Cited by 1,154Motivation and Self-Concept in SportsBehavioral Health and InterventionsDiabetes Management and Education

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A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health

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Ntoumanis, Nikos, Ng, Johan Y.Y., Prestwich, Andrew, Quested, Eleanor, Hancox, Jennie E., Thøgersen-Ntoumani, Cecilie, Deci, Edward L., Ryan, Richard M., Lonsdale, Chris, Williams, Geoffrey C.·2021·Health Psychology Review

DOI 10.1080/17437199.2020.1718529

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Abstract

There are no literature reviews that have examined the impact of health-domain interventions, informed by self-determination theory (SDT), on SDT constructs and health indices. Our aim was to meta-analyse such interventions in the health promotion and disease management literatures. Studies were eligible if they used an experimental design, tested an intervention that was based on SDT, measured at least one SDT-based motivational construct, and at least one indicator of health behaviour, physical health, or psychological health. Seventy-three studies met these criteria and provided sufficient data for the purposes of the review. A random-effects meta-analytic model showed that SDT-based interventions produced small-to-medium changes in most SDT constructs at the end of the intervention period, and in health behaviours at the end of the intervention period and at the follow-up. Small positive changes in physical and psychological health outcomes were also observed at the end of the interventions. Increases in need support and autonomous motivation (but not controlled motivation or amotivation) were associated with positive changes in health behaviour. In conclusion, SDT-informed interventions positively affect indices of health; these effects are modest, heterogeneous, and partly due to increases in self-determined motivation and support from social agents.

