We conducted a systematic review of psychosocial interventions among adult cancer caregivers published from 2011 to 2016. PsycINFO, PubMed, Proquest, Cochrane Library, Embase, Applied Social Sciences Index and s (ASSIA), Cumulative Index to Nursing and Allied Health Literature, Social Sciences Citation Index (SSCI) and EBSCO, China National Knowledge Infrastructure (CNKI) and WANFANG were searched. Inclusion criteria were: randomized controlled trails (RCTs); psychosocial intervention to cancer caregivers; psychosocial health indicators including quality of life, depression or anxiety.Results: 21 studies out of 4,666 identified abstracts met inclusion criteria, including 19 RCTs. The intervention modes fell into the following nine categories: family connect intervention, self-determination theory-based intervention (SDT), cognitive behavioral therapy (CBT), emotion-focused therapy (EFT), comprehensive health enhancement support system (CHESS), FOCUS programme, existential behavioral therapy (EBT), telephone interpersonal counseling (TIP-C), problem-solving intervention (COPE).Conclusion: paired-intervention targeting self-care and interpersonal connections of caregivers and symptom management of patients is effective in improving quality of life and alleviating depression of cancer caregivers while music therapy is helpful for reducing anxiety of cancer caregivers.

Intervention integrating physical activity with math: Math performance, perceived competence, and need satisfaction

Integrating physical activity (PA) with academics in the classroom is a newly explored approach, promising to improve both PA and academic achievement. The purposes of this study were to examine (a) the effect of lessons integrating PA with math, compared to traditional lessons, on math performance and perceived competence in math over an 8-week period, and (b) whether perceived competence in math and need satisfaction associated with the integrated lessons could predict math performance at the end of the intervention. Fourteen 4th and 5th grade classes were assigned to an integrated PA group (N = 106; using the “Move for Thought” kit), or a control group (N = 118; traditional lessons). A measure of perceived competence in math and a comprehensive, timed math test were completed before and after the intervention by both groups. Perceived need satisfaction associated with the integrated lessons was measured at the end of the intervention. The improvement in math performance in the integrated PA group was significantly larger compared to that of the control group. Perceived competence for math remained high and stable over time in both groups. Hierarchical regression analysis, controlling for gender and pretest math performance, showed that both perceived competence in math and satisfaction of the need for competence associated with the integrated lessons significantly predicted posttest math performance. This study makes a unique contribution to the literature on Self-Determination Theory-based interventions for enhancing academic performance by examining the effects of integrating PA with an academic subject.

Testing the Effects of a Self-Determination Theory-Based Intervention with Youth Gaelic Football Coaches on Athlete Motivation and Burnout

We conducted a cluster randomized controlled trial (RCT) to test the effects of a self-determination theory-based intervention on athlete motivation and burnout. In addition, we examined the feasibility and acceptability of the intervention. We randomly assigned youth Gaelic football coaches (N = 6) and their teams to an experimental or a delayed treatment control group (n = 3 each group). We employed linear mixed modeling to analyze changes in player motivation and burnout as a result of their coach participating in a 12-week SDT-based intervention. In addition, we conducted a fidelity assessment to examine whether the intervention was implemented as planned. The findings demonstrated the feasibility and acceptability of implementing a self-determination theory-based intervention in the coaching domain. In addition, this study demonstrated favorable trends in the quality of player motivation and burnout symptoms as a result of an SDT-based intervention.

Fostering autonomous motivation, physical activity and cardiorespiratory fitness in rheumatoid arthritis: protocol and rationale for a randomised control trial.

BackgroundPeople with rheumatoid arthritis are at greater risk of morbidity and mortality from cardiovascular disease than the general population. Sustained physical activity increases cardio-respiratory fitness and reduces cardiovascular disease risk factors. However, little is known about how we can effectively promote long-term participation in physical activity in patients with rheumatoid arthritis. The literature consistently calls for physical activity interventions, and their implementation, to be theoretically-grounded.Methods/DesignThis paper documents the protocol of a randomised control trial that investigates whether a Self-determination Theory-based intervention fosters the adoption and maintenance of physical activity (3, 6 and 12 months) sufficient to provide sustained cardiovascular and personal well-being benefits in patients with rheumatoid arthritis. The cost effectiveness of the intervention will also be determined. The trial is registered as Current Controlled Trials ISRCTN04121489.DiscussionResults from this trial will provide guidance regarding key social environmental factors that can be manipulated to support motivational processes conducive to positive health behaviour change and optimal functioning in patients with Rheumatoid Arthritis.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-445) contains supplementary material, which is available to authorized users.

AB0830-HPR Feelings of competence and relatedness during physical activity are related to well-being in rheumatoid arthritis patients: preliminary findings from a randomized control trial

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory disease that causes joint pain, swelling and stiffness with eventual structural damage leading to physical dysfunction. Consequently, people with RA tend to experience...

Promoting physical activity: development and testing of self-determination theory-based interventions.

A growing number of studies have pulled from Deci and Ryan's Self-Determination Theory to design interventions targeting health behavior change. More recently, researchers have begun using SDT to promote the adoption and maintenance of an active lifestyle. In this review, we aim to highlight how researchers and practitioners can draw from the SDT framework to develop, implement, and evaluate intervention efforts centered on increasing physical activity levels in different contexts and different populations. In the present paper, the rationale for using SDT to foster physical activity engagement is briefly reviewed before particular attention is given to three recent randomized controlled trials, the Canadian Physical Activity Counseling (PAC) Trial, the Empower trial from the UK, and the Portuguese PESO (Promotion of Health and Exercise in Obesity) trial, each of which focused on promoting physical activity behavior. The SDT-based intervention components, procedures, and participants are highlighted, and the key findings that have emanated from these three trials are presented. Lastly, we outline some of the limitations of the work conducted to date in this area and we acknowledge the challenges that arise when attempting to design, deliver, and test SDT-grounded interventions in the context of physical activity promotion.