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1. Written reflection in an eHealth intervention for adults with type 2 diabetes mellitus: a qualitative study

Author

Lie SS, Karlsen B, Niemiec CP, Graue M, and Oftedal B

Subjects
eHealth, guided self-determination, self-determination theory, self-management, type 2 diabetes mellitus, written reflection, Medicine (General), R5-920
Abstract

Silje S Lie,1 Bjørg Karlsen,1 Christopher P Niemiec,2 Marit Graue,3 Bjørg Oftedal1 1Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; 2Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA; 3Center for Evidence-Based Practice, Western Norway University of Applied Sciences, Bergen, Norway Background: Individuals with type 2 diabetes mellitus (T2DM) are responsible for the daily decisions and actions necessary to manage their disease, which makes self-management the cornerstone of diabetes care. Many patients do not reach recommended treatment goals, and thus it is important to develop and evaluate innovative interventions that facilitate optimal motivation for adequate self-management of T2DM. Objective: The aim of the current study was to explore how adults with T2DM experience using reflection sheets to stimulate written reflection in the context of the Guided Self-Determination (GSD) eHealth intervention and how written reflection might affect their motivation for self-management of T2DM. Methods: We used a qualitative design in which data were collected through individual interviews. The sample consisted of 10 patients who completed the GSD eHealth intervention, and data were analyzed using qualitative content analysis. Results: The qualitative content analysis yielded 2 main themes. We labeled the first theme as “Written reflection affects awareness and commitment in diabetes self-management”, which reflects 2 subthemes, namely, “Writing creates space and time for autonomous reflection” and “Writing influences individuals’ focus in diabetes self-management”. We labeled the second theme as “Written reflection is perceived as inapplicable in diabetes self-management”, which reflects 2 subthemes, namely, “Responding in writing is difficult” and “The timing of the writing is inappropriate”. Conclusion: Our findings indicate that written reflection in the context of the GSD eHealth intervention may be conducive to motivation for diabetes self-management for some patients. However, it seems that in-person consultation with the diabetes nurse may be necessary to achieve the full potential benefit of the GSD as an eHealth intervention. We advocate further development and examination of the GSD as a “blended” approach, especially for those who consider written reflection to be difficult or unfamiliar. Keywords: eHealth, guided self-determination, self-determination theory, self-management, type 2 diabetes mellitus, written reflection

