Content uploaded by Anne Elisabeth Münster Halvari
Author content
All content in this area was uploaded by Anne Elisabeth Münster Halvari
Content may be subject to copyright.
A preview of the PDF is not available
Motivational Predictors of Change in Oral Health: An Experimental Test of Self-Determination Theory
Abstract and Figures
We tested the hypothesis that a psychosocial dental intervention formulated in terms of self-determination theory would increase
patients’ perceived competence and autonomous motivation for dental care and would decrease their plaque and gingivitis over
a seven month period, compared to standard dental treatment. We also tested a process model in which the intervention was
expected to increase perceived dental competence and autonomous motivation, that they would be positively associated with
oral health behaviors (i.e., brushing and flossing), which was expected to decrease plaque and, in turn, decrease gingivitis.
We also examined whether: changes in perceived competence and autonomous motivation would mediate the effect of the intervention
on dental-health behaviors; dental-health behaviors would mediate the links from changes in perceived competence and autonomous
motivation to change in plaque; and change in plaque would mediate the relation of dental health behaviors to change in gingivitis.
Finally, we examined the fit of the overall model with structural equation modelling. Results supported all predictions.
Figures - uploaded by Anne Elisabeth Münster Halvari
Author content
All figure content in this area was uploaded by Anne Elisabeth Münster Halvari
Content may be subject to copyright.
... According to this, applying the PCS in specific thematic contexts requires relevant content modifications. For example, the content has been modified for randomized interventions in dental health [34], glucose control with diabetic patients [35][36][37][38], weight loss strategies [39], and tobacco dependence [40]. In general, the empirical evidence of the mediating role of perceived competency was corroborated in understanding the effects of interventions based on the model of self-determination. ...
... The interpretation was linear, where the increase in the score indicated a greater intensity of perceived competency. In reported studies of adaptations for health interventions, internal consistency has tended to be high (α > 0.80) [34][35][36][37][38]40]. ...
This research aimed to adapt and validate a measuring scale of perceived research competencies among undergraduate students. Perceived research competencies of undergraduate learning can be measured with a new scale adapted from self-determination theory. We assessed the validity of this new measure applied to 307 participating undergraduates from Lima (Peru). The instrument’s survey items in the perceived competencies scale were first translated from English to Spanish and then adapted to focus on participation in research activities. We obtained evidence for (a) content validity (through item analysis), (b) internal structure with Mokken Scaling Analysis and structural equation modeling to examine the item–construct relationship, differential item functioning, and reliability, and (c) association with external variables. The items were found to function one-dimensionally, with strong item–construct relationships and no differential functioning (academic semester and general self-esteem groups). Theoretically consistent associations were found between study satisfaction and anxiety symptoms (controlling for gender, semester, and social support). We also discussed the theoretical implications and practices of this newly adapted measurement instrument.
... SDT is considered very useful to understand the initiation and maintenance of behaviors and promote behavioral changes (Gillison et al., 2019;Kwasnicka et al., 2016). SDT-based interventions have been successfully applied to various health-related behaviors (Ng et al., 2012), such as promoting physical activity (Edmunds et al., 2008;Fortier et al., 2012), attending alcohol treatment (Richard et al., 1995), smoking cessation (Williams & Deci, 2001;Williams et al., 2002), glycemic and cholesterol control Williams et al., 2005;Williams et al., 2004), and engaging in oral health behaviors (Halvari & Halvari, 2006). ...
... First of all, our results attested to the positive association between the satisfaction of basic psychological needs and the adherence to RG practices, lending extra empirical support to Deci and Ryan's (2008a) contention that the satisfaction of basic psychological needs supports optimal motivation and is associated with more positive psychological and behavioral outcomes. Previous studies have shown that basic needs satisfaction could be applied to promote certain health-related behaviors, such as exercising (Edmunds et al., 2007;Fortier et al., 2012;Halvari & Halvari, 2006), or to reduce the use of potentially health-threatening commodities, such as smartphone, smoking, gambling, and glycemic control (Hui et al., 2019;Kushnir et al., 2016aKushnir et al., , 2016bWilliams et al., 2002). We found that a higher level of basic needs satisfaction was associated with stronger RG adherence. ...
