Self-determination Theory Process Model Research Articles

Determinants of glycaemic control among patients with type 2 diabetes: testing a process model based on self-determination theory

AimsTo investigate a hypothesised process model based on self-determination theory (SDT) in a population of people with type 2 diabetes. The model suggests that autonomy support from healthcare professionals is an important determinant of autonomous motivation and perceived competence in diabetes, which correlate positively in turn with wellbeing and negatively with HbA1c. MethodsThis cross-sectional study used baseline questionnaire data and HbA1c levels from a randomised controlled trial investigating the effects of a person-centred consultation program. The questionnaire used validated scales and items assessing autonomy support, wellbeing, motivation, self-care activities, diabetes distress and perceived competence. Pearson correlations were calculated, and mediation analysis was conducted by multivariate linear regression analysis. Results116 participants completed the questionnaire. Autonomy support was significantly correlated with perceived competence and controlled motivation. Perceived competence correlated negatively with diabetes distress and positively with self-care activities. Diabetes distress correlated negatively with wellbeing. Controlled motivation correlated positively with autonomous motivation, which correlated positively with both wellbeing and self-care activities. Self-care activities correlated negatively with HbA1c. ConclusionAs suggested by the hypothesised SDT process model, autonomy support, autonomous motivation and perceived competence are associated with better wellbeing and improved HbA1c.

Perceived Health Care Climate of Older People Attending an Exercise Program: Validation of the German Short Version of the Health Care Climate Questionnaire.

The role of perceived need support from exercise professionals in improving mental health was examined in a sample of older adults, thereby validating the short Health Care Climate Questionnaire. A total of 491 older people (M = 72.68 years; SD = 5.47) attending a health exercise program participated in this study. Cronbach's alpha was found to be high (α = .90). Satisfaction with the exercise professional correlated moderately with the short Health Care Climate Questionnaire mean value (r = .38; p < .01). The mediator analyses yielded support for the self-determination theory process model in older adults by showing both basic need satisfaction and frustration as mediating variables between perceived autonomy support and depressive symptoms. The short Health Care Climate Questionnaire is an economical instrument for assessing basic need satisfaction provided by the exercise therapist from the participant's perspective. Furthermore, this cross-sectional study supported the link from coaching style to the satisfaction/frustration of basic psychological needs, which in turn, predicted mental health. Analyses of criterion validity suggest a revision of the construct by integrating need frustration.

Motivational predictors of learning strategies, participation, exertion, and performance in physical education: A randomized controlled trial

Teachers’ support of student autonomy in physical education (PE) is believed to be important for students’ motivation and outcomes in PE. We tested the hypothesis that an intervention designed to help teachers to be more autonomy supportive in teaching their students to use learning strategies (relative to standard teaching) would increase students’ perceived autonomy support from the teachers, perceived competence, autonomous motivation, use of learning strategies and their exertion, participation, and grades in PE over a school year. We also tested a self-determination theory (SDT) process model. Experimental effects of the intervention yielded significant positive effects on changes in perceived autonomy support, learning strategies defined as absorption and effort regulation, as well as for performance (i.e., grades). In testing the SDT process model with SEM, most of the predicted paths were significantly supported.

Project TEAMS (Talking about Eating, Activity, and Mutual Support): a randomized controlled trial of a theory-based weight loss program for couples

BackgroundObesity risk is shared between spouses, yet existing weight loss programs focus on individuals and not the marital dyad. Given the interdependence of weight in couples, weight management outcomes might be improved by targeting joint weight loss and the creation of an interpersonal milieu that supports long-term behavior change. According to Self-Determination Theory (SDT), greater autonomous self-regulation of behaviors, and subsequently better treatment outcomes, are observed in needs supportive environments in which personally meaningful choice is supported and criticism and control are minimized. Correlational analyses confirm these pathways in weight management, with needs support from one’s spouse or partner emerging as a distinct predictor of weight loss success. Research is now needed to establish causal links and to develop and test weight loss interventions designed to facilitate the needs supportive behavior of spouses.MethodsProject TEAMS (Talking about Eating, Activity, and Mutual Support) is a randomized controlled trial testing a couples-based intervention, grounded in SDT, designed to change the social context of weight loss by training spouses to provide needs support for each other’s eating and physical activity behavior. Sixty-four couples will be randomized to either 6 months of behavioral weight loss treatment informed by SDT (SDT-WL) or to 6 months of standard behavioral weight loss treatment (BWL). Couples will attend weekly sessions for 6 months and will be assessed at 0, 3, 6, and 12 months. By bolstering needs support, SDT-WL is predicted to increase autonomous self-regulation and perceived competence and produce greater weight loss and maintenance than standard behavioral treatment. Exploratory analyses will examine the SDT process model prediction that the influence of needs support on treatment outcomes will be mediated by autonomous self-regulation and perceived competence.DiscussionThis study addresses the fundamental importance of interpersonal support in weight management by focusing on couples rather than individuals and using a rich theoretical framework to train spouses in supportive behaviors.Trial registrationClinicaltrials.gov; NCT02570009.