Published
2018

2. A global experiment on motivating social distancing during the COVID-19 pandemic

Author

Legate, N, Nguyen, T, Weinstein, N, Moller, A, Legault, L, Vally, Z, Tajchman, Z, Zsido, A, Zrimsek, M, Chen, Z, Ziano, I, Gialitaki, Z, Ceary, C, Jang, Y, Lin, Y, Kunisato, Y, Yamada, Y, Xiao, Q, Jiang, X, Du, X, Yao, E, Ryan, W, Wilson, J, Cyrus-Lai, W, Jimenez-Leal, W, Law, W, Unanue, W, Collins, W, Richard, K, Vranka, M, Ankushev, V, Schei, V, Lerche, V, Kovic, V, Krizanic, V, Kadreva, V, Adoric, V, Tran, U, Yeung, S, Hassan, W, Houston, R, Machin, M, Lima, T, Ostermann, T, Frizzo, T, Sverdrup, T, House, T, Gill, T, Fedotov, M, Paltrow, T, Jernsather, T, Rahman, T, Machin, T, Koptjevskaja-Tamm, M, Hostler, T, Ishii, T, Szaszi, B, Adamus, S, Suter, L, von Bormann, S, Habib, S, Studzinska, A, Stojanovska, D, Janssen, S, Stieger, S, Schulenberg, S, Tatachari, S, Azouaghe, S, Sorokowski, P, Sorokowska, A, Song, X, Morbee, S, Lewis, S, Sinkolova, S, Grigoryev, D, Drexler, S, Daches, S, Levine, S, Geniole, S, Akter, S, Vracar, S, Massoni, S, Costa, S, Zorjan, S, Sarioguz, E, Izquierdo, S, Tshonda, S, Alves, S, Pontinen, S, Solas, S, Ordonez-Riano, S, Ocovaj, S, Onie, S, Lins, S, Biberauer, T, Coksan, S, Khumkom, S, Sacakli, A, Ruiz-Fernandez, S, Geiger, S, Modares, S, Walczak, R, Betlehem, R, Vilar, R, Carcamo, R, Ross, R, Mccarthy, R, Ballantyne, T, Westgate, E, Ryan, R, Gargurevich, R, Afhami, R, Ren, D, Monteiro, R, Reips, U, Reggev, N, Calin-Jagema, R, Pourafshari, R, Oliveira, R, Nedelcheva-Datsova, M, Rahal, R, Ribeiro, R, Radtke, T, Searston, R, Jai-ai, R, Habte, R, Zdybek, P, Chen, S, Wajanatinapart, P, Maturan, P, Perillo, J, Isager, P, Kacmar, P, Macapagal, P, Maniaci, M, Szwed, P, Hanel, P, Forbes, P, Arriaga, P, Paris, B, Parashar, N, Papachristopoulos, K, Correa, P, Kacha, O, Bernardo, M, Campos, O, Bravo, O, Galindo-Caballero, O, Ogbonnaya, C, Bialobrzeska, O, Kiselnikova, N, Simonovic, N, Cohen, N, Nock, N, Hernandez, A, Thogersen-Ntouma, C, Ntoumanis, N, Johannes, N, Albayrak-Aydemir, N, Say, N, Neubauer, A, Martin, N, Torunsky, N, van Antwerpen, N, Van Doren, N, Sunami, N, Rachev, N, Majeed, N, Schmidt, N, Nadif, K, Corral-Frias, N, Ouherrou, N, Abbas, N, Pantazi, M, Lucas, M, Vasilev, M, Ortiz, M, Butt, M, Kurfali, M, Kabir, M, Muda, R, Rivera, M, Sirota, M, Seehuus, M, Parzuchowski, M, Toro, M, Hricova, M, Maldonado, M, Rentzelas, P, Vansteenkiste, M, Metz, M, Marszalek, M, Karekla, M, Mioni, G, Bosma, M, Westerlund, M, Vdovic, M, Bialek, M, Silan, M, Anne, M, Misiak, M, Gugliandolo, M, Grinberg, M, Capizzi, M, Barria, M, Mensink, M, Harutyunyan, M, Khosla, M, Dunn, M, Korbmacher, M, Adamkovic, M, Ribeiro, M, Terskova, M, Hruska, M, Martoncik, M, Voracek, M, Cadek, M, Frias-Armenta, M, Kowal, M, Topor, M, Roczniewska, M, Oosterlinck, M, Kohlova, M, Paruzel-Czachura, M, Sabristov, M, Romanova, M, Papadatou-Pastou, M, Lund, M, Antoniadi, M, Magrin, M, Jones, M, Li, M, Manavalan, M, Muminov, A, Kossowska, M, Friedemann, M, Wielgus, M, van Hooff, M, Varella, M, Standage, M, Nicolotti, M, Colloff, M, Bradford, M, Vaughn, L, Eudave, L, Vieira, L, Lu, J, Pineda, L, Matos, L, Perez, L, Lazarevic, L, Jaremka, L, Smit, E, Kushnir, E, Ferguson, L, Anton-Boicuk, L, Coelho, G, Ahlgren, L, Liga, F, Levitan, C, Micheli, L, Gunton, L, Volz, L, Stojanovska, M, Boucher, L, Samojlenko, L, Delgado, L, Kaliska, L, Beatrix, L, Warmelink, L, Rojas-Berscia, L, Yu, K, Wylie, K, Wachowicz, J, Desai, K, Barzykowski, K, Kozma, L, Evans, K, Kirgizova, K, Agesin, B, Koehn, M, Wolfe, K, Korobova, T, Morris, K, Klevjer, K, van Schie, K, Vezirian, K, Damnjanovic, K, Thommesen, K, Schmidt, K, Filip, K, Staniaszek, K, Grzech, K, Hoyer, K, Moon, K, Khaobunmasiri, S, Rana, K, Janjic, K, Suchow, J, Kielinska, J, Vasquez, J, Chanal, J, Beitner, J, Vargas-Nieto, J, Roxas, J, Taber, J, Urriago-Rayo, J, Pavlacic, J, Benka, J, Bavolar, J, Soto, J, Olofsson, J, Vilsmeier, J, Messerschmidt, J, Czamanski-Cohen, J, Waterschoot, J, Moss, J, Boudesseul, J, Lee, J, Kamburidis, J, Joy-Gaba, J, Zickfeld, J, Miranda, J, Verharen, J, Hristova, E, Beshears, J, Djordjevic, J, Bosch, J, Valentova, J, Antfolk, J, Berkessel, J, Schrotter, J, Urban, J, Roer, J, Norton, J, Silva, J, Pickering, J, Vintr, J, Uttley, J, Kunst, J, Ndukaihe, I