Motivational characteristics of obese adolescents toward physical activity: Contribution of self-determination theory

Behavior Change Techniques Involved in Physical Activity Interventions for Children With Chronic Conditions: A Systematic Review

BACKGROUND

Behavior change techniques (BCTs) have been extensively used in physical activity interventions for children, however, no systematic reviews have synthesized their effects.

PURPOSE

The present review aimed to identify the most promising BCTs used in physical activity interventions associated with (i) increased physical activity behavior and (ii) positive psychosocial outcomes in children with chronic conditions.

METHODS

A systematic search of 6 databases identified 61 articles as eligible for inclusion. Data, including BCTs, were extracted from these studies and analyzed descriptively. Due to the heterogeneity of interventions, chronic conditions, and outcome measures, a meta-analysis was not conducted.

RESULTS

Social support (unspecified), graded tasks, generalization of target behavior, and credible source were the most commonly reported and most promising (i.e., present in 2+ studies evidencing significant effects) BCTs across all studies. These BCTs were found to be especially relevant to improving psychosocial outcomes in the short- and long-term and improving physical activity behaviors in the long-term. Meanwhile, to improve short-term physical activity behaviors, in addition to social support (unspecified), action planning, goal setting (behavior), and problem solving were found to be promising BCTs.

CONCLUSIONS

The BCTs identified in this review may be relevant to incorporate when planning future interventions to support physical activity and psychosocial outcomes for children with chronic conditions.

Motivating Children and Adolescents in Obesity Treatment

Enhancing motivation is a crucial issue in pediatric obesity interventions, as behavioral changes related to food intake and physical exercise are difficult to carry out with an insufficient level of motivation. In the treatment setting, low motivation towards change may lead to early termination or inadequate treatment outcomes. This paper reviews widely-used models of motivation, including the transtheoretical model of change, self-determination theory, and motivational interviewing (MI). We introduce useful strategies based on each theoretical model to enhance motivation, such as an importance and confidence scale and a decisional balance technique. A review of recent MI interventions in children and adolescents is presented to discuss the efficacy of MI-based interventions and considerations for applying MI in pediatric obesity.

Concept Analysis of Relatedness in Physical Activity Among Adolescents

AIM

This analysis seeks to clarify the concept of relatedness in physical activity (PA) among adolescents.

BACKGROUND

Health-related behavior research highlights the importance of focusing on individual psychological needs such as relatedness in PA to improve adolescents' motivation toward PA. Although relatedness in PA has been associated with PA participation among adolescents, a thorough analysis of the concept is lacking. Conceptual clarification of relatedness in the context of PA is needed for promoting consistency between conceptual and operational definitions and refining empirical measurement.

DESIGN

The 6-steps of Rodgers' (2000) evolutionary method of concept analysis was used to analyze the data and identify attributes, surrogate/related terms, antecedents, and consequences of the relatedness concept.

METHOD

Several databases were used to extract relevant articles. A total of 113 were identified. Forty articles met the inclusion criteria. In addition, twenty-six articles were included through other sources. The review process yielded a final set of 66 articles.

RESULT

A refined definition of relatedness in PA is an adolescent's perception of feeling socially connected with significant people in a reciprocal, caring, and trusting relationship that is a self-system process and promotes a sense of belonging and internalization within PA contexts. Attributes, surrogate/related terms, antecedents and consequences of relatedness in PA were identified from extant literature.

CONCLUSION

This comprehensive analysis provides a clarification of the conceptual definition of relatedness in PA among adolescents. The concept can guide nurses in designing interventions to improve health behavior or promoting changes in health policy. Future research is needed to refine operational definitions of relatedness so that they represent the defining attributes of the concept.

Adolescents With Overweight or Obesity: A Qualitative Study of Participation in an Internet-Based Program to Increase Physical Activity

Adolescents who are overweight or obese are reported to be less active than their peers. Motivation is a critical factor in sustaining physical activity and thereby positive health outcomes. This qualitative study explores how participation in a 12-week Internet-based intervention study, Young & Active, influenced the participants' short-term and long-term motivation to increase and sustain physical activity. The overall purpose of Young & Active was to design, test, and evaluate a health-promoting Internet-based program for use in the school health services in Norway. The program was informed by self-determination theory and motivational interviewing. Two postintervention qualitative research interviews were conducted with 21 adolescents, aged 13 to 14 years, with a 9- to 12-month interval. The adolescents were recruited from a total of 84 participants from the Young & Active study intervention group. Data were analyzed using qualitative content analysis. Self-determination theory was used as a theoretical and explanatory framework. Following the motivational continuum from self-determination theory, all adolescents showed changes in motivation, from extrinsic toward more intrinsic motivation, and for some, a reversal after completing the program. Analysis of the adolescents' utterances formed patterns that could be divided into four main categories: (a) reinforcement of a habit, (b) promotion of competence and enjoyment, (c) boost of temporary change, and (d) reinforcement of adverse habits. An Internet-based intervention may help adolescents increase and sustain physical activity if participation is based on self-choice and if they have sufficient support in their social environments. The intervention alone is not enough to support adolescents who are less motivated or have other challenges in life and may even provoke resistance and reinforce negative health behavior. Such a program may be used together with face-to-face counseling in school health services, provided that it is further refined on a larger scale and that the counseling is performed by qualified health service professionals.

