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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

Relations Between Psychological Needs and Motivational Styles From Self-Determination Theory and the Core Principles from Motivational Interviewing. Parallels between MI main strategies and factors that are considered in SDT to facilitate integration are striking, providing a theoretical framework for understanding how change occurs. The construct of need satisfaction, as conceptualized within SDT, provides a useful way to understand the positive effects of motivational interviewing. Adapted from [38].
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Figure 3: Relations Between Psychological Needs and Motivational Styles From Self-Determination Theory and the Core Principles from Motivational Interviewing. Parallels between MI main strategies and factors that are considered in SDT to facilitate integration are striking, providing a theoretical framework for understanding how change occurs. The construct of need satisfaction, as conceptualized within SDT, provides a useful way to understand the positive effects of motivational interviewing. Adapted from [38].

Mentions: Many of the previous strategies are concordant with Motivational Interviewing (MI) [36], a counseling method aimed at promoting behavior change which has successfully been applied to a wide range of health behaviors [37]. Markland, Ryan, Tobin and Rollnick [38] and Vansteenkiste and Sheldon [39] have detailed the parallels between MI and SDT, showing that SDT's theoretical focus on the internalization of therapeutic change and on need satisfaction is fully compatible with key principles and clinical strategies within MI. MI involves avoiding controlling behaviors such as argumentation and direct persuasion for change. Instead, the approach seeks to empower participants to pursue change by eliciting their own personal reasons for change, expressing empathy, supporting self-efficacy, "rolling with" resistance, and helping them to become more aware of discrepancies between goals and actions. According to Markland et al[38] and Vansteenkiste & Sheldon [39] the construct of need satisfaction, as conceptualized within SDT, provides a useful way to understand the positive effects of motivational interviewing. MI's key components [33] may be interpreted in terms of the satisfaction of SDT's three needs by its provision of support for autonomously motivated change, presentation of a clear structure to the behavior change environment, and an engaged and involved relationship with the client so that he or she feels personally understood and accepted (see Figure 3). Thus, MI's practical techniques can help to translate SDT's concept of the facilitation of the process of internalization by need satisfaction into specific therapeutic practices and present new ways of testing and developing SDT.


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)

Relations Between Psychological Needs and Motivational Styles From Self-Determination Theory and the Core Principles from Motivational Interviewing. Parallels between MI main strategies and factors that are considered in SDT to facilitate integration are striking, providing a theoretical framework for understanding how change occurs. The construct of need satisfaction, as conceptualized within SDT, provides a useful way to understand the positive effects of motivational interviewing. Adapted from [38].
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Relations Between Psychological Needs and Motivational Styles From Self-Determination Theory and the Core Principles from Motivational Interviewing. Parallels between MI main strategies and factors that are considered in SDT to facilitate integration are striking, providing a theoretical framework for understanding how change occurs. The construct of need satisfaction, as conceptualized within SDT, provides a useful way to understand the positive effects of motivational interviewing. Adapted from [38].
Mentions: Many of the previous strategies are concordant with Motivational Interviewing (MI) [36], a counseling method aimed at promoting behavior change which has successfully been applied to a wide range of health behaviors [37]. Markland, Ryan, Tobin and Rollnick [38] and Vansteenkiste and Sheldon [39] have detailed the parallels between MI and SDT, showing that SDT's theoretical focus on the internalization of therapeutic change and on need satisfaction is fully compatible with key principles and clinical strategies within MI. MI involves avoiding controlling behaviors such as argumentation and direct persuasion for change. Instead, the approach seeks to empower participants to pursue change by eliciting their own personal reasons for change, expressing empathy, supporting self-efficacy, "rolling with" resistance, and helping them to become more aware of discrepancies between goals and actions. According to Markland et al[38] and Vansteenkiste & Sheldon [39] the construct of need satisfaction, as conceptualized within SDT, provides a useful way to understand the positive effects of motivational interviewing. MI's key components [33] may be interpreted in terms of the satisfaction of SDT's three needs by its provision of support for autonomously motivated change, presentation of a clear structure to the behavior change environment, and an engaged and involved relationship with the client so that he or she feels personally understood and accepted (see Figure 3). Thus, MI's practical techniques can help to translate SDT's concept of the facilitation of the process of internalization by need satisfaction into specific therapeutic practices and present new ways of testing and developing SDT.

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