Differences in autonomous motivation between a digital and a conventional prevention program: a longitudinal quasi-experiment

Background: Self-determination theory (SDT) is a widely used framework for explaining health behavior, yet research on autonomous motivation in preventive interventions, particularly telehealth interventions, remains scarce. This longitudinal study examines differences in autonomous motivation between participants in a digital and conventional prevention program over six months.

Methods: The quasi-experimental study included 163 participants, with 96 in the digital and 67 in the conventional program. Data was collected before, at 3 months into and after the intervention. Repeated-measures analyses of variance (ANOVAs) assessed changes in the Relative Autonomy Index (RAI). A first analysis without covariates was followed by an analysis controlling for age and gender.

Findings: At baseline, no significant group differences in RAI were observed (t(161) = 0.31, p = 0.756). In the digital intervention group, RAI declined continuously, whereas in the conventional group, RAI increased at three months before declining. The unadjusted ANOVA showed a significant time effect (F(2, 322) = 6.64, p < 0.001, η² = 0.040) and a significant time-by-group interaction (F(2, 322) = 4.83, p = 0.009, η² = 0.029). ... mehrWhen controlling for age and gender, the time effect was no longer significant (F(2, 316) = 2.88, p = 0.058, η² = 0.018), but the interaction effect remained (F(2, 316) = 4.51, p = 0.012, η² = 0.028), indicating a significant difference in RAI between both groups over time.

Discussion: Given the well-established role of autonomous motivation in predicting health behaviors, these findings highlight the importance of addressing basic psychological needs when designing telehealth interventions.