, Iyer, A, Vilares, I, Ivanov, A, Ropovik, I, Sula, I, Sarieva, I, Metin-Orta, I, Prusova, I, Pinto, I, Bozdoc, A, Almeida, I, Pit, I, Dalgar, I, Zakharov, I, Arinze, A, Ihaya, K, Stephen, I, Gjoneska, B, Brohmer, H, Flowe, H, Godbersen, H, Kocalar, H, Hedgebeth, M, Chuan-Peng, H, Sharifian, M, Manley, H, Akkas, H, Hajdu, N, Azab, H, Kaminski, G, Nilsonne, G, Anjum, G, Travaglino, G, Feldman, G, Pfuhl, G, Czarnek, G, Marcu, G, Hofer, G, Banik, G, Adetula, G, Bijlstra, G, Verbruggen, F, Kung, F, Martela, F, Foroni, F, Forest, J, Singer, G, Muchembled, F, Azevedo, F, Mosannenzadeh, F, Marinova, E, Strukelj, E, Etebari, Z, Bradshaw, E, Baskin, E, Garcia, E, Musser, E, van Steenkiste, I, Ahn, E, Quested, E, Pronizius, E, Jackson, E, Manunta, E, Agadullina, E, Sakan, D, Dursun, P, Dujols, O, Dubrov, D, Willis, M, Tumer, M, Beaudry, J, Popovic, D, Dunleavy, D, Djamai, I, Krupic, D, Herrera, D, Vega, D, Du, H, Mola, D, Chakarova, D, Davis, W, Holford, D, Lewis, D, Vaidis, D, Ozery, D, Ricaurte, D, Storage, D, Sousa, D, Alvarez, D, Boller, D, Dalla Rosa, A, Dimova, D, Marko, D, Moreau, D, Reeck, C, Correia, R, Whitt, C, Lamm, C, Solorzano, C, von Bastian, C, Sutherland, C, Overkott, C, Aberson, C, Wang, C, Niemiec, C, Karashiali, C, Noone, C, Chiu, F, Picciocchi, C, Brownlow, C, Karaarslan, C, Cellini, N, Esteban-Serna, C, Reyna, C, Ferreyra, C, Batres, C, Li, R, Grano, C, Carpentier, J, Tamnes, C, Fu, C, Ishkhanyan, B, Bylinina, L, Jaeger, B, Bundt, C, Allred, T, Vermote, B, Bokkour, A, Bogatyreva, N, Shi, J, Chopik, W, Antazo, B, Behzadnia, B, Becker, M, Bayyat, M, Cocco, B, Chou, W, Barkoukis, V, Hubena, B, Zuro, B, Aczel, B, Baklanova, E, Bai, H, Balci, B, Babincak, P, Soenens, B, Dixson, B, Mokady, A, Kappes, H, Atari, M, Szala, A, Szabelska, A, Aruta, J, Domurat, A, Arinze, N, Modena, A, Adiguzel, A, Monajem, A, El Arabi, K, Ozdogru, A, Rothbaum, A, Torres, A, Theodoropoulou, A, Skowronek, A, Jurkovic, A, Singh, A, Kassianos, A, Findor, A, Hartanto, A, Landry, A, Ferreira, A, Santos, A, De la Rosa-Gomez, A, Gourdon-Kanhukamwe, A, Luxon, A, Todsen, A, Karababa, A, Janak, A, Pilato, A, Bran, A, Tullett, A, Kuzminska, A, Krafnick, A, Urooj, A, Khaoudi, A, Ahmed, A, Groyecka-Bernard, A, Askelund, A, Adetula, A, Belaus, A, Charyate, A, Wichman, A, Stoyanova, A, Greenburgh, A, Thomas, A, Arvanitis, A, Forscher, P, Mallik, P, Coles, N, Miller, J, Moshontz, H, Urry, H, Ijzerman, H, Basnight-Brown, D, Ebersole, C, Chartier, C, Buchanan, E, Primbs, M, Nguyen, TV, Zsido, AN, Ceary, CD, Jang, YN, Lin, YJ, Xiao, QY, Jiang, XM, Du, XK, Ryan, WS, Wilson, JP, Collins, WM, Richard, KL, Kadreva, VH, Adoric, VC, Tran, US, Yeung, SK, Machin, MA, Lima, TJS, Sverdrup, TE, Hostler, TJ, von Bormann, SM, Janssen, SMJ, Schulenberg, SE, Drexler, SM, Levine, SL, Geniole, SN, Izquierdo, SM, Tshonda, SS, Alves, SG, Solas, SA, Ocovaj, SB, Geiger, SJ, Modares, SF, Walczak, RB, Carcamo, RA, Ross, RM, McCarthy, R, Westgate, EC, Ryan, RM, Ren, DN, Monteiro, RP, Reips, UD, Calin-Jagema, RJ, Rahal, RM, Ribeiro, RR, Chen, SC, Maturan, PLG, Perillo, JT, Isager, PM, Macapagal, PM, Maniaci, MR, Hanel, PHP, Forbes, PAG, Correa, PS, Bravo, ON, Galindo-Caballero, OJ, Ogbonnaya, CE, Nock, NL, Neubauer, AB, Martin, NI, Rachev, NR, Majeed, NM, Schmidt, ND, Corral-Frias, NS, Lucas, MY, Vasilev, MR, Ortiz, MV, Butt, MM, Rivera, MDT, Maldonado, MA, Metz, MA, Bosma, MJ, Silan, MA, Gugliandolo, MC, Barria, MFE, Kurfali, MA, Mensink, MC, Dunn, MR, Ribeiro, MFF, Kohlova, MB, Lund, ML, Magrin, ME, Jones, MV, Li, MY, Ortiz, MS, van Hooff, MLM, Varella, MAC, Colloff, MF, Vaughn, LA, Lu, JG, Pineda, LMS, Perez, LC, Lazarevic, LB, Jaremka, LM, Smit, ES, Ferguson, LJ, Coelho, GLD, Levitan, CA, Gunton, LA, Delgado, LGJ, Rojas-Berscia, LM, Agesin, BBE, Koehn, MA, Thommesen, KK, Suchow, JW, Vasquez, JEC, Vargas-Nieto, JC, Roxas, JCT, Pavlacic, JM, Soto, JA, Olofsson, JK, Vilsmeier, JK, Moss, JD, Lee, JM, Joy-Gaba, JA, Miranda, JF, Verharen, JPH, Beshears, JE, Djordjevic, JM, Valentova, JV, Berkessel, JB, Roer, JP, Norton, JO, Silva, JR, Pickering, JS, Kunst, JR, Ndukaihe, ILG, Bozdoc, AI, Almeida, IAT, Pit, IL, Arinze, AI, Stephen, ID, Kocalar, HE, Hedgebeth, MV, Travaglino, GA, Marcu, GM, Adetula, GA, Kung, FYH, Bradshaw, EL, Garcia, EOL, van