Motivation for Physical Activity among U.S. Adolescents: A Self-Determination Theory Perspective

Determinants of physical activity habit formation: a theory-based qualitative study among young adults

PURPOSE

Engagement in physical activity significantly contributes to reducing the onset and severity of chronic diseases. Nonetheless, establishing habits around this behaviour remains a persistent challenge. This research endeavours to discern the determinants influencing the formation of physical activity habit among young adults in Israel, drawing upon a socio-ecological model.

METHODS

A qualitative approach with phenomenological-hermeneutical method was used. In-depth interviews were carried to cover four levels of the socio-ecological model.

RESULTS

Interviewees were categorized into three subgroups according to their physical activity habit strength: Habitually physically active (n = 8), Variably physically active (n = 11), and physically inactive (n = 6). The content analysis yielded four overarching themes associated with physical activity habit formation. Intrapersonal determinants encompassed personal traits, perceptions and attitudes, perceived benefits, and emotional responses related to physical activity. Interpersonal determinants encompassed social support, modelling support, and peer pressure. Community determinants pertained to social norms, resource availability, and accessibility. Finally, public policy considerations encompassed educational policies as well as workplace policies and cultural influences.

CONCLUSIONS

This study highlights the unique determinants contributing to the formation of physical activity habit. As intrapersonal and interpersonal factors are significant determinants, interventions should focus on these elements in order to promote this behaviour among young adults.

The Effect of Motivation on Physical Activity among Middle and High School Students

The study addressed two main objectives: (i) to investigate disparities in motivation dimensions regarding extracurricular physical activity and (ii) to identify the influence of motivation on time spent in formal and informal physical activity. A sample of 704 adolescents (56% girls) from middle (46%) and high school (54%), with an average age of 14.88 ± 2.52, was assessed for different motivation dimensions using the Questionnaire of Motivation for Sports Activities (QMSA). Additionally, participants were categorized based on extracurricular physical activity practice. Multivariate analyses and multiple linear regressions were conducted to examine the effect of physical activity type on motivation dimensions and identify predictors of time spent in formal and informal physical activities, respectively. Results indicated that motivation varied significantly with extracurricular physical activity practice (p < 0.05), with students involved in extracurricular activities being more motivated. Sex and age differences were observed, with boys showing higher motivation in certain dimensions (achievement status (p < 0.001); group activity (p = 0.027); contextual (p = 0.004); technical improvement (p = 0.012) and older participants having lower scores in all dimensions. The influence of family and friends was a significant predictor only for boys in formal physical activity (p = 0.039). In terms of time spent in physical activity, group activity was a predictor for informal activities (p < 0.001), while technical improvement was a predictor for formal activities (p < 0.001), with notable sex differences. These findings underscore the importance of considering sex- and age-specific motivations when promoting physical activity among adolescents.

Pilot Randomized Controlled Trial of Lymfit: A Theory-Guided Exercise Intervention for Young Adults with Lymphoma

Despite the rapidly emerging evidence on the contributions of physical activity to improving cancer-related health outcomes, adherence to physical activity among young adults with lymphoma remains suboptimal. Guided by self-determination theory (SDT), the Lymfit intervention (a 12-week individualized exercise program with bi-weekly kinesiologist support and an activity tracker) aimed to foster autonomous motivation toward physical activity. This pilot randomized controlled trial aimed to evaluate the feasibility, acceptability, and preliminary effects of Lymfit. Young adults (N = 26; mean age of 32.1 years) with lymphoma who were newly diagnosed and those up to six months after completing treatment were recruited and randomly assigned one-to-one to either the intervention group (n = 13) or a wait-list control group (n = 13). All a priori feasibility benchmarks were met, confirming the feasibility of the study in terms of recruitment uptake, retention, questionnaire completion, intervention fidelity, missing data, Fitbit wear adherence, and control group design. The intervention acceptability assessment showed high ratings, with eight out of ten items receiving >80% high ratings. At post-intervention, an analysis of covariance models showed a clinically significant increase in self-reported physical activity levels, psychological need satisfaction, and exercise motivation in the intervention group compared to controls. Lymfit also led to meaningful changes in six quality-of-life domains in the intervention group, including anxiety, depression, fatigue, sleep disturbance, social roles and activities, and pain interference. The findings support Lymfit as a promising means to meet psychological needs and increase the autonomous motivation for physical activity in this group. A fully powered efficacy trial is warranted to assess the validity of these findings.

