Purpose:  Ng et al. (2012) meta-analysis of applications of self-determination theory (SDT; Ryan & Deci, 2017) in the health domain included many non-experimental studies. A more recent meta-analysis by Gillison et al. (2019) of intervention studies in this area did not calculate changes in indices of physical or mental health. Advancing the SDT literature in the health domain, we present a meta-analysis of experimental studies that tested changes in at least one SDT variable and at least one health-behavior, physical-health outcome, or psychological-health outcome.

Methods: 73 studies (N=30,088) met our inclusion criteria and provided sufficient data for the purposes of the review. The behaviour change techniques (BCTs) and SDT-based need supportive techniques used in the studies were also coded. Risk of bias was assessed using an adapted version of the Cochrane Risk of Bias Tool. To test whether changes in SDT-related constructs engender changes in other SDT-related constructs, health behavior, physical health and psychological health, a set of meta-regressions were conducted. Sensitivity analyses were applied to examine the robustness of the synthesized results by removing outliers and by examining whether any of the BCTs were associated with the effect sizes from individual studies.

Results/findings: A random-effects meta-analytic model (using Stata, v. 15) showed that the interventions produced small-to-medium changes in most SDT constructs at the end of the intervention period, and in health behaviors at the end of the intervention period and at the follow-up. Small positive changes in physical and psychological health outcomes were also observed at the end of the interventions. Increases in need support and autonomous motivation (but not controlled motivation or amotivation) were associated with positive changes in health behavior. 

Conclusions: Interventions in the health domain based on SDT produce modest (in the region of g= .30 to .60) but sustained increases in health behaviors and improvements in physical health, and short-term changes in psychological health. These effects are partly due to increases in self-endorsed motivation for change and support from social agents.

Purpose: Office working adults represent an at-risk population for high levels of sedentary behaviour (SB), which has been associated with an increased risk for numerous chronic diseases. Recent evidence has also suggested a relationship between greater SB and adverse mental health outcomes, including increased risk of anxiety and depression, and lower health-related quality of life. This study examined the effects of a Health Action Process Approach (HAPA) volitional intervention augmented with tailored text messages targeting reductions in workplace sitting time on work performance and health-related quality of life outcomes. A secondary purpose was to examine relationships between sedentary and non-SBs, and work and health-related outcomes. 

Methods: In this two-arm, repeated measure, randomized controlled trial, office workers (M_age= 45.18 ±11.33 years) were randomized into either a HAPA intervention (n = 29) or control (n = 31) condition. The intervention group received a single behavioural counselling (planning) session, as well as daily sedentary-related text messages over a 6-week period. Work performance and health-related outcomes including role limitations due to physical and emotional health problems, emotional well-being, and energy/fatigue were assessed at baseline and week 6 (post-intervention).

Results: Significant group by time interaction effects, that favoured the intervention group, were found for perceived role limitations due to emotional health problems (p = .031, ɳp2 = .08) and emotional well-being (p = .014, ɳp2 = .10). There was a trend interaction effect for energy/fatigue (p = .072, η_ρ² = .06). Significant time effects were found for role limitations due to physical health problems (p < .001, η_ρ² = .21), energy/fatigue (p = .012, η_ρ² = .10), and work performance (p < .001, η_ρ² = .44). Significant relations were also found between sitting time, standing time, walking time, break frequency and specific health-related outcomes at week 6 (p values< .05). 

Conclusions: A behavioural intervention targeting reductions in workplace sitting time may lead to improved emotional well-being and energy/fatigue, and contribute to fewer perceived role limitations due to emotional health problems among office workers.

Purpose: Many adults join fitness centers to increase physical activity; yet, fitness center attendance decreases over time. Self-Determination Theory suggests that individuals who have their basic psychological needs satisfied become more autonomously motivated to attend a fitness center to engage in activity; this hypothesis has yet to be tested. This study examined whether basic psychological needs satisfaction and autonomous regulation are related to fitness center visits in previously inactive exercise initiates.

