scholarly journals Older Adults’ Experiences of Behavior Change Support in a Digital Fall Prevention Exercise Program: Qualitative Study Framed by the Self-determination Theory

10.2196/26235 ◽  
2021 ◽  
Vol 23 (7) ◽  
pp. e26235
Author(s):  
Beatrice Pettersson ◽  
Rebecka Janols ◽  
Maria Wiklund ◽  
Lillemor Lundin-Olsson ◽  
Marlene Sandlund
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Classification System ◽  
Exercise Program ◽  
Psychological Needs ◽  
Self Determination ◽  
Behavior Change Techniques ◽  
And Behavior ◽  
Behavior Change Support ◽  
Step Program

Background Exercise is an effective intervention to prevent falls in older adults; however, long-term adherence is often poor. To increase adherence, additional support for behavior change has been advocated. However, consistency in the reporting of interventions using behavior change techniques is lacking. Recently, a classification system has been developed to increase consistency in studies using behavior change techniques within the self-determination theory. Objective This study aimed to explore expressions of self-determination among community-dwelling older adults using a self-managed digital fall prevention exercise program comprising behavior change support (the Safe Step program), which was developed in co-creation with intended users. Methods The qualitative study design was based on open-ended responses to questionnaires, and individual and focus group interviews. A deductive qualitative content analysis was applied using the classification system of motivation and behavior change techniques as an analytical matrix, followed by an inductive analysis. Twenty-five participants took part in a feasibility study and exercised in their homes with the Safe Step program for 4 months. The exercise program was available on computers, smartphones, and tablets, and was fully self-managed. Results In the deductive analysis, expressions of support were demonstrated for all three basic human psychological needs, namely, autonomy, competence, and relatedness. These expressions were related to 11 of the 21 motivation and behavior change techniques in the classification system. The inductive analysis indicated that autonomy (to be in control) was valued and enabled individual adaptations according to different rationales for realizing exercise goals. However, the experience of autonomy was also two-sided and depended on the participants’ competence in exercise and the use of technology. The clarity of the program and exercise videos was seen as key for support in performance and competent choices. Although augmented techniques for social support were requested, support through relatedness was found within the program. Conclusions In this study, the Safe Step program supported the establishment of new exercise routines, as well as the three basic human psychological needs, with autonomy and competence being expressed as central in this context. Based on the participants’ experiences, a proposed addition to the classification system used as an analytical matrix has been presented. Trial Registration ClinicalTrials.gov NCT02916849; https://clinicaltrials.gov/ct2/show/NCT02916849

scholarly journals Older Adults’ Experiences of Behavior Change Support in a Digital Fall Prevention Exercise Program: Qualitative Study Framed by the Self-determination Theory (Preprint)

2020 ◽  
Author(s):  
Beatrice Pettersson ◽  
Rebecka Janols ◽  
Maria Wiklund ◽  
Lillemor Lundin-Olsson ◽  
Marlene Sandlund
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Classification System ◽  
Exercise Program ◽  
Psychological Needs ◽  
Self Determination ◽  
Behavior Change Techniques ◽  
And Behavior ◽  
Behavior Change Support ◽  
Step Program

BACKGROUND Exercise is an effective intervention to prevent falls in older adults; however, long-term adherence is often poor. To increase adherence, additional support for behavior change has been advocated. However, consistency in the reporting of interventions using behavior change techniques is lacking. Recently, a classification system has been developed to increase consistency in studies using behavior change techniques within the self-determination theory. OBJECTIVE This study aimed to explore expressions of self-determination among community-dwelling older adults using a self-managed digital fall prevention exercise program comprising behavior change support (the Safe Step program), which was developed in co-creation with intended users. METHODS The qualitative study design was based on open-ended responses to questionnaires, and individual and focus group interviews. A deductive qualitative content analysis was applied using the classification system of motivation and behavior change techniques as an analytical matrix, followed by an inductive analysis. Twenty-five participants took part in a feasibility study and exercised in their homes with the Safe Step program for 4 months. The exercise program was available on computers, smartphones, and tablets, and was fully self-managed. RESULTS In the deductive analysis, expressions of support were demonstrated for all three basic human psychological needs, namely, autonomy, competence, and relatedness. These expressions were related to 11 of the 21 motivation and behavior change techniques in the classification system. The inductive analysis indicated that autonomy (to be in control) was valued and enabled individual adaptations according to different rationales for realizing exercise goals. However, the experience of autonomy was also two-sided and depended on the participants’ competence in exercise and the use of technology. The clarity of the program and exercise videos was seen as key for support in performance and competent choices. Although augmented techniques for social support were requested, support through relatedness was found within the program. CONCLUSIONS In this study, the Safe Step program supported the establishment of new exercise routines, as well as the three basic human psychological needs, with autonomy and competence being expressed as central in this context. Based on the participants’ experiences, a proposed addition to the classification system used as an analytical matrix has been presented. CLINICALTRIAL ClinicalTrials.gov NCT02916849; https://clinicaltrials.gov/ct2/show/NCT02916849