Steenkiste, IMM, Ahn, ER, Jackson, EA, Beaudry, JL, Du, HF, Davis, WE, Holford, DL, Lewis, DMG, Vaidis, DC, Ozery, DH, Ricaurte, DZ, Alvarez, DS, Correia, RC, Whitt, CM, Solorzano, CS, von Bastian, CC, Sutherland, CAM, Aberson, CL, Wang, CH, Niemiec, CP, Li, RR, Tamnes, CK, Fu, CHY, Allred, TB, Vermote, BJ, Shi, JX, Chopik, WJ, Bayyat, MM, Chou, WL, Balci, BB, Dixson, BJW, Kappes, HB, Aruta, JJB, Arinze, NC, El Arabi, KA, Ozdogru, AA, Rothbaum, AO, Torres, AO, Jurkovic, AP, Kassianos, AP, Landry, AT, Santos, AC, Luxon, AM, Todsen, AL, Tullett, AM, Kuzminska, AO, Krafnick, AJ, Askelund, AD, Charyate, AC, Wichman, AL, Thomas, AG, Forscher, PS, Mallik, PR, Coles, NA, Miller, JK, Urry, HL, IJzerman, H, Basnight-Brown, DM, Ebersole, CR, Chartier, CR, Buchanan, EM, Primbs, MA, Legate, N, Nguyen, T, Weinstein, N, Moller, A, Legault, L, Vally, Z, Tajchman, Z, Zsido, A, Zrimsek, M, Chen, Z, Ziano, I, Gialitaki, Z, Ceary, C, Jang, Y, Lin, Y, Kunisato, Y, Yamada, Y, Xiao, Q, Jiang, X, Du, X, Yao, E, Ryan, W, Wilson, J, Cyrus-Lai, W, Jimenez-Leal, W, Law, W, Unanue, W, Collins, W, Richard, K, Vranka, M, Ankushev, V, Schei, V, Lerche, V, Kovic, V, Krizanic, V, Kadreva, V, Adoric, V, Tran, U, Yeung, S, Hassan, W, Houston, R, Machin, M, Lima, T, Ostermann, T, Frizzo, T, Sverdrup, T, House, T, Gill, T, Fedotov, M, Paltrow, T, Jernsather, T, Rahman, T, Machin, T, Koptjevskaja-Tamm, M, Hostler, T, Ishii, T, Szaszi, B, Adamus, S, Suter, L, von Bormann, S, Habib, S, Studzinska, A, Stojanovska, D, Janssen, S, Stieger, S, Schulenberg, S, Tatachari, S, Azouaghe, S, Sorokowski, P, Sorokowska, A, Song, X, Morbee, S, Lewis, S, Sinkolova, S, Grigoryev, D, Drexler, S, Daches, S, Levine, S, Geniole, S, Akter, S, Vracar, S, Massoni, S, Costa, S, Zorjan, S, Sarioguz, E, Izquierdo, S, Tshonda, S, Alves, S, Pontinen, S, Solas, S, Ordonez-Riano, S, Ocovaj, S, Onie, S, Lins, S, Biberauer, T, Coksan, S, Khumkom, S, Sacakli, A, Ruiz-Fernandez, S, Geiger, S, Modares, S, Walczak, R, Betlehem, R, Vilar, R, Carcamo, R, Ross, R, Mccarthy, R, Ballantyne, T, Westgate, E, Ryan, R, Gargurevich, R, Afhami, R, Ren, D, Monteiro, R, Reips, U, Reggev, N, Calin-Jagema, R, Pourafshari, R, Oliveira, R, Nedelcheva-Datsova, M, Rahal, R, Ribeiro, R, Radtke, T, Searston, R, Jai-ai, R, Habte, R, Zdybek, P, Chen, S, Wajanatinapart, P, Maturan, P, Perillo, J, Isager, P, Kacmar, P, Macapagal, P, Maniaci, M, Szwed, P, Hanel, P, Forbes, P, Arriaga, P, Paris, B, Parashar, N, Papachristopoulos, K, Correa, P, Kacha, O, Bernardo, M, Campos, O, Bravo, O, Galindo-Caballero, O, Ogbonnaya, C, Bialobrzeska, O, Kiselnikova, N, Simonovic, N, Cohen, N, Nock, N, Hernandez, A, Thogersen-Ntouma, C, Ntoumanis, N, Johannes, N, Albayrak-Aydemir, N, Say, N, Neubauer, A, Martin, N, Torunsky, N, van Antwerpen, N, Van Doren, N, Sunami, N, Rachev, N, Majeed, N, Schmidt, N, Nadif, K, Corral-Frias, N, Ouherrou, N, Abbas, N, Pantazi, M, Lucas, M, Vasilev, M, Ortiz, M, Butt, M, Kurfali, M, Kabir, M, Muda, R, Rivera, M, Sirota, M, Seehuus, M, Parzuchowski, M, Toro, M, Hricova, M, Maldonado, M, Rentzelas, P, Vansteenkiste, M, Metz, M, Marszalek, M, Karekla, M, Mioni, G, Bosma, M, Westerlund, M, Vdovic, M, Bialek, M, Silan, M, Anne, M, Misiak, M, Gugliandolo, M, Grinberg, M, Capizzi, M, Barria, M, Mensink, M, Harutyunyan, M, Khosla, M, Dunn, M, Korbmacher, M, Adamkovic, M, Ribeiro, M, Terskova, M, Hruska, M, Martoncik, M, Voracek, M, Cadek, M, Frias-Armenta, M, Kowal, M, Topor, M, Roczniewska, M, Oosterlinck, M, Kohlova, M, Paruzel-Czachura, M, Sabristov, M, Romanova, M, Papadatou-Pastou, M, Lund, M, Antoniadi, M, Magrin, M, Jones, M, Li, M, Manavalan, M, Muminov, A, Kossowska, M, Friedemann, M, Wielgus, M, van Hooff, M, Varella, M, Standage, M, Nicolotti, M, Colloff, M, Bradford, M, Vaughn, L, Eudave, L, Vieira, L, Lu, J, Pineda, L, Matos, L, Perez, L, Lazarevic, L, Jaremka, L, Smit, E, Kushnir, E, Ferguson, L, Anton-Boicuk, L, Coelho, G, Ahlgren, L, Liga, F, Levitan, C, Micheli, L, Gunton, L, Volz, L, Stojanovska, M, Boucher, L, Samojlenko, L, Delgado, L, Kaliska, L, Beatrix, L, Warmelink, L, Rojas-Berscia, L, Yu, K, Wylie, K, Wachowicz, J, Desai, K, Barzykowski, K, Kozma, L, Evans, K, Kirgizova, K, Agesin, B, Koehn, M, Wolfe, K, Korobova, T, Morris, K, Klevjer, K, van