Responsible gambling (RG) is a practical approach to contain potential gambling-associated harms to an acceptable level. However, few studies have proposed a theoretical framework to account for significant individual differences in RG adherence, which hinders an effective RG promotion in public. To address this missing link, the current study aims to identify psychological need factors associated with adherence to RG practices. We applied the self-determination theory (SDT) to explore the association between the satisfaction of basic psychological needs (i.e., relatedness, competency, and autonomy) and RG adherence in a probability Chinese community adult sample (N = 1002; 55.7% women and M
age = 44.28 years), acquired from a telephone survey conducted in the 2018 fall with a two-stage cluster random sampling method. We found that the three types of basic needs satisfaction were significantly and positively related to RG adherence via a full mediation of flourishing. The findings provide practical insights to understanding individual differences in RG adherence and designing corresponding SDT-based interventions for gambling communities globally.
... Being autonomously motivated can promote engagement in and maintenance of health behaviors Ng et al., 2012;Patrick & Williams, 2012). Autonomous motivation has been positively associated with oral health behaviors (brushing and flossing one's teeth) (Halvari & Halvari, 2006), exercise and weight loss (Silva et al., 2011), healthy eating behavior (fruit/vegetable intake) (Dwyer et al., 2017;McSpadden et al., 2016;Shaikh, Yaroch, Nebeling, Yeh, & Resnicow, 2008), and it can predict health-related behaviors among adolescents, such as more physical activity and less marijuana use, smoking, and sexual intercourse (Gillison, Sebire, & Standage, 2012;Hardy, Dollahite, Johnson, & Christensen, 2015;Verloigne et al., 2011). ...
Background:
The construct of attributional style refers to the specific ways people explain events, both positive and negative. An optimistic attributional style (OAS) for negative events has been shown to be reliably associated with low rates of depression (Peterson et al., 1985; Sweeney et al., 1986; Hu et al., 2015). On the contrary, an optimistic attributional style for positive events is a separate phenomenon associated mainly with well-being, but these relationships remain underexplored.
Objective:
This study aimed to explore the predictive power of OAS-Positive, its relationships with subjective well-being, and possible personality mediators related to positive functioning. We hypothesized that the abilities to feel grateful and savor positive life events mediate the relationship between optimistic thinking about positive outcomes and subjective well-being.
Design:
A cross-sectional design was implemented. The participants were 271 adults from Moscow and Moscow Region (M age = 32.42, SD=12.9).
Results:
The results of regression analysis showed that both life satisfaction and subjective happiness depended on gratitude, self-esteem, and dispositional optimism, but only happiness was predicted by savoring the moment. The results of structural equation modeling were consistent with the hypothesis since the structural model revealed that the effects of OAS-Positive on subjective well-being were fully mediated by gratitude and savoring the moment, as well as self-esteem and dispositional optimism. The mediated effects of OAS-Negative through self-esteem and gratitude were inconsistent, and its total indirect effect on subjective well-being was not significant.
Conclusion:
This research provides preliminary evidence that optimistic thinking about positive life events promotes subjective well-being through a system of positive psychological traits and attitudes which include gratitude and savoring the moment.
... This makes it possible to explain the mechanisms underlying the successes and failures of changing health-related behavior. Understanding these mechanisms may be used in practical way, by for example, helping to develop effective clinical intervention procedures resulting in profound and lasting changes in patients' health behavior (Halvari and Halvari, 2006). This can significantly contribute to increasing the effectiveness of implementing pro-health measures. ...