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“Given that motivational factors are key mediators of behaviour change and concomitant health outcomes (Ntoumanis et al., 2021; Ntoumanis & Moller, 2023), identifying those factors enabling and thwarting autistic youth’s motivation to participate in PA is necessary to supporting the health of…”
BackgroundSelf-citation
Improving children’s fundamental movement skills through a family-based physical activity program: results from the “Active 1 + FUN” randomized controlled trial
Ha, A. S. C., Lonsdale, C., Lubans, D. R., Ng, F. F., & Ng, J. Y. Y. (2021) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-021-01160-5 · Cited by 41
“Researchers have shown that SDT-based interventions can promote beneficial outcomes in terms of individuals’ behavior and well-being [17, 18].”
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Willmott, T. J., & Rundle-Thiele, S. R. (2022) · Journal of Social Marketing · doi:10.1108/jsocm-05-2021-0117 · Cited by 34
Mindfulness improves psychological health and supports health behaviour cognitions: Evidence from a pragmatic RCT of a digital mindfulness‐based intervention
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“This finding may be the first signal of a gradual shift in motivation to look after one's health, which is a key component of successful behaviour change interventions in the health domain (see Ntoumanis et al., 2020, for a review).”
Technology as Infrastructure for Dehumanization:
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Integrating behavior and organizational change literatures to uncover crucial psychological mechanisms underlying the adoption and maintenance of organizational change
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“…the importance of these three needs for internalization and the development of autonomous motivation and for behavioral adoption and maintenance (Ng et al., 2012; Ntoumanis et al., 2021; Teixeira et al., 2020; Van den Broeck et al., 2016) and the importance of supporting them (Slemp et al., 2024).”
Understanding alcohol harm reduction behaviors from the perspective of self-determination theory: a research agenda
Richards, D. K., Pearson, M. R., & Witkiewitz, K. A. (2020) · Addiction Research & Theory · doi:10.1080/16066359.2020.1863378 · Cited by 30
“SDT has received substantial support across behavioral domains, including behaviors that promote physical health (Gillison et al. 2019; Ng et al. 2012; Ntoumanis et al. 2020).”
Background
The ENDORSE Feasibility Study: Exploring the Use of M-Health, Artificial Intelligence and Serious Games for the Management of Childhood Obesity
Zarkogianni, K., Chatzidaki, E., Polychronaki, N., Kalafatis, E., Nicolaides, N. C., Voutetakis, A., Chioti, V., Kitani, R.-A., Mitsis, K., Perakis, Κ., et al. (2023) · Nutrients · doi:10.3390/nu15061451 · Cited by 33
“This study was driven by Self Determination Theory with an emphasis on providing appropriate plans, meaningful rational, and positive/informational feedback to all participants in a respectful manner [19,21].”
The Impact of a Challenge-Based Learning Experience in Physical Education on Students’ Motivation and Engagement
Simón-Chico, L., González-Peño, A., Hernández-Cuadrado, E., & Álvarez, E. F. (2023) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe13040052 · Cited by 45
“Through the lens of self-determination theory (SDT) [2], an important research line has focused on the mechanisms explaining how interactions affect several behaviours in general health contexts [3] and, in particular, teacher–student interactions in the PE context [4].”
Background
The use of dance to improve the health and wellbeing of older adults: A global scoping review of research trials
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The effects of teamwork on critical thinking: A serial mediation analysis of the influence of work skills and educational motivation in secondary school students
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Optimizing outcomes in psilocybin therapy: Considerations in participant evaluation and preparation
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A Theory- and Evidence-Based Digital Intervention Tool for Weight Loss Maintenance (NoHoW Toolkit): Systematic Development and Refinement Study
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“Autonomous motivation has also been associated with change in energy balance behaviors for obesity management [16].”
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Teixeira, D., Rodrigues, F. F., Machado, S. E. D. C., Cid, L., & Monteiro, D. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.682480 · Cited by 32
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“Over the past decades, researchers have established that satisfaction of autonomy, competence, and relatedness is critical to most domains of human functioning such as health care [10, 11], mental health [12, 13], the development of well-being [14, 15], the development of intrinsic motivation [16], engagement at work…”
Background
When body positivity falls flat: Divergent effects of body acceptance messages that support vs. undermine basic psychological needs
Legault, L., & Sago, A. (2022) · Body Image · doi:10.1016/j.bodyim.2022.02.013 · Cited by 37
Does the Weekly Practice of Recalling and Elaborating Episodes Raise Well-Being in University Students?
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“Therefore, how can we improve satisfaction and reduce the frustration of basic psychological needs? A bulk of research (for reviews, see Ryan & Deci, 2020; Ntoumanis et al., 2020) demonstrated that need satisfaction is favored by an autonomy supportive social environment, characterized by expressing acceptance, showin…”
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Psychological needs as underlying forces of halal food purchase intention
Syed, S., Ahmad, F., & Shah, S. R. H. (2022) · Journal of Islamic marketing · doi:10.1108/jima-01-2022-0027 · Cited by 31
Using the Implementation Research Logic Model as a Lens to View Experiences of Implementing HIV Prevention and Care Interventions with Adolescent Sexual Minority Men—A Global Perspective
Nelson, L. E., Ogunbajo, A., Abu-Ba’are, G. R., Conserve, D. F., Wilton, L., Ndenkeh, J. J. N., Braitstein, P. K. A., Dow, D. E., Arrington‐Sanders, R., Appiah, P., et al. (2022) · AIDS and Behavior · doi:10.1007/s10461-022-03776-5 · Cited by 27
Setting performance and learning goals is useful for active and inactive individuals, if goals are personalized and flexible: commentary on Swann et al. (2020)
Kwaśnicka, D., Ntoumanis, N., & Sniehotta, F. F. (2020) · Health Psychology Review · doi:10.1080/17437199.2020.1762107 · Cited by 29
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Motivation Science
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Physical activity interventions to increase children's social and emotional learning: A systematic review and meta‐analysis based on the comprehensive school physical activity programme framework
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A Psychological Need-Fulfillment Perspective for Designing Social Robots that Support Well-Being
Janssen, S., & Schadenberg, B. R. (2024) · International Journal of Social Robotics · doi:10.1007/s12369-024-01102-8 · Cited by 29
“This premise has been investigated in various contexts, including education [16, 59], interpersonal relationships [133, 180], and healthcare [113, 120].”
Promoting self-determined motivation for physical activity: From theory to intervention work