Motivating Adolescents to Participate in Literacy Intervention: A Case Example From Telepractice

2021 ◽  
pp. 1-15
Author(s):  
Ginger G. Collins
Keyword(s):  
Behavior Change ◽  
Self Determination Theory ◽  
Literacy Skills ◽  
Language Intervention ◽  
Self Determination ◽  
Literacy Intervention ◽  
Behavior Change Techniques ◽  
Language Interventions ◽  
And Behavior ◽  
Motivation To Participate

Purpose: Motivation declines as children reach adolescence. Poor motivation inhibits participation and engagement in language-based interventions. The purpose of this tutorial is to demonstrate how intervention can be designed to increase client motivation to participate while improving language-based literacy skills. Method: Motivation and behavior change techniques based on self-determination theory are presented, as are examples of how to integrate these techniques into contextualized language intervention with adolescent clients. Conclusion: Incorporating motivation and behavior change techniques into contextualized language interventions with adolescents promotes self-determination and motivation through satisfaction of their need for autonomy, relatedness, and competence while simultaneously addressing language-based literacy deficits.

scholarly journals A classification of motivation and behavior change techniques used in self-determination theory-based interventions in health contexts.

2020 ◽  
Vol 6 (4) ◽  
pp. 438-455 ◽  
Author(s):  
Pedro J. Teixeira ◽  
Marta M. Marques ◽  
Marlene N. Silva ◽  
Jennifer Brunet ◽  
Joan L. Duda ◽  
...  
Keyword(s):  
Behavior Change ◽  
Self Determination Theory ◽  
Self Determination ◽  
Behavior Change Techniques ◽  
And Behavior

Gamification in Oral Health (Preprint)

2021 ◽  
Author(s):  
Rui Moreira ◽  
Nuno Durão ◽  
Rita Maria Cabral ◽  
Jessica Lourenço ◽  
Augusta Silveira ◽  
...  
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Behavior Change ◽  
Well Being ◽  
Health Behavior Change ◽  
Psychological Needs ◽  
Evidence Based ◽  
Care Providers ◽  
Behavior Change Techniques ◽  
And Behavior

BACKGROUND Our modern way of life, health and well-being depend on the individual's health behaviors. Motivation is a major factor of health behaviour change, and intrinsically motivated behavior change is desirable as it is both sustained and directly contributes to well-being. This raises the immediate question about what kind of interventions are best positioned to intrinsically motivate health behavior change. OBJECTIVE With this study we wanted to analyse the presence and efficiency of gamification mechanisms in oral healthcare-themed digital games and apps on promoting user engagement to comply with prevention policies. METHODS The search query was based on the electronic database PubMed. Applying exclusion and inclusion criteria, this study is focused on scholar work reporting original research of the value of gamification on oral healthcare. The final pool of data was scrutinized for the gamification features, evidence-based oral health and behavior change techniques. RESULTS Apps with high quality evidence-based educational content for oral self-care, employing gamification features and behavior change techniques, provide excellent results in functionality, effectiveness, efficiency and satisfaction. However, some authors highlighted issues such as the need to improve engagement, aesthetics, evidence-based information content, behavior change taxonomies, psychological needs, evaluation, validation, quality assessment and professional regulation of the oral healthcare apps. CONCLUSIONS In this systematic review, we did not find any app that included all the segments for learning, performing, and maintaining proper oral health care. Evidence-based oral healthcare gamification features represent potential new approaches for health care providers to change behavior in the form of learning, performing and maintaining proper oral hygiene. Evaluation, validation, quality assurance, best practice standards and guidelines are needed for improving app use.

scholarly journals Classification of Techniques Used in Self-Determination Theory-Based Interventions in Health Contexts: An Expert Consensus Study