Effectiveness of mHealth App-Based Interventions for Increasing Physical Activity and Improving Physical Fitness in Children and Adolescents: Systematic Review and Meta-Analysis

BACKGROUND

The COVID-19 pandemic has significantly reduced physical activity (PA) levels and increased sedentary behavior (SB), which can lead to worsening physical fitness (PF). Children and adolescents may benefit from mobile health (mHealth) apps to increase PA and improve PF. However, the effectiveness of mHealth app-based interventions and potential moderators in this population are not yet fully understood.

OBJECTIVE

This study aims to review and analyze the effectiveness of mHealth app-based interventions in promoting PA and improving PF and identify potential moderators of the efficacy of mHealth app-based interventions in children and adolescents.

METHODS

We searched for randomized controlled trials (RCTs) published in the PubMed, Web of Science, EBSCO, and Cochrane Library databases until December 25, 2023, to conduct this meta-analysis. We included articles with intervention groups that investigated the effects of mHealth-based apps on PA and PF among children and adolescents. Due to high heterogeneity, a meta-analysis was conducted using a random effects model. The Cochrane Risk of Bias Assessment Tool was used to evaluate the risk of bias. Subgroup analysis and meta-regression analyses were performed to identify potential influences impacting effect sizes.

RESULTS

We included 28 RCTs with a total of 5643 participants. In general, the risk of bias of included studies was low. Our findings showed that mHealth app-based interventions significantly increased total PA (TPA; standardized mean difference [SMD] 0.29, 95% CI 0.13-0.45; P<.001), reduced SB (SMD -0.97, 95% CI -1.67 to -0.28; P=.006) and BMI (weighted mean difference -0.31 kg/m2, 95% CI -0.60 to -0.01 kg/m2; P=.12), and improved muscle strength (SMD 1.97, 95% CI 0.09-3.86; P=.04) and agility (SMD -0.35, 95% CI -0.61 to -0.10; P=.006). However, mHealth app-based interventions insignificantly affected moderate to vigorous PA (MVPA; SMD 0.11, 95% CI -0.04 to 0.25; P<.001), waist circumference (weighted mean difference 0.38 cm, 95% CI -1.28 to 2.04 cm; P=.65), muscular power (SMD 0.01, 95% CI -0.08 to 0.10; P=.81), cardiorespiratory fitness (SMD -0.20, 95% CI -0.45 to 0.05; P=.11), muscular endurance (SMD 0.47, 95% CI -0.08 to 1.02; P=.10), and flexibility (SMD 0.09, 95% CI -0.23 to 0.41; P=.58). Subgroup analyses and meta-regression showed that intervention duration was associated with TPA and MVPA, and age and types of intervention was associated with BMI.

CONCLUSIONS

Our meta-analysis suggests that mHealth app-based interventions may yield small-to-large beneficial effects on TPA, SB, BMI, agility, and muscle strength in children and adolescents. Furthermore, age and intervention duration may correlate with the higher effectiveness of mHealth app-based interventions. However, due to the limited number and quality of included studies, the aforementioned conclusions require validation through additional high-quality research.

TRIAL REGISTRATION

PROSPERO CRD42023426532; https://tinyurl.com/25jm4kmf.

What are the correlates of intention to be physically active in Brazilian adolescents? A network analysis

OBJECTIVE

The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be physically active in Brazilian adolescents.

METHODS

This is a cross sectional study based on the third edition of the National School Health Survey. The study included a total of 53,937 adolescents. To assess the intention to be physically active, only who engaged in less than 300 min of physical activity per week were included. Participants were asked: "If you had the opportunity to practice physical activity most days of the week, what would your attitude be?" Individual characteristics, physical activity domains, social factors, school, and regional environments were used as exposures. Network analysis was utilized to evaluate the associations.

RESULTS

We observed that boys had higher intentions to be physically active compared to their peers, as did adolescents who perceived themselves as fat. In addition, students from private schools show a higher intention to regularly engage in physical activities, and in general, private schools offer more extracurricular physical activities.

CONCLUSION

In conclusion, individual factors such as sex and body image perception, and environmental factors such as school administrative dependency and availability of extracurricular activities had a significant contribution to the intention to be physically active among Brazilian adolescents.

