Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill.
Center for Advanced Hindsight, Duke University.
J Consult Clin Psychol. 2020 Aug;88(8):726-737. doi: 10.1037/ccp0000501. Epub 2020 May 21.
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.
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.
The sample-weighted average effect size for SDT interventions was = .23, and there were significant effects for physical activity, sedentary behavior, diet, alcohol consumption, and smoking cessation (.16 ≥ ≥ .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 ( ≥ .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.
The present review indicates that SDT interventions have a significant but small effect on health behavior change and suggests several directions for future research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
我们对基于自我决定理论（SDT）的促进健康行为改变的随机对照试验（RCT）进行了荟萃分析。本综述旨在：（a）量化 SDT 干预对健康行为的影响；（b）通过理论上指定的变量（自主动机和感知能力）检验中介作用；（c）确定干预效果的调节因素。
计算机检索和其他策略确定了 56 篇文章，这些文章提供了 65 项关于 SDT 干预的独立测试。通过 STATA 进行随机效应荟萃分析和元回归；使用元分析结构方程模型（MASEM）检验中介作用。
SDT 干预的样本加权平均效应大小为 =.23，并且在体育活动、久坐行为、饮食、饮酒和戒烟方面存在显著影响（.16 ≥ ≥.29）。效应大小既存在发表偏倚，也存在小样本偏倚，但在纠正偏倚后，仍然显著不同于零（尽管幅度较小，≥.15）。MASEM 表明，自主动机和感知能力中介了干预对行为的影响。元回归分析表明，样本、干预或方法的特征通常不会调节效应大小。
本综述表明，SDT 干预对健康行为改变有显著但较小的影响，并为未来的研究提供了几个方向。（PsycInfo 数据库记录（c）2020 APA，保留所有权利）。