2019 ◽  
Author(s):  
Marta M Marques ◽  
Martin S Hagger
Keyword(s):  
Behavior Change ◽  
Classification System ◽  
Self Determination Theory ◽  
Psychological Needs ◽  
Need Satisfaction ◽  
Self Determination ◽  
Expert Consensus ◽  
Psychological Need ◽  
Behavior Change Technique

While evidence suggests that interventions based on self-determination theory can be effective in motivating adoption and maintenance of health-related behaviors, and in promoting adaptive psychological outcomes, the motivational techniques that comprise the content of these interventions have not been comprehensively identified or described. The aim of the present study was to develop a classification system of the techniques that comprise self-determination theory interventions, with satisfaction of psychological needs as an organizing principle. Candidate techniques were identified through a comprehensive review of self-determination theory interventions and nomination by experts. The study team developed a preliminary list of candidate techniques accompanied by labels, definitions, and function descriptions of each. Each technique was aligned with the most closely-related psychological need satisfaction construct (autonomy, competence, or relatedness). Using an iterative expert consensus procedure, participating experts (N=18) judged each technique on the preliminary list for redundancy, essentiality, uniqueness, and the proposed link between the technique and basic psychological need. The procedure produced a final classification of 21 motivation and behavior change techniques (MBCTs). Redundancies between final MBCTs against techniques from existing behavior change technique taxonomies were also checked. The classification system is the first formal attempt to systematize self-determination theory intervention techniques. The classification is expected to enhance consistency in descriptions of self-determination theory-based interventions in health contexts, and assist in facilitating synthesis of evidence on interventions based on the theory. The classification is also expected to guide future efforts to identify, describe, and classify the techniques that comprise self-determination theory-based interventions in multiple domains.

scholarly journals Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

2021 ◽  
pp. 104973232199344
Author(s):  
Oladunni Oluwoye ◽  
Elizabeth Fraser
Keyword(s):  
Substance Use ◽  
Behavior Change ◽  
Theoretical Domains Framework ◽  
First Episode Psychosis ◽  
Barriers And Facilitators ◽  
First Episode ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Episode Psychosis ◽  
And Behavior

In this qualitative study, we explore providers’ experiences with addressing substance use among individuals with first-episode psychosis (FEP) enrolled in coordinated specialty care (CSC) programs. Three focus groups were conducted with 24 providers from CSC programs for FEP in Washington. Questions were focused on barriers and facilitators to addressing substance use using the Theoretical Domains Framework (TDF) as a guide. Thematic analysis was used to code all transcripts. Identified TDF domains were then mapped onto the COM-B (Capability, Opportunity, Motivation, Behavior) intervention functions and behavior change techniques. Seven theoretical domains were identified as the most relevant to addressing substance use: “Knowledge,” “Skills,” “Environmental Context and Resources,” “Social Influences,” “Social and Professional Role and Identity,” “Beliefs about Capabilities,” and “Reinforcement.” The use of the TDF provides a framework to explore barriers and facilitators for targeting substance use and suggestions for behavior change techniques when considering implementation of evidence-based strategies to enhance CSC models.

scholarly journals Exercise Experience of Elderly Medicaid Beneficiaries with Osteoarthritis Based on Self-Determination Theory

2021 ◽  
Vol 21 (3) ◽  
pp. 117-128
Author(s):  
Yang-Heui Ahn ◽  
Jihea Choi
Keyword(s):  
Behavior Change ◽  
Interpretative Phenomenological Analysis ◽  
Exercise Intervention ◽  
Self Determination Theory ◽  
Psychological Needs ◽  
Self Determination ◽  
Common Chronic Disease ◽  
External Regulation ◽  
Internalization Process ◽  
Medicaid Beneficiaries

Background: Osteoarthritis is the most common chronic disease among elders, and it crucially requires self-management. This study aimed to qualitatively examine exercise experiences of elderly Medicaid beneficiaries with osteoarthritis receiving exercise intervention based on self-determination theory (SDT).Methods: Eight elders who received a community-based exercise intervention were interviewed three times. Using the interview transcriptions and field notes, researchers conducted an interpretative phenomenological analysis based on SDT to explore the motivational process of exercise compliance.Results: Three meaningful profiles (non-compliant, intermitter, and compliant) were identified along with satisfaction with needs (autonomy, competence, and relatedness) that motivate exercise compliance based on SDT. Compliance of exercise is primarily initiated by external regulation and followed by the internalization process of recognizing and accepting the value of the behavior.Conclusions: The concepts of SDT could be used to explore factors associated with motivation and gradual behavior change among elderly Medicaid beneficiaries with osteoarthritis. Autonomy, competence, relatedness, external regulation, and identified regulation control may be applied to establish a strategy that promotes behavior change by satisfying the psychological needs and internalizing the behavior of these elders.

