1. Motivation Maddison Greaves H671

2. What is motivation? Definition from Dunsmore & Goodson (2006) Review: “Motivation encompasses self-regulatory processes involving the selection, activation, and sustained direction of behavior toward certain goals.” (Senecal, Nouwen, and White, 2000). Of the 44 studies reviewed, this was the only one to provide general definition. 91% of the studies did not provide a definition. 9% only provided conceptual definition. Why? What is motivation to you?

3. Dunsmore & Goodson (2006) 10 year review period 44 studies; 21 different theories! Purpose: trace the theoretical Hx, definitions and measurements of motivation. 1930s-40s: Drive theories; homeostasis. 1950s: Achievement theory. 1960s: Cognitive theories (HBM, TTM, TRA/TPB, SCT, SDT). Why focus on motivation? Why so many different theories?

4. Dunsmore & Goodson (continued) Methods: Agree/disagree with the inclusion & exclusion criteria? Results ( in addition to what already covered): Lack of reliable and valid measurement instruments for motivation. Issue here? Discussion: Motivation lacking focus and consensus. Complex concept. Unknown if interventions efforts actually influence motivation. Would it have been helpful to know the results in more depth?

5. Information-Motivation- Behavior Skills Model Developed to address need for theory-based HIV prevention interventions. Has been used for multiple health behaviors and populations since. Consistently confirmed to be effective. Key determinants of IMB Model: Information Motivation (personal & social) Behavioral skills

6. Self-Determination Theory Individual level theory of human motivation. Assumes humans innately motivated for growth & health. How does growth occur? What is “health?” Basic psychological needs vs. acquired needs. SDT assumes 3 basic human needs: autonomy, competence, relatedness.

7. SDT (continued)

8. Motivational Interviewing & SDT MI = Technique to support autonomy. MI = Clint centered & non judgmental. 4 elements of MI: Empathy expression, rolling with resistance, support of efficacy, discrepancy development. Goal of MI = enhance intrinsic motivation. What is the difference between intrinsic & extrinsic and why focus on intrinsic? Examples? SDT & MI have been successful at changing health behaviors, but SDT shown more effective at enhancing autonomous self-regulation. Why is this important? More investigation of both SDT & MI needed. Limitation of SDT = individual level theory

9. Elaboration Likelihood Model of Persuasion Motivation pertains to: Considering a message or not (central vs. peripheral route). Which route is more persuasive over attitude? Ability is also key. What is the usefulness of the ELM?

10. Measurement techniques IMB-model based “Options” intervention: HIV clinical trial. Theory-based, structured discussion. Measurements at baseline, 6 mo, 12 mo, 18 mo assessed: HIV risky & safer behaviors 3 IMB constructs (information, motivation, behavioral skills) ID’d participants’ readiness to change (motivation). How important (scale 0-10). How confident (scale 0-10). Summarizing of responses, discussing risk-reduction strategies & writing “prevention prescription” Why was all this done as the last steps of the intervention and importance? Positive response & significant impact on HIV risk behavior.

11. Measurement techniques SDT interventions: Most studies focus on motivation for behavior change. Assess autonomy. Autonomous reasons for behavior change or higher autonomy-supportive health care providers  autonomous motivation  behavior change. “Smokers Health Study” Participants were asked how much they wanted to stop smoking & how confident they were (scale 1-10). Physical Activity Counseling trial Enjoyment-enhancing strategies added. Why? Highly tailored to patients’ needs. Assess step (broad life goals, PA motives, self-efficacy/competence, etc.) Reflection important for motivation.

12. Measurement techniques ELM Interventions: Self-matching effects: Messages tailored to match (1) specific concerns of recipients, (2) aspects of the individuals’ personality, or (3) individuals’ cognitive processes produced increased persuasion. Measurement outcomes of tailored messages: Perceived to be more relevant & individualized. More time spent with the messages. Intention to change greater. Mechanisms of perceived relevance not clear.

13. Conclusions Motivation is complex construct lacking clear definition and consensus. Difficult to measure as well. Theories reviewed here have provided some examples of how to influence & measure motivation. Self-reported value based on a scale. Discussion of that value and patient-driven goal setting. Perceived relevance. Intention to change. How does the Theory of Triadic Influence incorporate motivation? Is there a theory you think stood out as the most effective for measuring and influencing motivation?

14. Questions? Thank you.