Self-determination theory interventions for health behavior change: Meta-analysis and meta-analytic structural equation modeling of randomized controlled trials

Paschal Sheeran, Charles E. Wright, Aya Avishai, Megan E. Villegas, Jan Willem Lindemans, William M.P. Klein, Alexander J. Rothman, Eleanor Miles, Nikos Ntoumanis

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We conducted a meta-analysis of randomized controlled trials (RCTs) to promote health behavior change based on self-determination theory (SDT). The review aimed to (a) quantify the impact of SDT interventions on health behaviors, (b) test mediation by theoretically specified variables (autonomous motivation and perceived competence), and (c) identify moderators of intervention effectiveness. Method: Computerized searches and additional strategies identified 56 articles that yielded 65 independent tests of SDT interventions. Random effects meta-analysis and metaregressions were conducted via STATA; meta-analytic structural equation modeling (MASEM) was used to test mediation. Results: The sample-weighted average effect size for SDT interventions was d+ = .23, and there were significant effects for physical activity, sedentary behavior, diet, alcohol consumption, and smoking cessation (.16≥d+≥.29). Effect sizes exhibited both publication bias and small sample bias but remained significantly different from zero, albeit of smaller magnitude, after correction for bias (d+≥.15). MASEM indicated that autonomous motivation and perceived competence mediated intervention effects on behavior. Metaregression analyses indicated that features of the sample, intervention, or methodology generally did not moderate effect sizes. Conclusion: The present review indicates that SDT interventions have a significant but small effect on health behavior change and suggests several directions for future research.

Original languageEnglish (US)
Pages (from-to)726-737
Number of pages12
JournalJournal of consulting and clinical psychology
Volume88
Issue number8
DOIs
StatePublished - Aug 2020

Bibliographical note

Funding Information:
We thank Jennifer Walker and Rachael Posey (Medical Librarians) for invaluable assistance with the computerized literature searches. This research was partly supported by Zilveren Kruis and the Joep Lange Institute.

Publisher Copyright:
© 2020 American Psychological Association.

Keywords

  • Health behavior
  • Meta-analysis
  • Physical activity
  • Randomized trial
  • Self-determination theory

PubMed: MeSH publication types

  • Journal Article
  • Meta-Analysis

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