The article presents the construction and validation process of the Health Behavior Motivation Scale (HBMS), which measures the motivation toward pro-health behaviors in population of healthy adults. The tool is conceptually based on Self-Determination Theory (SDT) and more precisely on one of its subtheories—Organismic Integration Theory (OIT). In the first stage of the construction, the linguistic validation with competent judges procedure allowed to eliminate the items which were not correctly formulated. Next, the psychometric properties of the HBMS were assessed in three studies. In Study 1 ( N = 323, M age = 31), the factorial structure of the HBMS was assessed with CFA. Since the preliminary structure was rejected, in order to identify the dimensionality of the items, EFA and Horn's Parallel Analysis were performed. The results showed that the HBMS scale has 5–dimensional structure (intrinsic regulation, integrated and identified regulation, introjected regulation, external regulation and amotivation). In Study 2 ( N = 342, M age = 33), the structure of the HBMS has been confirmed by conducting CFA analysis. Analyses preformed in this study provided good evidence for convergent and discriminant validity as well as the internal reliability of the HBMS subscales. Finally, in the LPA analysis two classes with distinct regulatory profiles have been extracted, which showed differences in the extend of health-related behaviors. In Study 3 ( N = 60, M age = 30) the test–retest reliability of the HBMS was confirmed. The scale can be therefore successfully used in future basic and applied studies as it possesses robust psychometric properties.
... At 95% confidence level, 80% power of test, and an effect size of 1.1 (Hedge's G), the minimum sample size required per group was at least 14 patients. This was based on the study of Halvari and Halvari (2006) with a difference of means on both groups of 0.24, the standard deviation in the intervention group of 0.26, and standard deviation in the control group of 0.14. Ethical clearance was sought from UERM Research Ethics Committee and the Institutional Review Board of the Lung Center of the Philippines. ...
Purpose. With continuous positive airway pressure (CPAP) being the treatment of choice for Obstructive Sleep Apnea (OSA),
adherence rates to CPAPare still low without a clear consensus of causes. The Self-Determination Theory (SDT) is a general theory of
human motivation that emphasizes the extent to which behaviors are relatively autonomous based on the psychological needs that are
critical to supporting the process of internalization and the development of optimal motivation. This study sought to determine whether the implementation of an SDT-based intervention is effective in improving: (1) perceived competence, (2) treatment self-regulation, (3) CPAP treatment adherence, and (4) Apnea–hypopnea index (AHI) of OSA patients.
Methods. Using a true experimental pretest-posttest design, 30 purposively selected participants were randomly allocated to
experimental and control groups. The SDT-based intervention included group sessions, individual sessions, and follow up phone calls
in three weeks. Written permission to conduct the study was obtained from the Institutional Review Board of the University of the East -
Ramon Magsaysay Memorial Medical Center, Inc. (UERMMMCI) and the Lung Center of the Philippines. Participation was voluntary
and all participants had the right to refuse or discontinue their participation at any time during the study. Data were analyzed using two-way repeated-measures ANOVA, student's T-test, and chi-square.
Results and Conclusion. The participants in the experimental group have increased adherence rates from Time 1 (60%) to Time 2
(92.9%) and Time 3 (85.7%). Although, when compared to the control group, no significant difference was noted across the different
periods of measurement (p=0.70810, p=0870, p=0.2403). There were higher proportions of patients who eventually became adherent
in the experimental group compared to the control group immediately after and 5 weeks after the intervention (p=0.0001). The
experimental group had significantly better improvement in AHI compared to the control group immediately after (p=0.0152) and 5
weeks after the intervention (p=0.0022). Considering the importance of CPAP adherence in effectively treating OSA, measures to
improve adherence such as SDT-based intervention could be usefully incorporated into OSA patients' treatment plans.
... Being autonomously motivated can promote engagement in and maintenance of health behaviors Ng et al., 2012;Patrick & Williams, 2012). Autonomous motivation has been positively associated with oral health behaviors (brushing and flossing one's teeth) (Halvari & Halvari, 2006), exercise and weight loss (Silva et al., 2011), healthy eating behavior (fruit/vegetable intake) (Dwyer et al., 2017;McSpadden et al., 2016;Shaikh, Yaroch, Nebeling, Yeh, & Resnicow, 2008), and it can predict health-related behaviors among adolescents, such as more physical activity and less marijuana use, smoking, and sexual intercourse (Gillison, Sebire, & Standage, 2012;Hardy, Dollahite, Johnson, & Christensen, 2015;Verloigne et al., 2011). ...