Schie, K, Vezirian, K, Damnjanovic, K, Thommesen, K, Schmidt, K, Filip, K, Staniaszek, K, Grzech, K, Hoyer, K, Moon, K, Khaobunmasiri, S, Rana, K, Janjic, K, Suchow, J, Kielinska, J, Vasquez, J, Chanal, J, Beitner, J, Vargas-Nieto, J, Roxas, J, Taber, J, Urriago-Rayo, J, Pavlacic, J, Benka, J, Bavolar, J, Soto, J, Olofsson, J, Vilsmeier, J, Messerschmidt, J, Czamanski-Cohen, J, Waterschoot, J, Moss, J, Boudesseul, J, Lee, J, Kamburidis, J, Joy-Gaba, J, Zickfeld, J, Miranda, J, Verharen, J, Hristova, E, Beshears, J, Djordjevic, J, Bosch, J, Valentova, J, Antfolk, J, Berkessel, J, Schrotter, J, Urban, J, Roer, J, Norton, J, Silva, J, Pickering, J, Vintr, J, Uttley, J, Kunst, J, Ndukaihe, I, Iyer, A, Vilares, I, Ivanov, A, Ropovik, I, Sula, I, Sarieva, I, Metin-Orta, I, Prusova, I, Pinto, I, Bozdoc, A, Almeida, I, Pit, I, Dalgar, I, Zakharov, I, Arinze, A, Ihaya, K, Stephen, I, Gjoneska, B, Brohmer, H, Flowe, H, Godbersen, H, Kocalar, H, Hedgebeth, M, Chuan-Peng, H, Sharifian, M, Manley, H, Akkas, H, Hajdu, N, Azab, H, Kaminski, G, Nilsonne, G, Anjum, G, Travaglino, G, Feldman, G, Pfuhl, G, Czarnek, G, Marcu, G, Hofer, G, Banik, G, Adetula, G, Bijlstra, G, Verbruggen, F, Kung, F, Martela, F, Foroni, F, Forest, J, Singer, G, Muchembled, F, Azevedo, F, Mosannenzadeh, F, Marinova, E, Strukelj, E, Etebari, Z, Bradshaw, E, Baskin, E, Garcia, E, Musser, E, van Steenkiste, I, Ahn, E, Quested, E, Pronizius, E, Jackson, E, Manunta, E, Agadullina, E, Sakan, D, Dursun, P, Dujols, O, Dubrov, D, Willis, M, Tumer, M, Beaudry, J, Popovic, D, Dunleavy, D, Djamai, I, Krupic, D, Herrera, D, Vega, D, Du, H, Mola, D, Chakarova, D, Davis, W, Holford, D, Lewis, D, Vaidis, D, Ozery, D, Ricaurte, D, Storage, D, Sousa, D, Alvarez, D, Boller, D, Dalla Rosa, A, Dimova, D, Marko, D, Moreau, D, Reeck, C, Correia, R, Whitt, C, Lamm, C, Solorzano, C, von Bastian, C, Sutherland, C, Overkott, C, Aberson, C, Wang, C, Niemiec, C, Karashiali, C, Noone, C, Chiu, F, Picciocchi, C, Brownlow, C, Karaarslan, C, Cellini, N, Esteban-Serna, C, Reyna, C, Ferreyra, C, Batres, C, Li, R, Grano, C, Carpentier, J, Tamnes, C, Fu, C, Ishkhanyan, B, Bylinina, L, Jaeger, B, Bundt, C, Allred, T, Vermote, B, Bokkour, A, Bogatyreva, N, Shi, J, Chopik, W, Antazo, B, Behzadnia, B, Becker, M, Bayyat, M, Cocco, B, Chou, W, Barkoukis, V, Hubena, B, Zuro, B, Aczel, B, Baklanova, E, Bai, H, Balci, B, Babincak, P, Soenens, B, Dixson, B, Mokady, A, Kappes, H, Atari, M, Szala, A, Szabelska, A, Aruta, J, Domurat, A, Arinze, N, Modena, A, Adiguzel, A, Monajem, A, El Arabi, K, Ozdogru, A, Rothbaum, A, Torres, A, Theodoropoulou, A, Skowronek, A, Jurkovic, A, Singh, A, Kassianos, A, Findor, A, Hartanto, A, Landry, A, Ferreira, A, Santos, A, De la Rosa-Gomez, A, Gourdon-Kanhukamwe, A, Luxon, A, Todsen, A, Karababa, A, Janak, A, Pilato, A, Bran, A, Tullett, A, Kuzminska, A, Krafnick, A, Urooj, A, Khaoudi, A, Ahmed, A, Groyecka-Bernard, A, Askelund, A, Adetula, A, Belaus, A, Charyate, A, Wichman, A, Stoyanova, A, Greenburgh, A, Thomas, A, Arvanitis, A, Forscher, P, Mallik, P, Coles, N, Miller, J, Moshontz, H, Urry, H, Ijzerman, H, Basnight-Brown, D, Ebersole, C, Chartier, C, Buchanan, E, Primbs, M, Nguyen, TV, Zsido, AN, Ceary, CD, Jang, YN, Lin, YJ, Xiao, QY, Jiang, XM, Du, XK, Ryan, WS, Wilson, JP, Collins, WM, Richard, KL, Kadreva, VH, Adoric, VC, Tran, US, Yeung, SK, Machin, MA, Lima, TJS, Sverdrup, TE, Hostler, TJ, von Bormann, SM, Janssen, SMJ, Schulenberg, SE, Drexler, SM, Levine, SL, Geniole, SN, Izquierdo, SM, Tshonda, SS, Alves, SG, Solas, SA, Ocovaj, SB, Geiger, SJ, Modares, SF, Walczak, RB, Carcamo, RA, Ross, RM, McCarthy, R, Westgate, EC, Ryan, RM, Ren, DN, Monteiro, RP, Reips, UD, Calin-Jagema, RJ, Rahal, RM, Ribeiro, RR, Chen, SC, Maturan, PLG, Perillo, JT, Isager, PM, Macapagal, PM, Maniaci, MR, Hanel, PHP, Forbes, PAG, Correa, PS, Bravo, ON, Galindo-Caballero, OJ, Ogbonnaya, CE, Nock, NL, Neubauer, AB, Martin, NI, Rachev, NR, Majeed, NM, Schmidt, ND, Corral-Frias, NS, Lucas, MY, Vasilev, MR, Ortiz, MV, Butt, MM, Rivera, MDT, Maldonado, MA, Metz, MA, Bosma, MJ, Silan, MA, Gugliandolo, MC, Barria, MFE, Kurfali, MA, Mensink, MC, Dunn, MR, Ribeiro, MFF, Kohlova, MB, Lund, ML, Magrin, ME, Jones, MV, Li, MY, Ortiz, MS, van Hooff, MLM, Varella, MAC, 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Abstract

