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A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description.

Silva MN, Markland D, Minderico CS, Vieira PN, Castro MM, Coutinho SR, Santos TC, Matos MG, Sardinha LB, Teixeira PJ - BMC Public Health (2008)

Bottom Line: Participants in the intervention group meet weekly or bi-weekly with a multidisciplinary intervention team (30 2 h sessions in total), and go through a program covering most topics considered critical for successful weight control.Comparison group receive a general health education curriculum.After the program, all subjects are follow-up for a period of 2 years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Exercise and Health, Faculty of Human Kinetics, Technical University of Lisbon, Portugal. mnsilva@fmh.utl.pt

ABSTRACT

Background: Research on the motivational model proposed by Self-Determination Theory (SDT) provides theoretically sound insights into reasons why people adopt and maintain exercise and other health behaviors, and allows for a meaningful analysis of the motivational processes involved in behavioral self-regulation. Although obesity is notoriously difficult to reverse and its recidivism is high, adopting and maintaining a physically active lifestyle is arguably the most effective strategy to counteract it in the long-term. The purposes of this study are twofold: i) to describe a 3-year randomized controlled trial (RCT) aimed at testing a novel obesity treatment program based on SDT, and ii) to present the rationale behind SDT's utility in facilitating and explaining health behavior change, especially physical activity/exercise, during obesity treatment.

Methods: Study design, recruitment, inclusion criteria, measurements, and a detailed description of the intervention (general format, goals for the participants, intervention curriculum, and main SDT strategies) are presented. The intervention consists of a 1-year group behavioral program for overweight and moderately obese women, aged 25 to 50 (and pre-menopausal), recruited from the community at large through media advertisement. Participants in the intervention group meet weekly or bi-weekly with a multidisciplinary intervention team (30 2 h sessions in total), and go through a program covering most topics considered critical for successful weight control. These topics and especially their delivery were adapted to comply with SDT and Motivational Interviewing guidelines. Comparison group receive a general health education curriculum. After the program, all subjects are follow-up for a period of 2 years.

Discussion: Results from this RCT will contribute to a better understanding of how motivational characteristics, particularly those related to physical activity/exercise behavioral self-regulation, influence treatment success, while exploring the utility of Self-Determination Theory for promoting health behavior change in the context of obesity.

Trial registration: Clinical Trials Gov. Identifier NCT00513084.

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Related in: MedlinePlus

Model Describing Internalization and Human Motivation. Model shows different types of motivation and regulation continuum reflecting varying degrees of internalization and self-determination. This continuum reflects a simplex-ordered structure, evident when the correlation between scales measuring adjacent types of motivation such as external regulation and introjected regulation is higher than the correlation between dimensions that lie further apart such as external regulation and identified regulation. Adapted from [68].
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Figure 1: Model Describing Internalization and Human Motivation. Model shows different types of motivation and regulation continuum reflecting varying degrees of internalization and self-determination. This continuum reflects a simplex-ordered structure, evident when the correlation between scales measuring adjacent types of motivation such as external regulation and introjected regulation is higher than the correlation between dimensions that lie further apart such as external regulation and identified regulation. Adapted from [68].

Mentions: According to Deci and Ryan, intrinsic motivation is linked to greater productivity, creativity, spontaneity, cognitive flexibility, and perseverance [12]. However, most human behaviors are not intrinsically motivated, which highlights the importance of studying extrinsic forms of motivation. Four types of extrinsic motivation have been described, which can be located on a self-determination continuum [15]. External regulation is at the lower end of the continuum. It means doing something in order to gain a reward or to avoid a punishment administered by others. Introjected regulation involves an internal feeling of obligation, a need to act in order to avoid feelings of guilt (although the pressure stems from inside, the individual does not feel free regarding the behavior). Identified Regulation concerns doing something based on the value of its consequences. In this case, the individual feels free to act and does so because the outcomes are personally important. Finally, when a behavior is coherent with the person's other values, personality schemas and sense of self, the regulation is fully self-determined and said to be integrated. SDT proposes that human motivation, vitality, development, and psychological adaptation can be explained by the process of internalization, that is, movement along this continuum [13]. A model describing internalization and human motivation is presented in Figure 1.


A randomized controlled trial to evaluate self-determination theory for exercise adherence and weight control: rationale and intervention description.

