是什么促使（前期）糖尿病患者运动？在乌干达农村地区对自我决定理论进行检验。
What Motivates People With (Pre)Diabetes to Move? Testing Self-Determination Theory in Rural Uganda.
作者信息
De Man Jeroen, Wouters Edwin, Absetz Pilvikki, Daivadanam Meena, Naggayi Gloria, Kasujja Francis Xavier, Remmen Roy, Guwatudde David, Van Olmen Josefien
机构信息
Centre for General Practice, Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium.
Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium.
出版信息
Front Psychol. 2020 Mar 24;11:404. doi: 10.3389/fpsyg.2020.00404. eCollection 2020.
INTRODUCTION
Sub-Saharan Africa is experiencing a rapid growth of type 2 diabetes (T2D) and its related burden. Regular physical activity (PA) is a successful prevention strategy but is challenging to maintain. Self-determination theory (SDT) posits that more autonomous forms of motivation are associated with more sustainable behavior change. Evidence to support this claim is lacking in sub-Saharan Africa. This study aims to explore the relationships between latent constructs of autonomous and controlled motivation, perceived competence, perceived relatedness, PA behavior, and glycemic biomarkers.
METHODS
Structural equation modeling was applied to cross-sectional data from a rural Ugandan population ( = 712, pre-diabetes = 329, diabetes = 383). Outcome measures included self-reported moderate and vigorous PA, pedometer counts, and fasting plasma glucose (FPG) and glycated hemoglobin (HbA1C).
RESULTS
Our findings support SDT, but also suggest that different types of motivation regulate different domains and intensities of PA. Higher frequency of vigorous PA - which was linked to a lower HbA1C and FPG - was predicted by autonomous motivation (β = 0.24) but not by controlled motivation (β = -0.05). However, we found no association with moderate PA frequency nor with pedometer counts. Perceived competence and perceived relatedness predicted autonomous motivation. Autonomous motivation functioned as a mediator between those needs and PA behavior.
CONCLUSION
This is the first study providing evidence for a SDT model explaining PA among people at risk of, or living with, T2D in a rural sub-Saharan African setting. Our findings suggest that individuals who experience genuine support from friends or family and who feel competent in doing vigorous PA can become motivated through identification of health benefits of PA as their own goals. This type of motivation resulted in a higher frequency of vigorous PA and better glycemic biomarkers. On the other hand, people who felt more motivated through pressure from others or through feelings of guilt or shame were not more engaged in PA.
CLINICAL TRIAL REGISTRATION
ISRCTN 11913581. Registered January 10, 2017.
引言
撒哈拉以南非洲地区2型糖尿病（T2D）及其相关负担正在迅速增长。定期体育活动（PA）是一种成功的预防策略，但难以维持。自我决定理论（SDT）认为，更自主的动机形式与更可持续的行为改变相关。撒哈拉以南非洲地区缺乏支持这一观点的证据。本研究旨在探讨自主动机和受控动机的潜在结构、感知能力、感知相关性、体育活动行为和血糖生物标志物之间的关系。
方法
将结构方程模型应用于乌干达农村人口的横断面数据（n = 712，糖尿病前期 = 329，糖尿病 = 383）。结果测量包括自我报告的中度和剧烈体育活动、计步器计数以及空腹血糖（FPG）和糖化血红蛋白（HbA1C）。
结果
我们的研究结果支持自我决定理论，但也表明不同类型的动机调节体育活动的不同领域和强度。自主动机（β = 0.24）可预测剧烈体育活动的较高频率，而剧烈体育活动的较高频率与较低的HbA1C和FPG相关，受控动机则不能（β = -0.05）。然而，我们发现与中度体育活动频率或计步器计数无关。感知能力和感知相关性可预测自主动机。自主动机在这些需求和体育活动行为之间起中介作用。
结论
这是第一项为自我决定理论模型提供证据的研究，该模型解释了撒哈拉以南非洲农村地区有T2D风险或患有T2D的人群的体育活动情况。我们的研究结果表明，那些从朋友或家人那里获得真诚支持且感觉有能力进行剧烈体育活动的个体，通过将体育活动对健康的益处视为自己的目标，能够变得积极主动。这种动机类型导致更高频率的剧烈体育活动和更好的血糖生物标志物。另一方面，那些因他人压力或内疚或羞耻感而更有动力的人，参与体育活动的程度并不更高。
临床试验注册
ISRCTN 11913581。2017年1月10日注册。
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