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This crosscountry, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one's core values) or behavioral intentions. Results supported hypothesized associations between people's existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges.

Published
2022

3. On the relations among work value orientations, psychological need satisfaction and job outcomes: a self-determination theory approach.

Author

Vansteenkiste M, Neyrinck B, Niemiec CP, Soenens B, De Witte H, and Van Den Broeck A

Abstract

Using self-determination theory, two studies found that holding an extrinsic, relative to an intrinsic, work value orientation was associated with less positive outcomes (i.e. less satisfaction with, dedication to and vitality while on the job) and more negative outcomes (i.e. higher emotional exhaustion, short-lived satisfaction after successful goal-attainment, and turn-over intention). These relations were not limited to job outcomes, but also emerged using indicators of employees' general mental health. Moreover, income level did not moderate these relations. Study 2 found that holding an extrinsic, relative to an intrinsic, work value orientation was detrimental to employees' job outcomes because these orientations thwarted the satisfaction of the basic psychological needs for autonomy, competence and relatedness at work. [ABSTRACT FROM AUTHOR]

Published
2007

4. Motivation and Lifestyle-Related Changes among Participants in a Healthy Life Centre: A 12-Month Observational Study.

Author

Sevild CH, Niemiec CP, Dyrstad SM, and Bru LE

Subjects
Adult, Exercise, Female, Humans, Life Style, Male, Obesity, Health Behavior, Motivation
Abstract

