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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Technological identity and basic psychological needs in the use of new technologies: A two-wave cross-national survey study
Heiskari, M., Celuch, M., Koivula, A., Savolainen, I., & Oksanen, A. (2025) · International Journal of Information Management · doi:10.1016/j.ijinfomgt.2025.102926 · Cited by 12
Introducing Sedatic Hunger: Eating To Survive, Not to Savor
Arslan, S., YILMAZ, H. Ö., & Çiydem, E. (2025) · Current Nutrition Reports · doi:10.1007/s13668-025-00677-6 · Cited by 10
“In recent decades, the study of eating behaviors has increasingly illuminated the intricate relationship between physiological needs and psychological motivations [1, 2].”
Intrinsic vs. extrinsic motivation in high school physical education: Which fuels adolescent achievement emotions better?
Işıkgöz, M. E. (2025) · PLoS ONE · doi:10.1371/journal.pone.0327393 · Cited by 24
“Motivation, another important concept in SDT, refers to a situation in which an individual is neither intrinsically nor extrinsically motivated to perform an activity [11].”
Influential
Nutrition knowledge and healthy-eating attitudes: the role of physical activity and lifestyle factors in adults
Orhan, B. E., Alkasasbeh, W. J., Karaçam, A., Canlı, U., Adigüzel, N. S., & Amawi, A. T. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1754963 · Cited by 9
The influence of intrinsic motivational forces on consumers' product purchase intentions
Syed, S., Shah, S. I. A., & Ahmad, F. (2021) · Journal of Mediterranean Tourism Research · doi:10.5038/2770-7555.1.2.1006 · Cited by 11
“They concluded that autonomy, competence and relatedness play a vital role in the development of individuals’ growth and well-being, however the absence of such leaves irreparable marks on the personality of the individuals (Kinnafick et al., 2016; Ntoumanis et al., 2020).”
Background
Effectiveness of Digital Interventions for Deficit-Oriented and Asset-Oriented Psychological Outcomes in the Workplace: A Systematic Review and Narrative Synthesis
Armaou, M., Araviaki, E., Dutta, S., Konstantinidis, S. T., & Blake, H. (2022) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe12100102 · Cited by 14
A randomized-controlled trial of a digital, small incentive-based intervention for working adults with short sleep
Ong, J. L., Massar, S. A. A., Lau, T., Ng, B. K. L., Chan, L. F., Koek, D., Cheong, K., & Chee, M. W. L. (2022) · SLEEP · doi:10.1093/sleep/zsac315 · Cited by 10
“Provision of too large incentives could also undermine building of intrinsic/ autonomous motivation, a key component of long-term behavior change [23] and shifting of attitudes toward sleep [24].”
“This has changed me to be a better mum”: A qualitative study exploring how the Australian Nurse-Family Partnership Program contributes to the development of First Nations women’s self-efficacy
Massi, L., Hickey, S. D., Maidment, S.-J., Roe, Y. L., Kildea, S. V., & Kruske, S. (2023) · Women and Birth · doi:10.1016/j.wombi.2023.05.010 · Cited by 11
A Web-Based Physical Activity Promotion Intervention for Inactive Parent-Child Dyads: Protocol for a Randomized Controlled Trial
Phipps, D. J., Green, W. T., Aho, R., Kettunen, E., Biddle, S., Hamilton, K., Laukkanen, A., Aunola, K., Chan, D. K. C., Hankonen, N. E., et al. (2024) · JMIR Research Protocols · doi:10.2196/55960 · Cited by 11
“…physical activity, calculated from an average of effect sizes from meta-analyses of self-determination theory–based interventions (Hedges g =0.45 [35]) and interventions targeting self-efficacy (Cohen d =0.48 [36]), with α set at .05 and statistical power set at .80 reveal a projected total…”
MethodInfluential
Effectiveness of Sports Nutrition Education Based on Self-Determination Theory for Male University Rowing Athletes: A Randomized Controlled Trial
Enatsu, N., SEINO, J., Tsuji, T., & Ogata, M. (2024) · Nutrients · doi:10.3390/nu16060799 · Cited by 9
“The results of a meta-analysis by Ntoumanis et al. indicate that SDT-based interventions have a positive impact on health parameters [22].”
Result
Optimal Well-Being After Psychopathology: Prevalence and Correlates
Devendorf, A. R., Rum, R., Kashdan, T. B., & Rottenberg, J. A. (2022) · Clinical Psychological Science · doi:10.1177/21677026221078872 · Cited by 10
Efectos de un programa de concienciación hacia la discapacidad en Educación Física (Effects of an Awareness Program Towards Disabilities in Physical Education)
Pérez-Tejero, J., Grassi-Roig, M., Álvarez, E. F., & López, J. C. (2022) · Retos · doi:10.47197/retos.v45i0.93777 · Cited by 12
Mediation Model of E-Learning Adoption
Othman, N. A., Alamsyah, D. P., & Utomo, S. M. (2022) · International Conference on ICT for Smart Society (ICISS) · doi:10.1109/iciss55894.2022.9915254 · Cited by 9
“In evaluating psychological motivation, it can be assessed from several indicators including enjoy, interest, usefulness, satisfied, expectation, and motivation [4], [21].”