Organized Physical Activity Program Participation, Physical Activity, and Related Psychosocial Factors Among Urban Adolescents

The study purpose was to examine whether adolescents who participated in organized physical activity (PA) programs differed from nonparticipants in motivation, social support, and self-efficacy related to PA; PA (min/hr); and sedentary screen time behavior. Thirty-nine 5th-7th grade adolescents participated in organized PA programs; 41 did not. Approximately 56.3% were Black, and 52.5% had annual family incomes <$20,000. Compared to nonparticipants, those who participated reported significantly higher social support (M = 2.32 vs. 3.13, p < .001) and fewer hours watching television or movies on a usual weekend day (M = 2.49 vs. 1.59, p = .016); and had higher accelerometer-measured vigorous PA (M = 0.58 vs. 1.04, p = .009) and moderate-to-vigorous PA (M = 2.48 vs. 3.45, p = .035). Involving adolescents in organized PA programs may be important for improving their moderate-to-vigorous PA, vigorous PA, and related psychosocial factors, as well as reducing sedentary screen time behavior.

An SMS Text Message-Based Type 2 Diabetes Prevention Program for Hispanic Adolescents With Obesity: Qualitative Co-Design Process

BACKGROUND

SMS text message-based interventions are a promising approach for reaching and engaging high-risk youths, such as Hispanic adolescents with obesity, in health promotion and disease prevention opportunities. This is particularly relevant, given that SMS text messaging is widely accessible and available and that adolescents are frequent texters. Including youths in the development of SMS text message content can lead to more acceptable and relevant messaging; however, few studies include this group as cocollaborators.

OBJECTIVE

This study aimed to use a co-design process to inform the development of SMS text messages that promote healthy physical activity (PA) and sleep behaviors among Hispanic adolescents with obesity.

METHODS

The co-design framework uses multiple methods across several phases. Self-determination theory and a literature review of SMS text message-based interventions guided the background and research phases. In the co-design phase, Hispanic adolescents (n=20) completed in-depth interviews to identify barriers and facilitators of PA and sleep, preferences for ways to emphasize key self-determination theory constructs (autonomy, competence, and relatedness), and suggestions for making SMS text message content engaging. In the design and content phase, interview findings were used to develop initial SMS text messages, which were then evaluated in the early evaluation phase by experts (n=6) and adolescents (n=6). Feedback from these panels was integrated into the SMS text message content during refinement.

RESULTS

The background phase revealed that few SMS text message-based interventions have included Hispanic adolescents. Common barriers and facilitators of activity and sleep as well as preferences for ways in which SMS text messages could provide autonomy, competence, and relatedness support were identified in the co-design phase. The youths also wanted feedback about goal attainment. Suggestions to make SMS text messages more engaging included using emojis, GIFs, and media. This information informed an initial bank of SMS text messages (N=116). Expert review indicated that all (116/116, 100%) SMS text messages were age and culturally appropriate; however, some (21/116, 18.1%) did not adequately address youth-identified barriers and facilitators of PA and sleep, whereas others (30/116, 25.9%) were not theoretically adherent. Adolescents reported that SMS text messages were easy to understand (116/116, 100%), provided the support needed for behavior change (103/116, 88.8%), and used mostly acceptable language (84/116, 72.4%). Feedback was used to refine and develop the final bank of 125 unique text messages.

CONCLUSIONS

Using a co-design process, a theoretically grounded, appealing, and relevant bank of SMS text messages promoting healthy PA and sleep behaviors to adolescents was developed. The SMS text messages will be further evaluated in a pilot study to assess feasibility, acceptability, and preliminary efficacy. The co-design process used in this study provides a framework for future studies aimed at developing SMS text message-based strategies among high-risk adolescents.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1016/j.cct.2023.107117.

Physical activity maintenance and increase in Chinese children and adolescents: the role of intrinsic motivation and parental support

Objective

This longitudinal study aimed to examine the association of intrinsic motivation, parental physical activity, and parental support with physical activity maintenance and increase among children and adolescents.

Methods

A sample of 2,424 children and adolescents in Shanghai, China participated in the two-wave survey before and during the COVID-19 pandemic. The questionnaire measured children and adolescents' physical activity and intrinsic motivation, as well as their parental physical activity and support (concern for their child and co-activity with their child). Multivariable logistic regressions were performed by groups to examine the associations between these factors and physical activity change.

Results

Most children and adolescents exhibited a decline in physical activity participation during the pandemic, as indicated by a mere 15.0 and 8.0% of individuals maintaining and increasing their pre-pandemic levels, respectively. Among the initially active participants, perceived self-choice [OR = 1.341 (95%CI: 1.173-1.533)] and parental concern [OR = 1.922 (95%CI: 1.204-3.068)] predicted maintained physical activity. Increased physical activity was predicted by perceived enjoyment [OR = 1.193 (95%CI: 1.046-1.362)] and parental co-activity (OR = 1.995 [95%CI: 1.095-3.633]).

Conclusion

This study provides longitudinal evidence that intrinsic motivation and parental support can have a positive impact when physical activity levels change significantly. Effective interventions targeting multilevel factors are needed to maintain or increase children and adolescents' physical activity.

