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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
Open accessAbstract
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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“Motivation activation and social support may be interpreted through Self-Determination Theory, which emphasizes the importance of autonomy, competence, and relatedness in sustaining behavior (29).”
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“Indeed, previous research indicated that promoting patients’ self-determination is related to benefits in terms of disease-related behaviors in psychosomatic medicine [113,114,115,116,117].”
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“Meta-analyses have found each of these factors to be associated with decreases in depressive symptoms, but no single treatment covers all mechanisms.”
From Effect of exercise for depression: systematic review and network meta-analysis of randomised controlled trials (2024) · cites this paper as [33]
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Sayers, S. L., Brown, L. A., Swinkels, C. M., May, A. M., Daniel, S. S., Crasta, D. J., Hill, M., Richards, J., & Goodman, M. S. (2025) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2025.06.006 · Cited by 3
Inflammatory Bowel Disease Self-Care Behaviors in Context of Psychosocial Factors
Anders-Rumsey, J., Kasmikha, L., Chiang, M., Hodish, G., Sheehan, J. L., Golbus, J. R., Wickman, U. L., Admon, A. J., Resnicow, K., Sturgeon, J. A., et al. (2025) · Digestive Diseases and Sciences · doi:10.1007/s10620-025-09326-y · Cited by 5
Treatment Adherence and Cognitive Emotion Regulation Skills in Patients With Diabetes Mellitus
Ekitli, G. B., Uğuz, Ö., Turgut, E. Ö., & Çam, M. O. (2025) · SAGE Open · doi:10.1177/21582440251363675 · Cited by 3
“In contrast, positive reappraisal was a significant positive predictor ( B = 0.14, p = .010), aligning with findings that cognitive reframing promotes emotional resilience and health-related goal pursuit (Ntoumanis et al., 2021).”
InfluentialWu, Q., Zhu, W., Zhang, Y., Lou, H., Liu, S., Wu, C., Xiang, J., Ren, N., & Cao, R. (2026) · BMC Public Health · doi:10.1186/s12889-025-26120-7 · Cited by 3
“When an individual possesses a higher level of autonomous motivation, this predicts an increase in positive outcomes for adolescents, which in the present study is manifested as greater exercise persistence [45].”
Claes, S., Wit, S. D., Clercq, B. D., & Annemans, L. (2026) · BMC Public Health · doi:10.1186/s12889-025-26028-2 · Cited by 6
“Other research has shown that interventions based on the Self-Determination Theory are promising for the promotion of health and well-being [62].”
YILMAZ, H. Ö., Arslan, S., & Yılmaz, S. (2026) · Nutrients · doi:10.3390/nu18030413 · Cited by 3
“It aligns with value-congruent health behavior models in which intrinsic religious motivation supports self-care without requiring synergistic effects with information skills [25,26].”
Jin, W., Li, B., & Zhao, X. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1751057 · Cited by 3
Wang, Y., Wu, C.-C., Lin, L., & Su, C.-H. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1737783 · Cited by 4
Zhuang, L., Wang, Q., Liu, Y., Shi, Y., Lv, R., Liang, J., Zhou, Y., & Lipowski, M. (2026) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2026.1757784 · Cited by 5
“Preliminary research even hints that genetic differences (e.g., in dopamine or serotonin pathways) could moderate psychological responses to exercise (11, 78, 79), though this is not well studied in adolescents.”
Tilga, H., Paap, H., Diloy-Peña, S., Burgueño, R., & Koka, A. (2026) · BMC Public Health · doi:10.1186/s12889-026-28141-2 · Cited by 3
“Instead, these researchers propose prioritizing a motivational climate focused on enjoyment and intrinsic motivation, as this approach has been shown to sustain students' engagement in physical activity beyond school settings [21, 32].”