scholarly journals Evaluation of the design and implementation of municipal ice cleat distribution programs for the prevention of ice-related fall injuries among older adults in Sweden

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253054
Author(s):  
Robin Holmberg ◽  
Johanna Gustavsson ◽  
Carl Bonander
Keyword(s):  
Older Adults ◽  
Behavior Change ◽  
Injury Rates ◽  
Fall Injuries ◽  
Behavior Change Theory ◽  
Barriers To Implementation ◽  
Group Interviews ◽  
Main Barrier ◽  
And Behavior ◽  
User Friendly

Introduction The risk for outdoor falls tends to increase during winter due to icy road conditions. Several Swedish municipalities have introduced programs that provide their senior citizens with a pair of ice cleats in an attempt to tackle this problem. In this paper, we perform a process evaluation to identify potential barriers to the success of these programs and analyze the logic of their design. Methods We sent a survey to all 290 Swedish municipalities to collect data on the characteristics of ice cleat distribution programs. We also performed focus-group interviews with older adults to gain insight into their thoughts about ice cleat programs. We synthesized our data with existing literature on ice cleats and behavior change theory to populate a logic model to identify and analyze hidden assumptions and potential flaws using program theory analysis. Results On average, about 40% of the eligible population living in the intervention municipalities collected a pair of ice cleats. While we identified some other, but mostly minor, barriers to implementation, the main barrier appears to be a lack of scale (i.e., insufficient procurement and distribution of ice cleats), as 90% of all purchased ice cleats were eventually distributed. While previous research suggests that ice cleats can decrease injury risks if worn, we find that there is limited evidence on the effects of distribution on ice cleat use. Our interviewees emphasized the potential utility of ice cleats for staying safe and active during winter but stressed that ice cleats need to be user-friendly and of high-quality to increase the likelihood that a distribution program encourages behavior change. Conclusion Existing ice cleat distribution programs appear to have reached a meaningful share of the targeted population. Additional research is required to assess their effects on ice cleat use and injury rates.

scholarly journals Reliability and Validity of the Chinese Nine-Item Basic Psychological Need Satisfaction Scale Based on Self-Determination Theory With Older Adults

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuting Yang ◽  
Miao Yao ◽  
Yongwei Yang ◽  
Qiong Ye ◽  
Ting Lin
Keyword(s):  
Older Adults ◽  
Item Analysis ◽  
Reliability And Validity ◽  
Self Determination Theory ◽  
Psychological Needs ◽  
Need Satisfaction ◽  
Self Determination ◽  
Internal Reliability ◽  
Satisfaction Scale ◽  
Validity Criterion

Background: Self-determination theory distinguishes three basic human psychological needs: competence, relatedness, and autonomy. The measurement of these needs in populations of older adults has been limited and inadequate. Yet, results from such an assessment are likely to be valuable in policymaking, specifically toward the goal of healthy aging.Aim: The objective of this study was to test the reliability and validity of the Chinese version of the Basic Psychological Need Satisfaction Scale (BPNS) based on self-determination theory with older adults.Methods: A total of 809 older adults were invited to participate in this study. We examined the item analysis, internal reliability, factorial validity, criterion validity, and measurement invariance across sex of a Chinese translation of the BPNS.Results: The findings demonstrated that the scale had a good factorial validity, criterion validity, and satisfactory internal reliability. All the items were qualified according to item analysis (p < 0.001). The Cronbach’s α coefficient for the total scale was 0.877. The coefficients of three subscales were 0.826 (autonomy), 0.807 (competence), and 0.847 (relatedness). Exploratory factor analysis indicated three factors that explained 75.12% of the total variance. Confirmatory factor analysis showed measurement fit exceeded the recommended criteria in all the cases. Measurement invariance analysis manifested that the factor loadings, factor variances and covariances, and residuals to measurement structure were invariant across the male and female participants.Conclusion: The Chinese version of the BPNS based on self-determination theory was proven to be reliable and valid. The usability of the scale to assess the satisfaction of the basic psychological needs of older adults in China was demonstrated.

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