Silva MN, Markland D, Minderico CS, Vieira PN, Castro MM, Coutinho SR, Santos TC, Matos MG, Sardinha LB, Teixeira PJ - BMC Public Health (2008)

Model Describing Internalization and Human Motivation. Model shows different types of motivation and regulation continuum reflecting varying degrees of internalization and self-determination. This continuum reflects a simplex-ordered structure, evident when the correlation between scales measuring adjacent types of motivation such as external regulation and introjected regulation is higher than the correlation between dimensions that lie further apart such as external regulation and identified regulation. Adapted from [68].
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2483280&req=5

Figure 1: Model Describing Internalization and Human Motivation. Model shows different types of motivation and regulation continuum reflecting varying degrees of internalization and self-determination. This continuum reflects a simplex-ordered structure, evident when the correlation between scales measuring adjacent types of motivation such as external regulation and introjected regulation is higher than the correlation between dimensions that lie further apart such as external regulation and identified regulation. Adapted from [68].
Mentions: According to Deci and Ryan, intrinsic motivation is linked to greater productivity, creativity, spontaneity, cognitive flexibility, and perseverance [12]. However, most human behaviors are not intrinsically motivated, which highlights the importance of studying extrinsic forms of motivation. Four types of extrinsic motivation have been described, which can be located on a self-determination continuum [15]. External regulation is at the lower end of the continuum. It means doing something in order to gain a reward or to avoid a punishment administered by others. Introjected regulation involves an internal feeling of obligation, a need to act in order to avoid feelings of guilt (although the pressure stems from inside, the individual does not feel free regarding the behavior). Identified Regulation concerns doing something based on the value of its consequences. In this case, the individual feels free to act and does so because the outcomes are personally important. Finally, when a behavior is coherent with the person's other values, personality schemas and sense of self, the regulation is fully self-determined and said to be integrated. SDT proposes that human motivation, vitality, development, and psychological adaptation can be explained by the process of internalization, that is, movement along this continuum [13]. A model describing internalization and human motivation is presented in Figure 1.

Bottom Line: Participants in the intervention group meet weekly or bi-weekly with a multidisciplinary intervention team (30 2 h sessions in total), and go through a program covering most topics considered critical for successful weight control.Comparison group receive a general health education curriculum.After the program, all subjects are follow-up for a period of 2 years.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Exercise and Health, Faculty of Human Kinetics, Technical University of Lisbon, Portugal. mnsilva@fmh.utl.pt

ABSTRACT

Background: Research on the motivational model proposed by Self-Determination Theory (SDT) provides theoretically sound insights into reasons why people adopt and maintain exercise and other health behaviors, and allows for a meaningful analysis of the motivational processes involved in behavioral self-regulation. Although obesity is notoriously difficult to reverse and its recidivism is high, adopting and maintaining a physically active lifestyle is arguably the most effective strategy to counteract it in the long-term. The purposes of this study are twofold: i) to describe a 3-year randomized controlled trial (RCT) aimed at testing a novel obesity treatment program based on SDT, and ii) to present the rationale behind SDT's utility in facilitating and explaining health behavior change, especially physical activity/exercise, during obesity treatment.

Methods: Study design, recruitment, inclusion criteria, measurements, and a detailed description of the intervention (general format, goals for the participants, intervention curriculum, and main SDT strategies) are presented. The intervention consists of a 1-year group behavioral program for overweight and moderately obese women, aged 25 to 50 (and pre-menopausal), recruited from the community at large through media advertisement. Participants in the intervention group meet weekly or bi-weekly with a multidisciplinary intervention team (30 2 h sessions in total), and go through a program covering most topics considered critical for successful weight control. These topics and especially their delivery were adapted to comply with SDT and Motivational Interviewing guidelines. Comparison group receive a general health education curriculum. After the program, all subjects are follow-up for a period of 2 years.

Discussion: Results from this RCT will contribute to a better understanding of how motivational characteristics, particularly those related to physical activity/exercise behavioral self-regulation, influence treatment success, while exploring the utility of Self-Determination Theory for promoting health behavior change in the context of obesity.

Trial registration: Clinical Trials Gov. Identifier NCT00513084.

Show MeSH
Related in: MedlinePlus