What Motivates People With (Pre)Diabetes to Move? Testing Self-Determination Theory in Rural Uganda
Loading...
Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Frontiers in Psychology
Abstract
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 (N = 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.
Description
Keywords
Type 2 diabetes, Physical activity, Self-determination theory, Sub-saharan Africa, Uganda, Psychological needs theory, Autonomous motivation, Controlled motivation
Citation
De Man J, Wouters E, Absetz P, Daivadanam M, Naggayi G, Kasujja FX, Remmen R, Guwatudde D and Van Olmen J (2020) What Motivates People With (Pre)Diabetes to Move? Testing Self-Determination Theory in Rural Uganda. Front. Psychol. 11:404. doi: 10.3389/fpsyg.2020.00404