Profiles of Basic Psychological Needs in Exercise Settings: An Examination of Differences in Contextual Motivation, Affect, and Achievement Goals

Understanding leisure-time physical activity is vital for a healthy world. It is well known that physical activity has positive effects on psychological health, but further evidence is required to ascertain how different environments influence positive behavioral outcomes. Thus, the aim of this study was to examine the differences in contextual motivation, affect, and achievement goals according to profiles of basic psychological needs in adult exercisers. The sample consisted of 401 young adult exercisers ranging in age from 18 to 40 years from fitness centers in Izmir, Turkey. Participants completed measures of basic needs satisfaction, exercise motivations, trait affect, and achievement goals. Hierarchical cluster analysis, k-mean cluster analysis, multivariate analysis of variance, and post hoc analyses were performed. The results in this study revealed that the participants in Cluster 1, who were labeled as "very satisfied", had higher scores than the other clusters in terms of positive behavioral outcomes. The results of this study revealed that greater satisfaction of the basic psychological needs leads to positive behavioral consequences in exercise contexts.

Flourishing, Affect, and Relative Autonomy in Adult Exercisers: A Within-Person Basic Psychological Need Fulfillment Perspective

Flourishing is a construct used to understand human growth. Exercise psychology research is scant concerning this valuable construct. Hence, our purpose was to examine different levels of flourishing and related constructs within a large group of self-reported exercisers from a basic psychological need profile perspective. Participants were 389 female and 387 male adults attending fitness centers. Hierarchical cluster analyses revealed the presence of three clusters with significantly different psychological need profiles across the three basic needs. Separate multivariate analyses of variance were used for the analyses for our demographic variables and psychological variables. Follow-up post hoc tests showed that these clusters differed significantly and were low to moderate in meaningfulness regarding exercise min/week and sports experience. The clusters differed significantly, with moderate to large meaningfulness, in flourishing, positive affect, and relative autonomy. Self-reported exercise and sports participation were not the important cluster characteristics. Our results indicated that self-reported levels of flourishing, positive affect, and autonomy differ even within a large group of self-reported exercisers attending fitness centers that on average exceeded the weekly-recommended number of moderate-to-vigorous activity minutes. Thus, our results suggest the importance of fitness centers in meeting their participants’ three basic needs.

Associations Between Parenting Factors, Motivation, and Physical Activity in Overweight African American Adolescents

Background

Positive parenting practices and environmental supports have been linked to physical activity (PA) levels in youth, yet factors associated with positive parenting styles have been understudied in African American adolescents.

Purpose

This study expands on previous literature by examining associations between motivation, parenting factors associated with Self-Determination Theory's psychological needs (competence, autonomy, and relatedness) including authoritative parenting, autonomy support and emotional and tangible support, and adolescent moderate-to-vigorous PA (MVPA) and light PA (LPA).

Methods

Participants were African American adolescents (N = 148; Mage = 13.6 years; MBMI% = 96.6) and their care-givers (Mage = 43.4 years; MBMI = 37.4) enrolled in the Families Improving Together for Weight Loss trial. Parenting factors were measured using self-report surveys, and PA minutes were measured using 7-day accelerometry estimates.

Results

Regression analyses indicated that overall models for MVPA (F(11,134) = 4.35; R2 = 0.26) and LPA (F(11,134) = 5.84, R2 = 0.32) were significant. Adolescent motivation for PA (B = 0.58, SE = 0.16) was positively associated with MVPA minutes. Authoritative parenting (B = 15.71, SE = 4.38) and tangible support (B = 8.53, SE = 4.02) were positively associated with adolescent LPA minutes. Unexpectedly, emotional support was negatively associated with both MVPA (B = -0.47, SE = 0.17) and LPA (B = -11.22, SE = 4.79), with follow-up analyses showing this relationship stronger in males.

Conclusion

Findings highlight the importance of adolescent motivation for PA onMVPA and positive parenting styles and tangible supports on adolescent LPA in overweight African American youth. Recommendations for integrating these factors within the context of intervention studies are discussed.

Development and validation of the 'Echelle de Motivation envers l'Activité Physique en contexte de Santé': A motivation scale towards health-oriented physical activity in French

This article presents the validation of the 'Echelle de Motivation envers l'Activité Physique en contexte de Santé' including the six forms of motivation underlined by self-determination theory. Study 1 underlines the content validity of a pool of 30 items ( N = 20). Study 2 supports the six-factor structure validity of the 18-item Echelle de Motivation envers l'Activité Physique en contexte de Santé ( N = 309). Study 3 ( N = 191) confirms structure validity, as well as concurrent validity and 2-week temporal reliability. The Echelle de Motivation envers l'Activité Physique en contexte de Santé can be considered as a valid and reliable tool to use in prevention or rehabilitation contexts.