Healthy Life Centers (HLCs) have been established throughout Norway to support lifestyle changes and promote physical and mental health. We conducted a 12-month observational study among participants in an HLC that aimed to improve physical activity (PA) and dietary behaviors, and this study examined predictors of completion, and changes in psychological variables, lifestyle behaviors, and physical health indicators. The participants (N = 120, 71% female, mean age = 44 years) reported symptoms of psychological distress (77%) and were obese (77%). No baseline characteristics were found to be consistent predictors of completion (42%). Completers had significant improvements in autonomous motivation for PA ( d = 0.89), perceived competence for PA ( d = 1.64) and diet ( d = 0.66), psychological distress ( d = 0.71), fruit intake ( d = 0.64), vegetable intake ( d = 0.38), BMI among all participants ( d = 0.21) and obese participants ( d = 0.34), body fat percentage among all participants ( d = 0.22) and obese participants ( d = 0.33), and lower body strength ( d = 0.91). Fat-free mass and all forms of PA remained unchanged from baseline to 12 months. Hence, there were indications of improvement among completers on psychological variables, lifestyle behaviors, and physical health indicators. The low rate of completion was a concern, and the unchanged levels of PA reflect an important area of focus for future interventions in the context of HLCs.

Published
2022
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5. Initiation and maintenance of lifestyle changes among participants in a healthy life centre: a qualitative study.

Author

Sevild CH, Niemiec CP, Bru LE, Dyrstad SM, and Husebø AML

Subjects
Adaptation, Psychological, Adult, Attitude to Health, Cardiovascular Diseases prevention & control, Female, Humans, Male, Middle Aged, Motivation, Norway, Qualitative Research, Risk Reduction Behavior, Young Adult, Exercise, Health Behavior, Healthy Lifestyle, Personal Autonomy
Abstract

Background: Since the early 2000s, Healthy Life Centres have been established in Norway to promote physical and mental health. Yet to date, little is known about the efficacy of Healthy Life Centres in promoting health behaviour change and maintenance or the factors that underlie these processes. Accordingly, the aim of the current study was to examine the factors that participants in a Healthy Life Centre perceive as relevant for the initiation and maintenance of lifestyle changes toward more physical activity and consumption of a healthier diet., Method: Participants were purposely recruited from among adherers in a 12-month multi-method research project at a Healthy Life Centre. Individual, semi-structured interviews were conducted with 8 women and 6 men who were between the ages of 20 and 61 years old. Data were analysed using Systematic Text Condensation., Results: Three main themes were derived from this analysis. The first theme focused on the motives behind initiation and maintenance of lifestyle changes along with the importance of a relationally supportive environment to promote perceived competence in pursuing a healthy lifestyle. The second theme focused on strategies for coping with the challenges and potential pitfalls that were associated with various unpleasant experiences and life events. The third theme focused on several specific skills that were helpful to the initiation and maintenance of lifestyle changes., Conclusion: The current study enhanced an understanding of the initiation and maintenance of lifestyle changes, although these processes were not disentangled in participants' experiences. In line with self-determination theory, the results suggested that lifestyle change is more likely to be initiated and maintained when goals are not only achievable but also regulated with autonomous motivation and of intrinsic value. Conversely, lifestyle change is difficult to maintain when motives are external to the self. Further, cognitive and behavioural skills were valuable and necessary in coping with unpleasant emotions. Finally, the critical function of self-regulation skills for making realistic plans and prioritizations in order to balance healthy lifestyle behaviours with the routines of "daily life" while monitoring outcomes was readily apparent. Healthy Life Centres can contribute to these processes in meaningful ways.

Published
2020
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6. Effects of an evidence-based computerized virtual clinician on low-density lipoprotein and non-high-density lipoprotein cholesterol in adults without cardiovascular disease: The Interactive Cholesterol Advisory Tool.

Author

Block RC, Abdolahi A, Niemiec CP, Rigby CS, and Williams GC

Subjects
Adult, Cardiovascular Diseases prevention & control, Cardiovascular Diseases therapy, Female, Humans, Male, Middle Aged, Risk Assessment methods, Risk Factors, Surveys and Questionnaires, Decision Support Techniques, Equipment Design standards, Evidence-Based Practice methods, Lipoproteins, LDL analysis, Mobile Applications standards
Abstract

There is a lack of research on the use of electronic tools that guide patients toward reducing their cardiovascular disease risk. We conducted a 9-month clinical trial in which participants who were at low (n = 100) and moderate (n = 23) cardiovascular disease risk-based on the National Cholesterol Education Program III's 10-year risk estimator-were randomized to usual care or to usual care plus use of an Interactive Cholesterol Advisory Tool during the first 8 weeks of the study. In the moderate-risk category, an interaction between treatment condition and Framingham risk estimate on low-density lipoprotein and non-high-density lipoprotein cholesterol was observed, such that participants in the virtual clinician treatment condition had a larger reduction in low-density lipoprotein and non-high-density lipoprotein cholesterol as their Framingham risk estimate increased. Perceptions of the Interactive Cholesterol Advisory Tool were positive. Evidence-based information about cardiovascular disease risk and its management was accessible to participants without major technical challenges., Competing Interests: Declaration of Conflicting Interest: Geoffrey C. Williams and C. Scott Rigby are shareholders in Self-Determined Health, Inc., the company to which the SBIR grant was awarded. Drs. Williams and Rigby were involved in the development of the virtual clinician and contributed only to the introduction and methods sections of this report. Dr. Williams managed subjects in both of the moderate risk groups, and those subjects were informed (via the study consent form) of Dr. Williams’ interest in the company. Drs. Williams and Rigby did not have access to the data or contribute to the interpretation of the results., (© The Author(s) 2015.)

