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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Jago, R., Tibbitts, B., Willis, K., Sanderson, E., Kandiyali, R., Reid, T., MacNeill, S., Kipping, R., Campbell, R. M., Sebire, S. J., et al. (2022) · Public Health Research · doi:10.3310/zjqw2587 · Cited by 2
Experiência profissional e formação académica dos profissionais de exercício físico: relação das pressões no trabalho com as necessidades psicológicas básicas no contexto laboral
Cerca, L., Teixeira, D., Carraça, E. V., Raposo, F. Z., Silva, M. N., & Palmeira, A. L. (2023) · Retos · doi:10.47197/retos.v47.95899 · Cited by 3
Controlling Your Own Motivation Is an Acquired Skill
Wolters, C. A. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0033 · Cited by 2
How Does Context Shape Motivation?
Bong, M. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0044 · Cited by 2
How Do We Motivate People? By Working with Their Self-Beliefs
Usher, E. L. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0054 · Cited by 7
Pleasure, Utility, and Goals
Kim, S. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0008 · Cited by 2
Extrinsic Incentives/Rewards
Grolnick, W. S. (2023) · Oxford University Press eBooks · doi:10.1093/oso/9780197662359.003.0026 · Cited by 4
Deep health: A qualitative, woman-centered perspective of health during pregnancy
Epstein, C. M., Houfek, J. F., & Jones, L. P. (2023) · Midwifery · doi:10.1016/j.midw.2023.103628 · Cited by 3
Design of P-FLANN Model for Intelligent Water Fountain Sound Pleasantness Monitoring Using Bio-inspired Computing and Human Speech Perception
Brahma, B., Dash, T. K., Panda, G., Prasad, L. V. N., & Kulkarni, R. (2023) · Journal of Artificial Intelligence and Technology · doi:10.37965/jait.2023.0229 · Cited by 2
“Out of which the importance of psychological health cannot be neglected [2].”
Background
Experiences of postpartum mothers and a significant other in a dyadic physical activity programme
Carr, R. M., Thøgersen‐Ntoumani, C., Ntoumanis, N., Prestwich, A., Gucciardi, D. F., & Quested, E. (2023) · Asian Journal of Sport and Exercise Psychology · doi:10.1016/j.ajsep.2023.07.003 · Cited by 2
Self-citation
An application of Organismic Integration Theory to enhance basic psychological needs satisfaction and motivation for rehabilitation in older stroke survivors: A randomized controlled trial study
Srisodsaluk, P., Pothiban, L., Wonghongkul, T., & Chintanawat, R. (2023) · Geriatric Nursing · doi:10.1016/j.gerinurse.2023.08.008 · Cited by 2
Motivational Influences on Health, Well-Being, and Lifestyle: Validation of the Spanish Version of the Treatment Self-Regulation Questionnaire in Four Health Domains
Santos-Roig, M. D. L., Fusinato-Ponce, C., & Fernández‐Alcántara, M. (2023) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe13110164 · Cited by 3
“The present study’s results are in line with the research on self-determination and the various components of physical health [40,41], overall well-being [42,43], and the adoption or continuation of healthy behaviors [44,45].”
Result
A heuristic design toolkit for web conferencing software based on self-determination theory
Wu, M., Shen, X., Zhang, L., Liu, X., Zhang, H., & Hu, Y. (2023) · Computer Standards & Interfaces · doi:10.1016/j.csi.2023.103831 · Cited by 3
ONLINE PURCHASE THROUGH MOTIVATION AND SATISFACTION ON REPEAT INTENTION: THE CONCEPT OF SELF DETERMINATION THEORY
Azizah, Y., & Amin, S. (2023) · ABM International Journal of Administration Business and Management · doi:10.31967/abm.v5i1.718 · Cited by 2
“Self-determination theory still provides a lot of research gaps, namely it has no effect on variables (Ntoumanis et al., 2021), (L. A. Williams et al., 2019a).”
Background
A Psychological Examination of the Status Syndrome and Its Application for Promoting Well-Being
Rodríguez-González, L. C., & Repetto, P. B. (2024) · Clinical Nursing Research · doi:10.1177/10547738241231044 · Cited by 2
“Similarly, social disparities and cultural backgrounds compromise motivational dimensions that significantly shape long-term outcomes (Gillison et al., 2019; Ntoumanis et al., 2021; Ryan et al., 2022; Sheeran et al., 2020).”
Background
Motivation
Reisman, F. K., Keiser, L., Westphal, J., & Hammrich, P. L. (2024) · Cambridge University Press eBooks · doi:10.1017/9781009199193.004 · Cited by 2
Evaluative Review: Differences in Knowledge and Perspectives on Generic Drugs Among Health and Non-Health Students
Cahyani, H., Thanh, K. L. T., & Faisal, U. M. (2024) · Indonesian Journal of Education Research (IJoER) · doi:10.37251/ijoer.v5i2.927 · Cited by 2
“In Indonesia, with diverse geographic conditions and varying levels of accessibility, health education is the key to achieving equitable access to health services [13]-[14].”
Background
A Motivational Technology Perspective on the Use of Smart Wrist-Worn Wearables for Postpartum Exercise and Weight Management
Kim, H. S., & Chung, M.-Y. (2024) · Health Communication · doi:10.1080/10410236.2024.2343472 · Cited by 2
“Scholars have found a positive relationship between the three psychological states of self-determination and behavior via intrinsic motivation (Ntoumanis et al., 2021).”