Background
The effectiveness of the Dutch Meaningful Roles program in children: a study protocol for a cluster randomized controlled study
van Loon, A. W. G., & Kaufman, T. M. L. (2023) · BMC Public Health · doi:10.1186/s12889-023-16362-8 · Cited by 9
“, autonomy, competence and relatedness), as well as positive changes in physical and psychological health [22].”
Background
Effects of a physical activity and endometriosis-based education program delivered by videoconference on endometriosis symptoms: the CRESCENDO program (inCRease physical Exercise and Sport to Combat ENDOmetriosis) protocol study
Boulley, G. E., Philip, C., Warembourg, S., Lenôtre, L., Flore, P., Faure, P., Michy, T., Letouzey, V., Arnold, C., Piluso, C., et al. (2023) · Trials · doi:10.1186/s13063-023-07792-1 · Cited by 14
“These strategies are from the self-determination theory [36–38], a theory often used in promotion of PA in several context including health context.”
Background
Unveiling the Impact of Mobile Fitness Applications on Motivational Orientation in Sustaining Exercise Behaviors: A Qualitative Investigation
Southcott, E., & Jooste, J. (2023) · Physical Culture and Sport Studies and Research · doi:10.2478/pcssr-2024-0008 · Cited by 12
Implementation of Peer-Assisted Physical Activity Via Telehealth for Adults on the Autism Spectrum: A Mixed Methods Feasibility Study
Tovin, M. M., & Núñez-Gaunaurd, A. (2024) · Physical Therapy · doi:10.1093/ptj/pzae005 · Cited by 10
The Effect of a Novel Video Game on Young Soccer Players' Sports Performance and Attention: Randomized Controlled Trial
Madueño, A. F., Fernández, G. M., Cortés, J. M., & Carnero-Díaz, Á. (2024) · JMIR Serious Games · doi:10.2196/52275 · Cited by 8
“Studies have increasingly focused on the psychological and cognitive aspects of athletes over the years [19,20], having highlighted attention, memory, and motivation as crucial psychological variables for athletes [21,22].”
Engaging in and Sustaining Physical Activity and Exercise: A Descriptive Qualitative Study of Adults 65 Years and Older Using the Self-Determination Theory
Mappanasingam, A., Madigan, K., Kalu, M. E., Maximos, M., & Bello-Haas, V. P. M. D. (2024) · Journal of Ageing and Longevity · doi:10.3390/jal4020011 · Cited by 10
“Over the past two decades, the value and relevance of self-determination theory (SDT, Figure 1) in understanding PA behavior [26] has been underscored, with increasing applications to the health domain, health care, and health behavior intervention research [27–29].”
Background
Technology-Supported Physical Activity and Its Potential as a Tool to Promote Young Women’s Physical Activity and Physical Literacy: Systematic Review
Watson‐Mackie, K., Arundell, L., Lander, N., McKay, F. H., Jerebine, A., Venetsanou, F., & Barnett, L. M. (2024) · Journal of Medical Internet Research · doi:10.2196/52302 · Cited by 16
“%) decreased participant PA [63]; the authors theorized that this decrease may be due to wearable fitness trackers only increasing external motivation rather than autonomous motivation, which promotes long-term behavior change [80].”
Impact of fitness coach behavior on exercise motivation, commitment, and enjoyment: A longitudinal study
Braga-Pereira, R., Furtado, G. E., Campos, F. J. A., Sampaio, A. R., & Teques, P. (2024) · PLoS ONE · doi:10.1371/journal.pone.0310931 · Cited by 13
Self-determined motivation and driving styles as dependent on the perception of traffic climate by Turkish and Israeli drivers
Kaçan, B., Özkan, T., & Ben‐Ari, O. T. –. (2025) · Transportation Research Part F Traffic Psychology and Behaviour · doi:10.1016/j.trf.2025.01.034 · Cited by 9
Investigating the Relationship between Psychological Capital and Physical Activity among University Students: The Mediating Effects of Health Consciousness and Health Motivation
Huang, D., Tang, H., Jing, L., Lei, H., Li, X., & Koh, D. (2025) · SAGE Open · doi:10.1177/21582440251355777 · Cited by 8
“In motivation theory research, motivation is considered one of the key factors influencing individuals’ engagement in specific behaviors (Ntoumanis et al., 2021).”