Motivational factors associated with physical activity and quality of life in people with severe mental illness.

There has been increasing interest for investigating the role of motivation in physical activity among people with severe mental illness (SMI). Autonomous motivation has been suggested to have a potentially important role in adoption and maintenance of physical activity. However, the knowledge about factors that facilitate autonomous motivation among people with SMI is scarce. The aim of this study was to examine factors associated with motivation for physical activity as well as the relationships between motivation, physical activity and health-related quality of life in individuals with SMI that were currently physically active. A cross-sectional design was used, and 88 participants were recruited from a public health network promoting physical activity for people with SMI. They answered a questionnaire package consisting of scales measuring psychological need support - psychological need satisfaction - and motivation for physical activity, physical activity and health-related quality of life. The majority of participants reported to be in regular physical activity. Associations between variables were tested according to the self-determination theory process model. Structural equation modelling yielded good fit of the process model to the data. Specifically, a need-supportive environment was positively associated with psychological need satisfaction, while psychological need satisfaction was positively associated with autonomous motivation and mental health-related quality of life, and negatively associated with controlled motivation and amotivation. Physical activity was positively associated with autonomous motivation and physical health-related quality of life, and negatively associated with amotivation. This study indicates that individuals with SMI can be regularly physically active when provided with suitable opportunities. Furthermore, the present results suggest that it is vital for health-care practitioners to emphasise creating a need-supportive environment when organising physical activity because such an environment is associated with both increased autonomous motivation for physical activity and mental health-related quality of life.

Physical activity and motivational predictors of changes in health behavior and health among DM2 and CAD patients.

This study tested a physical activity intervention and the self-determination theory (SDT) process model of health-behavior change and health among 108 adult patients with both diabetes mellitus type 2 (DM2) and coronary artery disease (CAD). Patients were randomly assigned to an organized physical activity intervention group (led by instructors) or a non-physical activity control group. At baseline and after 12months, we measured the following: needs satisfaction, autonomous and controlled motivation for physical activity, perceived competence for physical activity and blood sugar testing, physical activity and blood sugar testing, body weight, glucose control (HbA1c), and self-perceptions of general health and vitality. The intervention produced, as hypothesized, significant changes in all study variables in favor of the experimental group (Cohen's d effect sizes: 0.23-0.72), except the non-significant result for controlled motivation and body weight. The data supported the SDT process model, in which the effect of the intervention significantly predicted indirect changes in behavior and health through motivation variables. Considering the moderate to large effects on increases in motivation, behavior, and health, promoting organized physical activity programs that are perceived as need-supportive may have important health implications for patients with DM2 and CAD.

Changes in Motivation and Burnout Indices in High-Performance Coaches Over the Course of a Competitive Season

Being subject to a great range of demands is believed to increase burnout propensity in high-performance coaches. This study is the first to explore whether the 4-step self-determination theory process model is a valuable framework to better understand the process influencing burnout and well-being in high-performance coaches (N = 343, M = 40.33 years) throughout a competitive season. Findings indicated that coaches on average increased in burnout and decreased in well-being. Hypotheses were to a large extent supported: change in perceived environment → change in psychological need satisfaction → change in autonomous motivation → change in burnout and well-being.

Need satisfaction, motivational regulations and exercise: moderation and mediation effects.

BackgroundBased on the Self-determination theory process model, this study aimed to explore relationships between the latent constructs of psychological need satisfaction, autonomous motivation and exercise behaviour; the mediational role of autonomous motivation in the association of psychological need satisfaction with exercise behaviour; as well as gender and age differences in the aforementioned associations.MethodsAdult active members of an Internet-based exercise program (n = 1091) between 18 and 78 years of age completed a test battery on motivational aspects based on Self-determination theory. The Basic Psychological Needs in Exercise Scale and the Behavioural Regulation in Exercise Questionnaire-2 were used to measure need satisfaction and type of motivation and the Leisure Time Exercise Questionnaire to measure self-reported exercise.ResultsNeed satisfaction predicted autonomous motivation, which in turn predicted exercise, especially for women. Autonomous motivation was found to mediate the association between need satisfaction and exercise. Age and gender moderated several of the paths in the model linking need satisfaction with motivation and exercise.ConclusionThe results demonstrated gender and age differences in the proposed sequential mechanisms between autonomous motivation and exercise in the process model. This study thus highlights a potential value in considering moderating factors and the need to further examine the underlying mechanisms between needs, autonomous motivation, and exercise behaviour.