Quested, E., Kritz, M., Hancox, J. E., Ntoumanis, N., & Thøgersen‐Ntoumani, C. (2021) · Society for Transparency, Openness, and Replication in Kinesiology eBooks · doi:10.51224/b1003 · Cited by 32
“, fitness instructors) can be trained in providing need support to others and thereby promote autonomous motivation, psychological well-being and physical activity in others (Hancox et al., 2018; Ntoumanis et al., 2020; Ntoumanis et al., 2018).”
BackgroundInfluentialSelf-citation
Associations between Perceived Teacher Autonomy Support, Self-Determined Motivation, Physical Activity Habits and Non-Participation in Physical Education in a Sample of Lithuanian Adolescents
Jankauskienė, R., Urmanavicius, D., & Bacevičienė, M. (2022) · Behavioral Sciences · doi:10.3390/bs12090314 · Cited by 38
“since autonomous motivation is associated with increased engagement in PA and the latter might promote the development of habits [48].”
Background
Decoding the Influence of eHealth on Autonomy, Competence, and Relatedness in Older Adults: Qualitative Analysis of Self-Determination Through the Motivational Technology Model
Cotter, L. M., Shah, D. V., Brown, K., Mares, M., Landucci, G., Saunders, S., Johnston, D. C., Pe‐Romashko, K., Gustafson, D. H., Maus, A., et al. (2024) · JMIR Aging · doi:10.2196/56923 · Cited by 27
“Broadly, the impact of self-determination theory on various measures of overall health has been well documented in several meta-analyses [9,14,15].”
Background
The Co-Occurrence of Satisfaction and Frustration of Basic Psychological Needs and Its Relationship with Exercisers’ Motivation
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“Self-determination theory (SDT) is a macro-theory of motivation that has been used to investigate motivation in several health-related behaviors (Ntoumanis et al., 2020).”
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Associations between previous sport and exercise experience and physical literacy elements among physically inactive Danes
Elsborg, P., Heinze, C., Melby, P. S., Nielsen, G., Bentsen, P., & Ryom, K. (2021) · BMC Public Health · doi:10.1186/s12889-021-11299-2 · Cited by 32
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BackgroundResult
A self-support approach to satisfy basic psychological needs during difficult situations
Behzadnia, B., & FatahModares, S. (2022) · Motivation and Emotion · doi:10.1007/s11031-022-09968-9 · Cited by 29
“It has shown that instructors’ need-supportive behaviors helped clients to pursue healthy behaviors, as well as experienced greater need satisfaction, intrinsic motivation, and well-being (Ntoumanis et al., 2020).”
Background
Web-based need-supportive parenting program to promote physical activity in secondary school students: a randomized controlled pilot trial
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“Overall, research based on the SDT in the health domain has demonstrated that SDT-informed interventions positively affect health behaviour [18].”
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Using self-determination theory to understand eating behaviors and weight change in emerging adults
LaCaille, R. A., Hooker, S. A., & LaCaille, L. J. (2020) · Eating Behaviors · doi:10.1016/j.eatbeh.2020.101433 · Cited by 24
PhD students’ relatedness, motivation, and well-being with multiple supervisors
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Integrating the theory of planned behavior and the self‐determination theory to promote Mediterranean diet adherence: A randomized controlled trial
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Autonomous motivation, social support, and physical activity in school children: moderating effects of school-based rope skipping sports participation
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A systematic review of gerontechnologies to support aging in place among community-dwelling older adults and their family caregivers
Moreno, A., Scola, M.-C., Sun, H., Durce, H., Couve, C., Acevedo, K., & GUTMAN, G. M. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1237694 · Cited by 31
Exercise motivation, physical exercise, and mental health among college students: examining the predictive power of five different types of exercise motivation
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Development and feasibility of a mobile phone application designed to support physically inactive employees to increase walking
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Design and evaluation of an independent 4‐week, exosuit‐assisted, post‐stroke community walking program
Nuckols, R. W., Chang, C., Kim, D., Eckert-Erdheim, A. M., Orzel, D., Baker, L. M., Baker, T. C., Wendel, N. C., Quinlivan, B., Murphy, P., et al. (2023) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14998 · Cited by 24
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“…reference lists of five relevant reviews, four of which examined physical activity in the context of self-determination theory, were screened to capture additional articles (Car-rillo et al., 2019; Manninen et al., 2022; Ntoumanis et al., 2021; Teixeira et al., 2012; Wasserkampf & Kleinert, 2016).”
Defending Behavior in Bullying and Defenders’ Psychosocial Outcomes among Children and Adolescents: A Series of Three-Level Meta-Analyses
Tian, X., Huebner, E. S., & Tian, L. (2025) · Journal of Youth and Adolescence · doi:10.1007/s10964-025-02176-x · Cited by 22
“Additionally, failing to intervene successfully under peer pressure may leave defenders with unmet relational or competence needs, exacerbating mental health issues (Ntoumanis et al., 2021).”
Profiles of motivations for responsible drinking among college students: A self-determination theory perspective
Richards, D. K., Pearson, M. R., & Field, C. A. (2020) · Addictive Behaviors · doi:10.1016/j.addbeh.2020.106550 · Cited by 25
“…motivations are associated with improved health outcomes (Ng et al., 2012), and SDT-based interventions, which aim to support the psychological needs, result in increased selfdetermined motivation for engaging in health-promoting behaviors (Gillison et al., 2019; Ntoumanis et al., 2020).”
BackgroundResultInfluential
Self-determination theory interventions versus usual care in people with diabetes: a protocol for a systematic review with meta-analysis and trial sequential analysis
Mathiesen, A. S., Rothmann, M. J., Zoffmann, V., Jakobsen, J. C., Gluud, C. N., Lindschou, J., Due‐Christensen, M., Rasmussen, B., Marqvorsen, E. H. S., & Thomsen, T. (2021) · Systematic Reviews · doi:10.1186/s13643-020-01566-5 · Cited by 20
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BackgroundMethodInfluential
Motivation for health behaviour: A predictor of adherence to balanced and healthy food across different coastal Mediterranean countries
Ljubičić, M., Sarić, M. M., Klarin, I., Rumbak, I., Barić, I. C., Ranilović, J., EL-Kenawy, A., Παπαγεωργίου, Μ., Vittadini, E., Černelič-Bizjak, M., et al. (2022) · Journal of Functional Foods · doi:10.1016/j.jff.2022.105018 · Cited by 29
Intuitive eating and biomarkers related to cardiovascular disease in older adults
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Using self‐determination theory in research and evaluation in primary care
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“Ntoumanis et al.21 performed a meta‐analysis of over 70 studies of SDT‐informed intervention studies covering a wide range of health behaviours mainly concerning the primary prevention of disease.”
Background