Motivational Profiles for Physical Activity Practice in Adults with Type 2 Diabetes: A Self-Determination Theory Perspective

Drawing on Self-Determination Theory, this study explored the motivational profiles toward Physical Activity (PA) among adults with type 2 diabetes and the relationships between motivational profile, perceived competence and PA. Participants were 350 men and women (Mean age 62.77 years) who were interviewed on their motivations toward PA, perceived level of competence to practice, and PA practice. Cluster analyses reveal the existence of three distinct profiles: "High Combined" (ie, high scores on motivations ranging from intrinsic to external regulation, moderate level on amotivation), "Self-Determined" (ie, high scores on intrinsic, integrated, and identified regulations; low scores on other regulations), and "Moderate" (ie, moderate scores on all regulations). Participants with "High Combined" and "Self-Determined" profiles reported higher perceived competence and longer leisure-time PA practice in comparison to those with a "Moderate" profile. This study highlights the necessity of adopting a person-centered approach to better understand motivation toward PA among type 2 diabetics.

Exercise and Epstein's TARGET for treatment of depressive symptoms: A randomized study

This study was designed with a dual goal: (1) to compare the change in the scores of depressive symptoms by means of the implementation of three intervention programs in comparison to a control group: a) based on Epstein's TARGET (ET), b) without TARGET strategies (NET), and c) under conditions of active exercise (AE); and (2) to analyze whether the Self-determination Index (SDI) predicts the reduction of depressive symptoms. The participants (N = 106; 68 females and 38 males), aged between 18-30 years, were randomly assigned to one of the groups. Each treatment lasted 8 weeks (3 hours/week). Of the ET participants, 59.26% showed a therapeutic response, defined as a 50% reduction in the reference score, versus 25.93% for the NET, 19.23% for the AE, and 3.84% for the control group. After six months, the ET group increased their percentage of therapeutic response by slightly more than 10%, which did not occur in the other groups. SDI predicted lower levels of depressive symptoms, and our findings indicate that TARGET strategies can have a direct effect on depressive symptoms at the time of intervention and an indirect effect at a later stage due to their impact on future levels of physical activity.

Child self-reported motivations for weight loss: impact of personal vs. social/familial motives on family-based behavioral weight loss treatment outcomes

PURPOSE

Parent motivation is related to successful treatment outcome among children enrolled in obesity treatment. However, the impact of child weight loss motivation on treatment outcome has not been investigated. The current study evaluated weight loss motives among treatment-seeking, overweight children, and their relationship to treatment outcome.

METHODS

The current study is a secondary analysis of a primary study examining a parent-only and parent + child childhood obesity treatment. Study participants included 77 children (aged 8-12, 58 % female). Assessments were completed at baseline, post-treatment, and at 6-months post-treatment. Children completed standardized height and weight procedures. In addition, they completed a checklist of reasons children may be motivated to lose weight. Motives were divided into two scales reflecting personal and social/familial reasons to lose weight. Regression analyses were used to calculate associations between the number of weight loss motives endorsed and treatment completion, sessions attended, and child BMI.

RESULTS

A greater number of social/familial motives were significantly predictive of session attendance, treatment completion, and a lower child BMI at the post-treatment assessment.

CONCLUSIONS

Children who are motivated to lose weight because of family/social influences may be more highly engaged in treatment and lose more weight, as compared to children who are less motivated by family and social reasons.

Self-determined motivation and physical activity in children and adolescents: a systematic review and meta-analysis

OBJECTIVE

Self-determination theory is used as a framework for examining the relation between motivation and physical activity. The purpose of this review was to systematically review studies that assessed the association between self-determined motivation and physical activity levels in children and adolescents.

METHOD

We searched electronic databases in April 2013. Included studies assessed the relation between motivation (as outlined in self-determination theory) and physical activity in children and adolescents.

RESULTS

Forty-six studies (n=15,984 participants) met the inclusion criteria. Meta-analysis indicated that overall levels of self-determined motivation had a weak to moderate, positive associations with physical activity (ρ=.21 to .31). Autonomous forms of motivation (i.e., intrinsic motivation and identified regulation) had moderate, positive associations with physical activity (ρ=.27 to .38), whereas controlled forms of motivation (i.e., introjection and external regulation) had weak, negative associations with physical activity (ρ=-.03 to -.17). Amotivation had a weak, negative association with physical activity (ρ=-.11 to -.21).

CONCLUSIONS

Evidence provides some support for self-determination theory tenets. However, there was substantial heterogeneity in most associations and many studies had methodological shortcomings.