Motivation for physical activity in young adults with physical disabilities during a rehabilitation stay: a longitudinal test of self‐determination theory

AbstractWe tested a self‐determination theory (SDT) process model during a 3 week physical activity rehabilitation stay among young adults with a physical disability (N = 44, Mage = 24.7, SD = 5.1). As hypothesized, perceived autonomy support positively predicted needs satisfaction at the end of the stay (r = .38, p &lt; .01). Further, needs satisfaction was positively linked to changes in autonomous motivation for physical activity (r = .47, p &lt; .01). Both changes in autonomous motivation and self‐efficacy were associated with physical activity increases over the stay (r = .57, p &lt; .01 and r = .47, p &lt; .01, respectively). Bootstrapping results supported the SDT process model, indicating a support for a development toward more self‐determined motivation in rehabilitation.

Oral health and dental well‐being: testing a self‐determination theory model

AbstractThis study tested a self‐determination theory (SDT) process model of oral health and subjective dental well‐being. The results showed that: (1) patients' perceptions of autonomy‐supportive dental professionals were significantly positively predictive of patients' psychological needs satisfaction in treatment; (2) needs satisfaction was significantly related to perceived dental competence (positive), autonomous motivation (positive), and controlled motivation (negative) for dental care; (3) perceived competence was significantly positively, and controlled motivation was significantly negatively associated with self‐rated oral health and oral‐health‐related quality of life; (4) autonomous motivation for dental treatment was significantly positively associated with valuing continued dental treatment; and (5) the three oral‐health‐related variables were all significantly positively linked to subjective dental well‐being. A structural equation model supported the SDT process model.

A self-determination process model of physical activity adoption in the context of a randomized controlled trial

Objective: The PA Counseling (PAC) trial tested a primary care intervention using Self-Determination Theory (SDT) as the guiding framework. This paper presents specific results related to SDT constructs in a physical activity (PA) context. Specifically, whether patients who received both brief autonomy supportive PA counseling from their health-care provider and intensive (3 month) autonomy supportive counseling from a PA counselor would report greater levels of autonomy support, autonomous motivation, perceived competence and PA adoption, than patients receiving only brief counseling. In addition, we tested Williams’ SDT process model in the context of PA adoption. Method: Measures of autonomous motivation and perceived competence for PA were measured at baseline and 6 weeks. PA was assessed at baseline and 13 weeks. An autonomy support index was calculated by multiplying minutes of counseling by perceptions of autonomy support. Group differences in autonomy support, autonomous motivation, perceived competence and PA were examined. The SDT process model of PA adoption was tested via path analysis. Results: The results showed higher autonomy support and autonomous motivation at 6 weeks and higher PA levels at 13 weeks for the experimental group. The SDT process model for PA adoption showed that autonomous motivation and perceived competence at 6 weeks significantly predicted 13-week PA for the experimental group. Conclusions: This study provides a rigorous field test of SDT theory in a PA context. It demonstrates the versatility and applicability of the SDT model for health behavior change. SDT-trained PA counselors appear to provide valuable contribution to facilitating patient behavior change, by increasing patient autonomous motivation for PA.

Testing a self-determination theory intervention for motivating tobacco cessation: Supporting autonomy and competence in a clinical trial.

A longitudinal randomized trial tested the self-determination theory (SDT) intervention and process model of health behavior change for tobacco cessation (N = 1006). Adult smokers were recruited for a study of smokers' health and were assigned to intensive treatment or community care. Participants were relatively poor and undereducated. Intervention patients perceived greater autonomy support and reported greater autonomous and competence motivations than did control patients. They also reported greater medication use and significantly greater abstinence. Structural equation modeling analyses confirmed the SDT process model in which perceived autonomy support led to increases in autonomous and competence motivations, which in turn led to greater cessation. The causal role of autonomy support in the internalization of autonomous motivation, perceived competence, and smoking cessation was supported.

Testing a self-determination theory process model for promoting glycemic control through diabetes self-management.

A longitudinal study tested the self-determination theory (SDT) process model of health behavior change for glycemic control within a randomized trial of patient activation versus passive education. Glycosylated hemoglobin for patients with Type 2 diabetes (n=159) was assessed at baseline, 6 months, and 12 months. Autonomous motivation and perceived competence were assessed at baseline and 6 months, and the autonomy supportiveness of clinical practitioners was assessed at 3 months. Perceptions of autonomy and competence were promoted by perceived autonomy support, and changes in perceptions of autonomy and competence, in turn, predicted change in glycemic control. Self-management behaviors mediated the relation between change in perceived competence and change in glycemic control. The self-determination process model fit the data well.