Background. This study is based on self-determination theory and the research on dispositional optimism and unrealistic optimism. Dispositional optimism is known to be protective of well-being and is related to adaptive coping strategies. Investigations related to unrealistic optimism, on the other hand, revealed that it may have both positive and negative consequences. Objective. To investigate dispositional optimism and two kinds of specific optimism as predictors of autonomous motivation to follow stay-at-home orders during the COVID-19 pandemic in a sample of Russian young adults: constructive optimism, meaning belief in the role of effort; and defensive optimism, meaning unrealistic expectations and denial that a problem exists. Design. A correlational (cross-sectional) study was conducted to measure adherence to the recommendation to stay at home, autonomous motivation, dispositional optimism, constructive optimism, and defensive optimism. An online survey was completed by 1,403 young adults (68% women) during the first month of lockdown. Results. The findings demonstrate that constructive optimism and its underlying dispositional optimism predict both autonomous motivation and adherence to the recommendation to stay at home, while defensive optimism produces the opposite, undermining effects. Structural equation modeling revealed the effect of gender on adherence to the recommendation (higher in women), mediated by different types of optimism and autonomous motivation. Conclusion. Dispositional optimism together with situation-specific constructive and defensive types of optimism are essential for explaining the health-related behavior and its motivation. These results contribute to self-determination theory, considering the role of personality factors in determining motivation.
... The Self-Determination Theory is focused on the person acquiring motivation by developing a sense of autonomy and competence. Interventions based on this theory have been tested in the context of tobacco dependence, diet, physical activity and dental care (Fortier et al., 2007;Halvari & Halvari, 2006;Ryan & Deci, 2007;Williams et al., 1998Williams et al., , 2006. ...
Objectives:
An invitation to cancer screening with a single (fixed) appointment time has been shown to be a more effective way at increasing uptake compared with an invitation with an open (unscheduled) appointment. The present study tested whether offering more than one fixed appointment could further enhance this effect or be detrimental to people's intention.
Design:
Experimental online hypothetical vignette survey.
Methods:
1,908 respondents who stated that they did not intend to participate in Bowel Scope Screening (BSS) were offered either one, two, four or six hypothetical fixed BSS appointments (all of which covered the same time of day to control for individual preferences).
Results:
Participants who were given more than one appointment to choose from were less likely to intend to book an appointment despite multiple appointments being perceived as more convenient.
Conclusions:
These results suggest that when it comes to offering people appointments for cancer screening, less (choice) is more, at least if alternatives fail to serve an inherent preference.
Objectives
Many patients do not engage in health behaviors that can control common, chronic illnesses. Clinicians have opportunities to promote health behaviors yet may lack skills for coaching effectively about health behaviors. Our aims are to: present definitions of coaching, propose concepts for coaching about behavior change from two theories, share theory-guided research on behavior change relevant to ambulatory care settings, and delineate how concepts from these theories can guide coaching.
Methods
In our discussion, we explain how two behavioral theories are complementary and applicable to coaching, present empirical support for these theories, and describe applications of these concepts for practice.
Conclusions & Practice Implications
Self-determination theory can guide clinicians in how to interact with patients to meet patients’ psychological needs, to promote health behaviors, and subsequent health status. Self-regulation theory can guide coaches in what concepts to address for behavior change. These complementary theories have been supported in rigorous research with adult populations in ambulatory care settings.
Теория самодетерминации – современный подход к изучению человеческой мотивации, личности и психологического благополучия. В данной статье рассмотрены основные темы дискуссий, развернувшихся на прошедшей в Гентском университете конференции по теории самодетерминации (Бельгия, 13–16 мая 2010 года). Анализируются перспективы развития теории, новые направления эмпирических исследований, вопросы кросс-культурной универсальности базовых положений теории. Представлены современные исследования в русле пяти мини-теорий, из которых в настоящее время состоит теория самодетерминации. Это теория организмической интеграции, теория когнитивной оценки, теория каузальных ориентаций, теория базовых психологических потребностей, теория содержания целей. Вторая часть статьи посвящена основным направлениям практического применения теории самодетерминации в области детско-родительских отношений, психологии обучения, психологии труда, клинической психологии и психологии здоровья.
The authors describe new developments in structural equation modeling as incorporated in LISREL V. The procedures are illustrated on data from three previous studies.
