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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.

Purpose: The aim of the current study was to examine whether patient perceptions of autonomy support from the treatment team in a vocational rehabilitation program will be associated with change (increase) in need satisfaction, autonomous motivation, perceived competence, well-being, physical activity, and return to work (RTW), and whether the self-determination theory (SDT) Model of Health Behavior will provide adequate fit to the data., Method: A total of 90 participants were enrolled in a longitudinal study and completed measures at four time points over 15 months., Results: Participants reported increases in all variables, and in general these changes were maintained at six weeks post-rehabilitation and at 15 months post-baseline. As well, the SDT Model of Health Behavior provided adequate fit to the data., Conclusions: These results underscore the importance of health care practitioners' providing support for their patients' autonomy, competence, and relatedness to improve well-being, physical activity, and RTW in the context of vocational rehabilitation. Implications for Rehabilitation Vocational rehabilitation that emphasizes physical activity is associated with increases in patients' well-being, physical activity, and return to work (RTW). It is important for health care practitioners to provide support for their patients' autonomy, competence, and relatedness in the context of vocational rehabilitation, as doing so is associated with increases in patients' autonomous motivation, perceived competence, and psychosocial outcomes.

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.)

The potential benefits of children's engagement in sport for their psychological, social, and physical health are well established. Yet children may also experience psychological and social impairments due, in part, to a variety of detrimental coach behaviors. In the current study, we proposed and tested a conditional process model of children's self-reported behavioral engagement and behavioral disaffection in sport based on self-determination theory. Results from a sample of 245 youth soccer players suggested that structure from coaches related positively to behavioral engagement and negatively to behavioral disaffection, and that these relations were mediated by athletes' basic psychological need satisfaction. Importantly, and in line with our hypotheses, these indirect effects were moderated by autonomy support from coaches, such that the mediation was evident only among those who reported higher levels of autonomy support. These findings underscore the importance of coaches' providing guidance, expectations, and feedback (i.e., structure) in a way that respects athletes' volition (i.e., autonomy support).

A previous randomized clinical trial based on self-determination theory (SDT) and consistent with the Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence demonstrated that an intensive intervention could change autonomous self-regulation and perceived competence, which in part facilitated long-term tobacco abstinence. The current article describes a pragmatic comparative effectiveness trial of three SDT-based intensive tobacco-dependence interventions. Eligible participants are randomized to one of the three treatment conditions designed to facilitate long-term maintenance of tobacco abstinence, namely, Community Care (CC), which includes the 6 month SDT-based intervention previously shown to promote autonomous self-regulation, perceived competence, medication use, and tobacco abstinence; Extended Need Support (ENS), which extends the 6 month SDT-based intervention to 12 months and trains an important other to provide support for smokers' basic psychological needs; and Harm Reduction (HR), which provides extended need support and recommends medication use for participants who do not want to stop smoking completely within 30 days but who are willing to reduce their cigarette use by half. The primary outcome is 12 month prolonged abstinence from tobacco, which is assessed one year following termination of treatment (two years post-randomization). Secondary outcomes include 7- and 30 day point prevalence tobacco abstinence, number of days using smoking-cessation medication, change in autonomous self-regulation and perceived competence, and perceived need support from important others., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence., Purpose: The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence., Methods: One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention., Results: Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence., Conclusions: An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.

Using self-determination theory, two studies investigated the relations among perceived need support from parents, their adolescents' autonomous self-regulation for academics, and the adolescents' well-being. Study 1 indicated that perceived need support from parents independently predicted adolescents' well-being, although when mothers' and fathers' data were examined separately, the relation was stronger for mothers than for fathers. In Study 2, autonomous self-regulation for planning to attend college was a significant partial mediator of the relation of adolescents' perceived need support to well-being. Thus, perceived need support from parents does seem important for the development of adolescents' autonomous self-regulation and well-being.