Could the Hybridization of the SE/TGfU Pedagogical Models Be an Alternative for Learning Sports and Promoting Health? School Context Study

The present study aims to analyze the influence of the Sport Education (SE)/Teaching for understanding (TGfU) hybrid unit on enjoyment, perceived competence, intention to be physically active, skill execution, decision making, performance and game involvement. A short-term (12-lesson) pre-test/post-test quasi-experimental design was conducted in two groups: control (technical approach: 70 students; age = 14.43 ± 0.693; n = 32 female) and experimental (hybrid unit SE-TGfU: 67 students; age = 13.91 ± 0.900; n = 30 female). The coding instrument was based on the Game performance Assessment Instrument. The Enjoyment and Perceived Competence Scale and the Measure of Intentionality to be Physically Active questionnaire were also used. The results of pairwise comparisons between the groups showed higher post-test scores for most dependent variables for boys and girls using the hybrid SE/TGfU unit. Lower post-test scores were found in pairwise comparisons for several dependent variables in both boys and girls. The present study showed that the application of hybrid models SE/TGfU could increase and help facilitate students' game involvement and game performance, enjoyment, perceived competence and intention to be physically active, in both boys and girls. In future studies, it would be necessary to analyze psychological variables in the educational context for a deeper assessment.

Analysis of Academic Psychological Variables, Physical Education, and Physical Activity Levels of Mexican Students

Physical inactivity is a current worldwide, and especially Mexican adolescents. Therefore, this study has the following objectives: (i) to analyze the PA-LT pattern of Mexican adolescents; (ii) to analyze whether there are differences in emotional intelligence, basic psychological needs, academic motivation, self-esteem, and academic satisfaction according to the PA-LT pattern; (iii) to analyze the relationship between emotional intelligence, basic psychological needs, academic motivation, self-esteem, and academic satisfaction. A total of 748 secondary school students participated, of which 374 were girls (Mean age = 13.99; SD = 0.30) and 374 boys (Mean age = 14.02; SD = 0.33). The questionnaire comprised the following scales: IE, NPB-ESC, EMA, EA, and SIE. The main results obtained show that none of the girls stick to any active physical activity pattern during their spare time. In addition, physically active boys obtained better scores in emotional clarity, emotional repair, perception of academic competence, perception of social relationships, extrinsic motivation, intrinsic motivation, self-esteem, and satisfaction with school.

Motivation, Physical Activity, and Affect in Community-Dwelling Stroke Survivors: An Ambulatory Assessment Approach

BACKGROUND

Motivation is a frequently reported but far less studied driver for post-stroke physical activity participation. Motivation and physical activity may be important contributors to the prevention management and alleviation of affective symptoms among stroke survivors.

PURPOSE

To investigate the real-time associations between motivation, physical activity, and affect in the daily lives of community-dwelling stroke survivors using ecological momentary assessment (EMA) and accelerometry.

METHODS

Forty community-dwelling stroke survivors wore an accelerometer on the thigh and completed EMA surveys assessing motivation (autonomous motivation, controlled motivation) and affect (negative affect, positive affect) eight times daily for 7 days. Multivariate regression analysis and multilevel modeling investigated the associations between motivation, physical activity, and affect.

RESULTS

Greater autonomous motivation for physical activity was associated with less sedentary behavior (β = -0.40, p = .049) and more moderate-to-vigorous physical activity (β = 0.45, p = .020) participation in daily life. Greater autonomous motivation was momentarily associated with less depressed affect (β = -0.05, p < .001) and greater positive affect (β = 0.13, p < .001). Moreover, greater controlled motivation was momentarily associated with greater depressed affect (β = 0.06, p < .001). More intense physical activity was momentarily associated with greater positive affect (β = 0.13, p = .016). No moderating effect of motivation on the association between physical activity and affect was found.

CONCLUSIONS

Motivation and physical activity are momentarily associated with affect among stroke survivors. Assessing and fostering autonomous motivation may be beneficial for promoting physical activity and managing positive and depressed affect as stroke survivors return to the community.