A Control-Value Approach to Affective Growth
Pekrun, R. H. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0055 · Cited by 4
Linnenbrink‐Garcia, L. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0065 · Cited by 3
Wulandari, D., Purba, F. D., Alfikalia, A., Kertamuda, F., Rahmania, T., Sabrina, O. A., Hidayah, K. N., & Fatimah, S. (2023) · F1000Research · doi:10.12688/f1000research.123583.2 · Cited by 3
Gibson, S. C. (2024) · Journal of Leisure Research · doi:10.1080/00222216.2023.2298517 · Cited by 3
Thai, H., Audet, É. C., & Koestner, R. (2024) · Vaccine · doi:10.1016/j.vaccine.2024.04.023 · Cited by 4
Kaur, H., Pavela, G., Pekmezi, D., Rogers, L. Q., Cole, W. W., Parrish, K. B., Sayer, R. D., Wyatt, H. R., Crane, T. E., Badr, H., et al. (2024) · Supportive Care in Cancer · doi:10.1007/s00520-024-08907-3 · Cited by 3
Application of Self-Determination Theory to Wildlife Disease Risk Communication
Smith, K. A., Faust, R., Boley, B. B., & D’Angelo, G. J. (2024) · Society & Natural Resources · doi:10.1080/08941920.2024.2411693 · Cited by 3
“A large body of research in diverse domains, including recreation management (Smith, Landon, and Fulton 2023a), health care (Ntoumanis et al. 2021; Williams and Deci 1996), and public messaging (Martela et al. 2021; Moller, Deci, and Ryan 2006) has provided evidence of the critical role of personal…”
Wiesmüller, F., Haag, D., Sareban, M., Mayr, K., Mürzl, N., Porodko, M., Puelacher, C., Moser, L.-M., Philippi, M., Traninger, H., et al. (2025) · JMIR mhealth and uhealth · doi:10.2196/57413 · Cited by 8
“Nonetheless, considering the broader context of health behavior change, which ties in closely with multiple of the above-mentioned cardiac rehabilitation components, there is a considerable body of research supporting the importance of (intrinsic) motivation [8].”
Skog, R., Olsson, E. M. G., Gorman, J. R., Bober, S. L., Lampic, C., & Wettergren, L. (2025) · PLoS ONE · doi:10.1371/journal.pone.0322368 · Cited by 3
Hamzawi, S., Ding, Q. S., & Song, H. (2025) · Journal of Social Marketing · doi:10.1108/jsocm-08-2023-0204 · Cited by 3
D'Sa, M. B., Relph, N., Liverpool, S., Tebble, G., & Owen, M. B. (2025) · PLOS mental health. · doi:10.1371/journal.pmen.0000227 · Cited by 3
“Person-alizing or tailoring interventions to address the specific needs or issues of individual CYP enhances the effectiveness and sustainability of interventions in real-world settings [156,157].”
The motivation of physical education college students to become teachers after graduation
Sindiani, M., & Tsuk, S. (2025) · Frontiers in Education · doi:10.3389/feduc.2025.1597280 · Cited by 3
Turner, M. J., Frost, N., Outar, L., O'Connor, H., Tóth, R., Tóth, L., Chadha, N. J., & Wood, A. G. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1557885 · Cited by 5
Karin, E., Gucciardi, D. F., Rigotti, T., Parker, S. K., Kalisch, R., & Crane, M. F. (2025) · Anxiety Stress & Coping · doi:10.1080/10615806.2025.2564323 · Cited by 3
“Autonomous motivation, in turn, promotes adaptive health behaviors and positive outcomes (Ntoumanis et al., 2021).”
Patients’ personality in disease self-management. A self-determination perspective
Ene, C. A., Rîndaşu, C., & Ionescu, D. (2021) · Current Psychology · doi:10.1007/s12144-021-02240-2 · Cited by 3
“, 2016) or need-supportive interventions’ efficiency in physical and psychological health (Ntoumanis et al., 2020) and start to appreciate an involved patient’s value.”
BackgroundKroemeke, A., & Sobczyk‐Kruszelnicka, M. (2021) · British Journal of Health Psychology · doi:10.1111/bjhp.12573 · Cited by 3
Öz Belirleme Kuramı Temelinde Bir Müdahale Aracı Olarak Video Oyunları
Sevinçli, M. C., & Eger, M. (2022) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.974968 · Cited by 6
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Antunes, R., Monteiro, D., Silva, C., Filipe, D., Cordeiro, F. J. C., & Frontini, R. (2022) · Current Psychology · doi:10.1007/s12144-022-03908-z · Cited by 6
Metadata
- 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
- 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
- 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
- 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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