Basic psychological needs satisfaction, intrinsic motivation, and studying sports protect university student-athletes from burnout: insights from Latvia
Vilks, S., & Koļesovs, A. (2025) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2025.1548583 · Cited by 13
Interactive Conversational Agents to Improve Dietary Behaviors for Health Promotion: Mixed Systematic Review
Amil, S., Gagnon, M., Bédard, A., Da, S. M. A. R., Mora, D. Z., Drapeau, V., & Desroches, S. (2025) · Journal of Medical Internet Research · doi:10.2196/78220 · Cited by 8
“Recent digital interventions embedding SDT principles report higher user engagement, stronger intentions to change, and greater satisfaction [58].”
The AI-IARA framework: How to cultivate human agency before artificial intelligence optimizes it a(ny)way
van Zyl, L. E. (2026) · The Journal of Positive Psychology · doi:10.1080/17439760.2026.2632939 · Cited by 9
Integrating Physical Activity Into Routine Psychiatric Care
Stubbs, B., Ma, R., Teychenne, M. J., Kinnafick, F., Mossaheb, N., Korman, N., Trott, M., Rosenbaum, S., Schuch, F. B., Firth, J., et al. (2026) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2026.0026 · Cited by 10
Metacognition and Self-determination, Impulsivity and Emotional intelligence, and its relation with wellbeing and health indicators in young adults
Muñoz, J. A. C., Pozo, M. D. R. H., & Barahona, I. (2021) · Interacciones Revista de Avances en Psicología · doi:10.24016/2021.v7.216 · Cited by 12
Relationship between exercise motivation and social support in a support facility for persons with disabilities in Japan
Inui, Y., Ogawa, T., Tanaka, Y., Hayashida, K., & Morioka, S. (2022) · Annals of Medicine · doi:10.1080/07853890.2022.2049860 · Cited by 8
“AM and CM are considered to be independent constructs, and it is necessary to consider motivation from both aspects [19].”
Background
Psychometric Approaches in Self-Determination Theory
Howard, J. L. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780197600047.013.15 · Cited by 9
Motivation and Basic Psychological Needs Satisfaction in Active Travel to Different Destinations: A Cluster Analysis with Adolescents Living in Germany
Renninger, D., Bachner, J., García‐Massó, X., Molina‐García, J., Reimers, A. K., Marzi, I., Beck, F., & Demetriou, Y. (2023) · Behavioral Sciences · doi:10.3390/bs13030272 · Cited by 10
Progressive muscle relaxation in pandemic times: bolstering medical student resilience through IPRMP and Gagne's model
Nair, B., Khan, S., Naidoo, N. S., Jannati, S., Shivani, B., & Banerjee, Y. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1240791 · Cited by 16
Does mindfulness benefit adolescents’ academic adaptation? The mediating roles of autonomous and controlled motivation
Fan, Q., Li, Y., Hu, W., Zhang, H., Zhao, F., & Henderson, S. L. (2024) · Current Psychology · doi:10.1007/s12144-024-06082-6 · Cited by 10
“Based on SDT, autonomous and controlled motivations function as factors influencing individual behavioral out - comes, such as academic performance and behaviors conducive to physical health (Mouratidis et al., 2018; Ntoumanis et al., 2020).”
Is culture the key? Emotional intelligence, autonomous motivation and physical activity of student-athletes from China and Russia
Rogaleva, L. N., Zhong, T., & García-Más, A. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1420430 · Cited by 8
Basic Psychological Need Satisfaction as Correlates of Physical Activity Trajectories During Adolescence
Gallant, F., Giroux, M., Gunnell, K. E., Registe, P. P. W., Mekari, S., Doré, I., Sabiston, C. M., & Bélanger, M. F. (2024) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.14743 · Cited by 13
“Given that Self-Determination Theory-informed interventions are effective at improving or maintaining physical activity [24], understanding how the different basic psychological needs relate to distinct trajectories of physical activity could help inform the design of interventions aimed at…”
What drives Chinese youth to use fitness-related health information on social media? An analysis of intrinsic needs, social media algorithms, and source credibility
Zhang, X., Tang, Q. Q., & Cai, Y. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1445778 · Cited by 10
Health-related quality of life, motivational regulation and Basic Psychological Need Satisfaction in Education Outside the Classroom: an explorative longitudinal pilot study
Ellinger, J., Mess, F., Blaschke, S., & Mall, C. (2022) · BMC Public Health · doi:10.1186/s12889-021-12450-9 · Cited by 11
“A meta-analysis led to the assumption that a foundation of SDT in particular could possibly promise success regarding physical and mental health because the results suggest a positive association between SDT-based constructs and indicators of mental health [13], such as well-being and healthrelated quality of life (HR…”
Background
Patient life aspirations in the context of Duchenne Muscular Dystrophy: a mixed-methods case–control study
Schwartz, C. E., Biletch, E., Stuart, R. B. B., & Rapkin, B. D. (2022) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-022-00500-8 · Cited by 8

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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