Differential Patterns in Motivations for Practicing Sport and Their Effects on Physical Activity Engagement across the Lifespan

This study aims to report what motivates individuals to be physically active, to determine whether motivating factors influence physical activity (PA) levels, and whether this differs across the lifespan. This is a cross-sectional study with 498 individuals: 117 adolescents, 306 adults, and 75 older adults. PA was assessed using Baecke’s questionnaire, and motivating factors for practicing sports were investigated using a scale with twelve questions. The factor analysis identified three motivating factors for sports practice: psychosocial, bodily, and well-being. The scale’s overall reliability and internal consistency indicated a Cronbach’s alpha of 0.885. The analysis of covariance (ANCOVA) adjusted for sex indicated the three factors as having a significant effect on PA (p < 0.050); however, only the well-being factor showed a significant interaction with age groups (p = 0.023, ηp2 = 0.030). Subsequently, the effect of the well-being factor on PA scores in each age group was explored through regression analyses. Only older adults showed a significant association in the unadjusted [OR = 0.378, p = 0.001, R2 = 0.243] and the sex-adjusted analysis [OR = 0.377, p = 0.001, R2 = 0.288]. These results help us to better understand the underlying motivational reasons in different age groups for engaging in sports.

Understanding physical activity declines during COVID-19: The affective repercussions of disruption to exercise routines

Recent research has examined psychological factors that forestalled declines in physical activity (PA) during the early stages of the COVID-19 pandemic. Surprisingly, there has been limited evidence of an association between intrinsic motivation (IM) and PA. We reasoned that IM may have not predicted PA because COVID-19 restrictions limited opportunities to engage in exercise in ways that produced positive affective experiences (i.e., inherent rewards). Using data from a cross-sectional survey (N = 373 participants), we tested a moderated mediation model that predicted perceived changes to affective experiences during exercise would mediate the association between disruption to one's exercise routine and self-reported declines in PA, and that effects would be moderated by IM. Evidence of moderated mediation was found, suggesting that disruptions to exercise routines were associated with fewer positive affective experiences during exercise that predicted declines in PA engagement, especially for people who typically exercised for intrinsic reasons.

The art of forming habits: applying habit theory in changing physical activity behaviour

Background

Habits are obtained as a consequence of cue-contingent behavioural repetition. Context cues stimulate strong habits without an individual contemplating that action has been initiated. Because of its health-enhancing effects, making physical activity a part of one’s life is essential. This study examined the associations of physical activity (PA) behaviours with PA habits and the role of autonomous motivation in developing PA habits.

Methods

This study used a cross-sectional design. A structured questionnaire was implemented through emails to 226 university students, where PA levels, habits and autonomous motivation were self-reported.

Results

Binary logistic regression identified age groups, gender and participants who were trying to lose weight as the significant predictors in meeting physical activity guidelines. Path analysis showed that moderate-intensity physical activity (β = 0.045, CI = 0.069–0.248) and strength training exercises (β = 0.133, CI = 0.148–0.674) were significantly associated with PA habits (p < 0.01). Autonomous motivation was directly associated with PA habits (β = 0.062, CI = [0.295–0.541], p < 0.01) and was also significantly related to moderate-intensity physical activity (β = 0.243, CI = [0.078–0.266], p < 0.01) and strength training exercises (β = 0.202, CI = [0.033–0.594], p < 0.05).

Conclusions

The emphasis on experiment-based logic and interest in habit formation in the research community is extensive. As the college years offer an excellent opportunity to establish healthy behavioural interventions, encouraging students in regular PA and exhibiting an autonomous motivation towards PA may be necessary.

Autonomous motivation and action planning are longitudinally associated with physical activity during adolescence and early adulthood

We examined the associations of autonomous motivation, controlled motivation, and physical activity (PA) planning with PA participation over six years across the adolescent-to-adult transition. Participants from the NEXT Generation Health Study, a nationally representative cohort study of U.S. 10th graders (N=2785), completed surveys yearly from 2010 to 2016 (four years post-high school). This study used data from Waves 2 (W2) through 7 (W7). Data were analyzed using growth models accounting for the complex survey design and controlling for sex, race/ethnicity, and body mass index. A piecewise growth model with two pieces (Piece 1: W2-W4; Piece 2: W4-W7) indicated that PA declined during late adolescence (W2-W4) (b=-0.31, β=-0.22, p<.001), but did not decline after the transition into early adulthood (W4-W7) (b=-0.08, β=-0.04, p=.052). Autonomous motivation was positively associated with PA at all waves (b=0.23-0.33, β=1.90-4.37, p<.001). Controlled motivation was only positively associated with PA at W3 (12th grade) (b=0.13, β=1.54, p=.011). PA planning varied significantly between individuals and significantly predicted PA (b=0.44, β=0.21, p<.001). Although PA decreased significantly during late adolescence, PA did not decrease significantly after transitioning into early adulthood (one to four years post-high school). Elevated autonomous motivation and PA planning were consistently and significantly associated with higher PA, suggesting that these may be useful intervention targets during this adolescent-to-adult transition.