Authors: Ntoumanis, N., Ng, J. Y. Y., Prestwich, A., Quested, E., Hancox, J. E., Thøgersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Lonsdale, C., & Williams, G. C.
Affiliations: Curtin University (AU)
Chinese University of Hong Kong (HK)
University of Leeds (GB)
University of Nottingham (GB)
School of Psychology, Curtin University, Perth, Australia
University of South-Eastern Norway (NO)
Australian Catholic University (AU)
University of Rochester Medicine (US)
Corresponding author: Ntoumanis, Nikos
ORCID: Ntoumanis, Nikos
Ng, Johan Y.Y.
Prestwich, Andrew
Quested, Eleanor
Hancox, Jennie E.
Thøgersen-Ntoumani, Cecilie
Deci, Edward L.
Ryan, Richard M.
Lonsdale, Chris
Williams, Geoffrey C.
Venue: Health Psychology Review
Publisher: Informa UK Limited
Published: 2020-02-03
Volume: 15
Issue: 2
Pages: 214-244
ISSN: 1743-7199 (ISSN-L)
1743-7202
DOI: 10.1080/17437199.2020.1718529
OpenAlex: W3002054708
Cited by: 1,154
References: 118
Citations by year: 2026: 237 · 2025: 209 · 2024: 181 · 2023: 264 · 2022: 124 · 2021: 107 · 2020: 31
FWCI: 21.15
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc-nd
creativecommons.org/licenses/by-nc-nd/4.0/ (unspecified)
Locations: Health Psychology Review (publishedVersion, cc-by-nc-nd)
PubMed (publishedVersion)
Repository@Nottingham (University of Nottingham) (publishedVersion, cc-by-nc-nd)
University of Birmingham Research Portal (University of Birmingham) (publishedVersion, cc-by-nc-nd)
White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by-nc-nd)
NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
Topics: Social Sciences › Psychology › Social Psychology › Motivation and Self-Concept in Sports
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Keywords: self-determination theory, health promotion, disease management, autonomous motivation, need support, controlled motivation, amotivation, health behavior, physical health, mental health
MeSH terms: Health Promotion, Humans, Mental Health, Motivation, Health Behavior, Personal Autonomy

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A meta-analysis of self-determination theory-informed intervention studies in the health domain: effects on motivation, health behavior, physical, and psychological health

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