Methods: Using a 12-week longitudinal cohort study design, inactive adults (N=160) who were joining a fitness center completed measures of demographics, basic psychological needs satisfaction in exercise, and behavioral regulation in exercise at baseline and 4 weeks after starting their exercise programs. Fitness center visits were captured via membership card swipe; the total number of visits per week was calculated for each participant. Multilevel Poisson regression models were used to predict weekly fitness center visits.

Results: Overall, there was a significant decrease in the number of fitness center visits per week (b=-0.05, SE=0.01, p<.001; M=1.9 visits in week 1 and 0.9 visits in week 12). Those who had greater psychological needs satisfaction at baseline (p<.001) and who experienced greater increases in needs satisfaction in the first 4 weeks (p<.001) had more fitness center visits. Further, there was a significant interaction between change in needs satisfaction and time (p=.018). Those who saw greater increases in needs satisfaction had greater reductions in fitness center visits over time (Week 12 M=1.2 visits, 1.4 fewer visits than week 1), yet they remained higher than those who decreased in needs satisfaction over time (Week 12 M=0.5 visits, 0.3 fewer visits than week 1). The same pattern emerged for autonomous regulation.

Conclusions: Those who experience greater increases in needs satisfaction and autonomous regulation attend the fitness center more frequently, but may also experience a more rapid decline in fitness center visits over time. Future research is needed to clarify how changes in needs satisfaction and autonomous regulation are related to physical activity adoption.

Purpose:

Approximately 50% of Australian adults are insufficiently active and over 50% of Australian workers report that they sit often or all of the time at work. High-intensity interval training (HIIT) is a potent and time-efficient mode of exercise that has been shown to elicit physical and mental health benefits in adult populations. However, no previous study has evaluated the efficacy of HIIT delivered for highly sedentary adults in a ‘real world’ workplace setting. The  primary aim of our study was to evaluate the feasibility and impact of the WORK-HIIT intervention on sedentary adults’ physical and mental health.

 Methods:

We conducted the Work-HIIT pilot RCT at the University of Newcastle, Australia, March-July 2019. Participants were sedentary adults 18+yrs (n= 45.4 ± 10.7yrs; 41 female) randomized to the Work-HIIT (n=24) intervention on the wait-list control group (n=23). Work-HIIT included a variety of aerobic and muscular fitness exercise combinations lasting 8 minutes (30:30 sec work:rest intervals) and participants attend up to 3 sessions / week for 8-weeks. The primary outcome was cardiorespiratory fitness. Secondary outcomes included muscular fitness, body composition, motivation to exercise, and HIIT self-efficacy. Data were analysed using linear mixed models and Cohen’s d effect sizes were calculated. Process evaluation measures were used to assess program feasibility.

Results:

There was a small but non-significant treatment effect for cardiorespiratory fitness [+2.9 laps (-4.19-10.14), p=0.403, d=0.34].  Significant and large group-by-time differences were found for muscular fitness [push-ups 3.5 repetitions (95% CI (0.69-6.33), p=0.016, d=0.95; standing jump 10.1cm (95% CI (3.24-17.08), p=0.005, d=1.12]; autonomous motivation [0.23 units (95% CI (0.03-0.44), p=0.024, d=0.76]; and HIIT self-efficacy [16.53 units (8.77-24.30), p<0.001, d=1.57]. No significant intervention effects were found for body composition (p>0.05). Participant ratings showed high levels of perceived benefit and enjoyment. Participants’ average heart rate and peak heart rate during sessions were 85.9% HR max. and 92% HRmax, respectively.

Conclusions:

Our study provides evidence for the feasibility and preliminary efficacy of Work-HIIT to improve muscular fitness, motivation, and HIIT self-efficacy in sedentary adults. Future research testing of the scalability and sustainability of Work-HIIT via a larger, multi-site program trial is required.