I: Background.- 1. An Introduction.- 2. Conceptualizations of Intrinsic Motivation and Self-Determination.- II: Self-Determination Theory.- 3. Cognitive Evaluation Theory: Perceived Causality and Perceived Competence.- 4. Cognitive Evaluation Theory: Interpersonal Communication and Intrapersonal Regulation.- 5. Toward an Organismic Integration Theory: Motivation and Development.- 6. Causality Orientations Theory: Personality Influences on Motivation.- III: Alternative Approaches.- 7. Operant and Attributional Theories.- 8. Information-Processing Theories.- IV: Applications and Implications.- 9. Education.- 10. Psychotherapy.- 11. Work.- 12. Sports.- References.- Author Index.
Self-determination theory was applied to explore the motivational basis of adherence to long-term medication prescriptions. Adult outpatients with various diagnoses who had been on a medication for at least 1 month and expected to continue (a) completed questionnaires that assessed their autonomous regulation, other motivation variables, and perceptions of their physicians' support of their autonomy by hearing their concerns and offering choice; (b) provided subjective ratings of their adherence and a 2-day retrospective pill count during an interview with a clinical psychologist; and (c) provided a 14-day prospective pill count during a subsequent, brief telephone survey. LISREL analyses supported the self-determination model for adherence by confirming that patients' autonomous motivation for adherence did mediate the relation between patients' perceptions of their physicians' autonomy support and their own medication adherence.
Two studies tested self-determination theory with 2nd-year medical students in an interviewing course. Study 1 revealed that (a) individuals with a more autonomous orientation on the General Causality Orientations Scale had higher psychosocial beliefs at the beginning of the course and reported more autonomous reasons for participating in the course, and (b) students who perceived their instructors as more autonomy-supportive became more autonomous in their learning during the 6-month course. Study 2, a 30-month longitudinal study, revealed that students who perceived their instructors as more autonomy-supportive became more autonomous in their learning, which in turn accounted for a significant increase in both perceived competence and psychosocial beliefs over the 20-week period of the course, more autonomy support when interviewing a simulated patient 6 months later, and stronger psychosocial beliefs 2 years later.
Objective-To describe and explain the socioeconomic gradient in sickness absence. Design-Analysis of questionnaire and sickness absence data collected from the first phase of the Whitehall II study. Grade of employment was used as a measure of socioeconomic status. Setting-20 civil service departments in London. Subjects-6900 male and 3414 female civil servants aged 35-55 years. Main outcome measures-Rates of short spells (less-than-or-equal-to 7 days) and long spells (>7 days) of sickness absence. Results-A strong inverse relation between grade of employment and sickness absence was evident. Men in the lowest grade had rates of short and long spells of absence 6.1 (95% confidence interval 5.3 to 6.9) and 6.1 (4.8 to 7.9) times higher than those in the highest grade. For women the corresponding rate ratios were 3.0 (2.3 to 3.9) and 4.2 (2.5 to 6.8) respectively. Several risk factors were identified, including health related behaviours (smoking and frequent alcohol consumption), work characteristics (low levels of control, variety and use of skills, work pace, and support at work), low levels of job satisfaction, and adverse social circumstances outside work (financial difficulties and negative support). These risk factors accounted for about one third of the grade differences in sickness absence. Conclusion-Large grade differences in sickness absence parallel socioeconomic differences in morbidity and mortality found in other studies. Identified risk factors accounted for a small proportion of the grade differences in sickness absence. More accurate measurement of the risk factors may explain some of the remaining differences in sickness absence but other factors, as yet unrecognised, are likely to be important.
Based on a literature review a model of motivation was constructed with dispositional achievement motives at the global level, relative autonomy at the context-specific level, and performance and satisfaction in school at the criterion level. Among 110 elementary-school pupils, assessments included the Achievement Motives Scale for achievement motives, the Self-regulation Questionnaire for relative autonomy, the Mathematics Test for Children, and the Satisfaction at School Scale. Both bivariate and multiple regression analyses yielded the following significant results: (i) The motive to achieve success correlated positively and the motive to avoid failure correlated negatively with relative autonomy at school. (ii) The motive to avoid failure correlated negatively with performance in mathematics. (iii) Satisfaction in school correlated positively with the motive to achieve success, relative autonomy, and performance. The results are discussed in relation to achievement motivation and self-determination theory.