Published
2016
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7. Outcomes of the Smoker's Health Project: a pragmatic comparative effectiveness trial of tobacco-dependence interventions based on self-determination theory.

Author

Williams GC, Niemiec CP, Patrick H, Ryan RM, and Deci EL

Subjects
Comparative Effectiveness Research methods, Female, Humans, Male, Middle Aged, Program Evaluation, Psychological Theory, Smoking Cessation psychology, Personal Autonomy, Smoking Cessation methods, Tobacco Use Disorder therapy
Abstract

A pragmatic comparative effectiveness trial examined whether extending the duration of a cost-effective, intensive tobacco-dependence intervention designed to support autonomy will facilitate long-term tobacco abstinence. Participants were randomly assigned to one of three tobacco-dependence interventions based on self-determination theory, namely, Intensive Treatment (IT; six contacts over 6 months), Extended Need Support (ENS; eight contacts over 12 months) and Harm Reduction (HR; eight contacts over 12 months with medication use if willing to reduce cigarette use by half). Among participants who completed the interventions, analyses revealed beneficial effects of ENS (15.7 versus 3.8%; χ 2 (1) = 6.92, P < 0.01) and HR (13.6 versus 3.8%; χ 2 (1) = 5.26, P < 0.05), relative to IT, on 12-month prolonged abstinence from tobacco. Also, analyses revealed beneficial effects of ENS (77.7 versus 43.0%; χ 2 (1) = 24.90, P < 0.001) and HR (84.0 versus 43.0%; χ 2 (1) = 37.41, P < 0.001), relative to IT, on use of first-line medications for smoking cessation. Hence, two new interventions were found to be efficacious particularly among participants who completed the interventions. Smokers who stay in treatment for an additional 6 months may benefit from an additional two contacts with practitioners, and thus it seems reasonable for policy makers to offer additional contacts given the health benefits associated with prolonged tobacco abstinence., (© The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Published
2016
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8. Virtual Look AHEAD program: initial support for a partly virtualized intensive lifestyle intervention in type 2 diabetes.

Author

Williams GC, Niemiec CP, Elliot AJ, LaGuardia JG, Gorin AA, and Rigby CS

Subjects
Adult, Female, Humans, Life Style, Male, Motivation, Personal Autonomy, Pilot Projects, Weight Loss, Diabetes Mellitus, Type 2 therapy, Online Systems, Risk Reduction Behavior, Virtual Reality Exposure Therapy methods, Weight Reduction Programs methods
Published
2014
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9. Cost-effectiveness of intensive tobacco dependence intervention based on self-determination theory.

Author

Pesis-Katz I, Williams GC, Niemiec CP, and Fiscella K

Subjects
Adult, Cost-Benefit Analysis, Humans, Insurance, Health statistics & numerical data, Personal Autonomy, United States, Smoking Cessation economics, Smoking Cessation methods, Tobacco Use Disorder economics, Tobacco Use Disorder therapy
Abstract

Objectives: To evaluate cost-effectiveness of a tobacco dependence intervention based on self-determination theory (SDT) and consistent with the Public Health Service (PHS)-sponsored Clinical Practice Guideline for Treating Tobacco Use and Dependence., Study Design: Adult smokers were recruited into a randomized cessation-induction trial of an intensive intervention versus community care. Seven-day point prevalence (7dPP) tobacco abstinence and cost-effectiveness of the intervention were examined using 737 participants with health insurance., Methods: Community care (CC) participants received smoking-cessation pamphlets and information on local treatment programs. Intervention participants received those materials and were asked to meet 4 times over 6 months with study counselors to discuss their health in a manner that supported autonomy and perceived competence. The third-party payer's perspective was used for this analysis, and the primary outcome was cost-effectiveness using self-reported 7dPP tobacco abstinence at 6 months. Sensitivity analyses were performed using costs of generic medications, biochemically validated tobacco abstinence, actual rates of tobacco abstinence, life-years saved (not adjusted for quality of life), and costs in 2011 US dollars. A subgroup analysis was conducted using smokers who did not want to stop within 30 days., Results: Smokers in the intervention, relative to CC, were more likely to attain 7dPP tobacco abstinence at 6 months. The overall incremental cost-effectiveness ratio was $1258 per quality-adjusted life-year saved, in US dollars. The sensitivity and subgroup analyses yielded similar results., Conclusions: An intervention based on SDT and consistent with the PHS Guideline facilitated tobacco abstinence among insured smokers and was cost-effective compared with other tobacco dependence and medical interventions.

Published
2011

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