Factors Influencing Autonomy in Middle-Aged and Elderly Women with Urinary Incontinence
Zhang, Y., Li, J., Hu, Y., Chen, L., Cai, W., & Ren, W. (2024) · International Urogynecology Journal · doi:10.1007/s00192-024-05838-9 · Cited by 4
“A high level of autonomy plays an important positive role in improving patients' ability to manage the disease, adopting healthy behaviors, promoting disease rehabilitation, and enhancing happiness [12, 13].”
Aligning extracurricular school activities with physical literacy: pilot evaluation through self-study of practice
Schmittwilken, L., Harding-Kuriger, J., & Carl, J. (2024) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2024.1415689 · Cited by 9
Evaluating an Expanded Health Action Process Approach Model of Health Promotion to Predict Physical Activity Levels of Individuals With Chronic Health Conditions and Disabilities
Wu, J.-R., Chan, F., Tansey, T. N., Ditchman, N., Berven, N. L., & Hoyt, W. T. (2024) · Rehabilitation Counseling Bulletin · doi:10.1177/00343552241268735 · Cited by 2
“Meta-analytic studies have indicated that SDT is useful in predicting health-related behaviors (Hagger et al., 2016; Ng et al., 2012; Ntoumanis et al., 2021).”
The impact of COVID-19 on physical activity and mental health: A mixed-methods approach
Hung, W. T., Bell, V., & Wong, K. K. (2024) · Journal of Health Psychology · doi:10.1177/13591053241275599 · Cited by 3
“Several theories, including theory of planned behaviours (McEachan et al., 2011), social determination theory Ntoumanis et al., 2021) and social cognitive theory (Young et al., 2014), have stressed the significance of social support and social connectedness in PA behavioural change.”
Frustrated cyber-abuser: Narcissistic traits in the context of the basic psychological needs and cyber dating abuse
Valachová, M., & Lisá, E. (2024) · Computers in Human Behavior · doi:10.1016/j.chb.2024.108465 · Cited by 4
A randomized controlled trial of a “Small Changes” behavioral weight loss treatment delivered in cardiac rehabilitation for patients with atrial fibrillation and obesity: study protocol for the BE-WEL in CR-AF study
Williamson, T. M., Rouleau, C. R., Wilton, S. B., Valdarchi, A. B., Moran, C., Patel, S. N., Lutes, L. D., Aggarwal, S., Arena, R. A., & Campbell, T. S. (2024) · Trials · doi:10.1186/s13063-024-08527-6 · Cited by 2
“…for Lifelong Health) Small Changes program is a group-based, manualized BWLT approach consistent with the 2020 Canadian Clinical Practice Guidelines for adult obesity [28] and is informed by prominent behavior change theories (e.g., Social Cognitive Theory, Self-Determination Theory) [29, 30].”
Method
The Effects of Mindfulness Training in the Physical Education on Intention to Physical Activity, Mental Health and Academic Performance among High-School Students
Khanbeiki, A. (2024) · Physical activity in children. · doi:10.61186/pach.2024.470015.1022 · Cited by 3
“Numerous studies have explored the influence of different interventions in PE on students' motivation and their intention to engage in physical activity (PA) (35).”
Assessing and exploring self-enacted behavior change techniques: frequency, structure, and relevance for physical activity and healthy eating
Schüler, J., & Bieleke, M. (2024) · Current Psychology · doi:10.1007/s12144-024-06899-1 · Cited by 2
“In contrast to controlled motivation in which people feel internally pres-sured (introjected motivation), or are pressured from outside (external regulation), more autonomous forms of regulation change health behavior more effectively and sustainably (e.g., Ntoumanis et al., 2021).”
Effect of self-determination training on personality characteristics in adolescents with visual impairment
Shabani, R. G. S., & Ashori, M. (2024) · Current Psychology · doi:10.1007/s12144-024-06915-4 · Cited by 2
Autonomy support in prenatal consultation: A quantitative observation study in maternity care
Kors, J., Martin, L. G., Verhoeven, C. J. M., Henrichs, J., Peerdeman, S. M., & Kusurkar, R. A. (2025) · European Journal of Midwifery · doi:10.18332/ejm/197053 · Cited by 2
Impact of In-Person and Mobile Exercise Coaching on Psychosocial Factors Affecting Exercise Adherence in Inactive Women With Obesity: 20-Week Randomized Controlled Trial
Gjestvang, C., Kalhovde, J. M., Tangen, E. M., Clemm, H. H., & Haakstad, L. A. H. (2025) · Journal of Medical Internet Research · doi:10.2196/68462 · Cited by 3
Online Intervention Program Based on Need‐Supportive Activities to Promote Physical Activity and Cognitive Functions in Physical Education
Behzadnia, B., Marcos, F. M. L., Khalilpourshiraz, Z., & Karimi, A. (2025) · Journal of Teaching in Physical Education · doi:10.1123/jtpe.2024-0128 · Cited by 2
“We delivered activities to support and satisfy students ’ basic psychological needs (viz., autonomy, competence, and relatedness; Behzadnia & FatahModares, 2020) through a need-supportive teaching approach (Ntoumanis et al., 2021) in online PE programs.”
What is Home? Creating a Psychological-Based Framework of Home With Basic Psychological Needs Theory.
Howard, M. C. (2025) · Psychological Reports · doi:10.1177/00332941251329850 · Cited by 2
“Of note, many of the other microtheories propose that the need for autonomy is central in understanding human motivation (Ntoumanis et al., 2021; Roth et al., 2019; Ryan & Deci, 2019; Ryan et al., 2021).”
Emerging Adults Report Internal, External, and Social/Environmental Motivations for Weight-Related Self-Monitoring Application Use
Hahn, S. L., Burnette, C. B., Bornstein, C., Nagata, J. M., Loth, K. A., & Neumark‐Sztainer, D. (2025) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2025.03.006 · Cited by 2

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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