Purpose:         The United Kingdom and the European Union have declared a climate emergency. There are enormous economic, human, and environmental costs of inactivity, climate change, air pollution and congestion and active travel can help reduce and prevent these. In England, however, only 26% of all trips are made by walking and only 2% are made by cycling and collectively, walking and cycling contribute just 4% of total distance travelled.

‘Beat the Street’ is a community-wide intervention which aims to increase active travel by turning an area into a 6-week game. Residents earn points and prizes by walking and cycling and tapping a smartcard on RFID readers called ‘Beat Boxes’ placed on lampposts at half-mile intervals. To-date, over 1 million people have taken part in the intervention, however, the impact of the program on adult active travel is yet to be explored.

Methods:         In Autumn 2019, Beat the Street was delivered throughout the London Borough of Hounslow. Prior, and immediately following the intervention, residents were invited to complete a self-report questionnaire (Sport England Active Lives Survey-SF) to assess changes in physical activity. Time-stamp data generated through Beat Box activity provided an objective measure of intervention engagement and a traffic survey camera was used to measure the number of cars travelling along 1 target road between 1-week pre- and 1-week post-intervention.

Results:           28,219 people took part in the six-week game. Between pre- and post-intervention there was 7% decrease in adults reporting less than 30mins of activity per week and a 13% rise in adults reporting 150+ mins (n=346, p<0.01). Beat box data ascertained that 25% of total taps at all Beat Boxes were made between 08:00-08:59am and a further 28% were made between 3:00-3:59pm, typical travel to school/work periods. Further, traffic camera data showed that between the week before and week following Beat the Street, 1199 and 705 fewer cars and 130 and 36 fewer vans were observed travelling along Cambridge Road between 07:00-09:30am and 2:00-4:30pm, respectively.

Conclusions:    These data sources, in combination, suggest gamification may be an encouraging approach to increasing levels of active travel at a community-wide level.

Purpose: The UK currently has low levels of cycling: 28% of adults cycle less than once a month, although many of these (57%) would like to cycle more. Designed in partnership with a major UK bank and third sector cycling organisation, the Cycle Nation Project (CNP) is a workplace-based initiative to encourage bank staff who infrequently cycle to cycle more. CNP includes a 12-week bike loan and a practical 9-week foundation (or 6-week intermediate) group cycling course delivered by colleagues (self-identified cycle-enthusiasts trained to be Cycle Champions). This feasibility study aimed to explore recruitment, attendance, retention and indicative outcomes.

Methods: CNP was delivered to employees at four bank offices across the UK between August 2019 - March 2020. The recruitment target was 30 staff at each site. Measurements included self-reported cycling frequency and wellbeing (Warwick-Edinburgh Mental Wellbeing Scale) at baseline, 9 weeks and 13 weeks. Cycle Champions recorded weekly session attendance.

Results: CNP was delivered at Site 1 between 6^th August - 6^th October 2019 to 14 participants (mean age 37.7±11.0 years; 12 men, 2 women; 9 foundation, 5 intermediate). 12/14 (86%) completed the programme, attending on average 72.4% of weekly sessions. Multifaceted recruitment strategies used at Site 2 achieved recruitment of 32 participants (mean age 37.8±9.4 years; 18 men, 14 women; 17 foundation, 15 intermediate). 26/32 (81%) completed the programme between 1^st October - 27^th November 2019, but only attended 49.2% of sessions. At Site 1, all participants attended baseline, 85.7% 9-week and 71.4% 13-week measurements. At 9 weeks, mean self-reported total cycle rides increased from 1.6±3.2 to 6.5±5.4 per week; cycle commutes increased from 0.7±1.8 to 3.0±3.7 and leisure rides from 0.4±0.7 to 2.2±1.7 per week. Wellbeing increased from 52.9±4.1 to 56.1±4.1.

Conclusions: Multifaceted strategies succeeded in achieving recruitment targets, but session attendance decreased as day-length shortened. Initial results suggest CNP has potential to increase cycling and wellbeing. Findings from four sites will be available in June.