A Systematic Review Exploring the Social Cognitive Theory of Self-Regulation as a Framework for Chronic Health Condition Interventions

Abstract

BackgroundTheory is often recommended as a framework for guiding hypothesized mechanisms of treatment effect. However, there is limited guidance about how to use theory in intervention development.MethodsWe conducted a systematic review to provide an exemplar review evaluating the extent to which use of theory is identified and incorporated within existing interventions. We searched electronic databases PubMed, PsycINFO, CENTRAL, and EMBASE from inception to May 2014. We searched clinicaltrials.gov for registered protocols, reference lists of relevant systematic reviews and included studies, and conducted a citation search in Web of Science. We included peer-reviewed publications of interventions that referenced the social cognitive theory of self-regulation as a framework for interventions to manage chronic health conditions. Two reviewers independently assessed articles for eligibility. We contacted all authors of included studies for information detailing intervention content. We describe how often theory mechanisms were addressed by interventions, and report intervention characteristics used to address theory.ResultsOf 202 articles that reported using the social cognitive theory of self-regulation, 52% failed to incorporate self-monitoring, a main theory component, and were therefore excluded. We included 35 interventions that adequately used the theory framework. Intervention characteristics were often poorly reported in peer-reviewed publications, 21 of 35 interventions incorporated characteristics that addressed each of the main theory components. Each intervention addressed, on average, six of eight self-monitoring mechanisms, two of five self-judgement mechanisms, and one of three self-evaluation mechanisms. The self-monitoring mechanisms ‘Feedback’ and ‘Consistency’ were addressed by all interventions, whereas the self-evaluation mechanisms ‘Self-incentives’ and ‘External rewards’ were addressed by six and four interventions, respectively. The present review establishes that systematic review is a feasible method of identifying use of theory as a conceptual framework for existing interventions. We identified the social cognitive theory of self-regulation as a feasible framework to guide intervention development for chronic health conditions.

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“…More focal, targeted behavioral intervention approaches include attention modification/bias training, central executive training, and emotion regulation strategies. It is unclear the extent to which many of these are different names for the same thing or incorporate subsets of key, overlapping features (Tougas, Hayden, McGrath, Huguet, & Rozario, 2015). …”

A group-mediated physical activity intervention in older knee osteoarthritis patients: effects on social cognitive outcomes

“…Findings from the PA literature consistently demonstrate that change in SCT constructs are salient predictors of adoption and maintenance of regular PA (McAuley & Blissmer, 2000; Olson & McAuley, 2015; Stacey et al, 2015; Tougas et al, 2015). Within the context of SCT, self-efficacy (SE) beliefs are of particular importance to promoting PA among knee OA patients as a one’s confidence in their ability to perform mobility tasks, (mobility-related SE), self-regulate the ability to plan and carry out PA in the face of challenges (self-regulatory SE) and overcome barriers to PA (barrier SE) all are integral to successfully adopting and maintaining regular PA (Focht et al, 2005).…”

“…Within the context of SCT, self-efficacy (SE) beliefs are of particular importance to promoting PA among knee OA patients as a one’s confidence in their ability to perform mobility tasks, (mobility-related SE), self-regulate the ability to plan and carry out PA in the face of challenges (self-regulatory SE) and overcome barriers to PA (barrier SE) all are integral to successfully adopting and maintaining regular PA (Focht et al, 2005). Furthermore, not only does SE directly impact behavior, it also indirectly influences PA through other social cognitive constructs such as one’s self-regulatory skills and their outcome expectations associated with engaging in PA (Doerksen & McAuley, 2014; Tougas et al, 2015). Accordingly, given the well-established challenge in promoting PA maintenance in knee OA patients, determining the extent to which behavioral interventions may yield positive change in these SCT constructs is an integral consideration in enhancing the efficacy of implementing PA in the self-management of knee OA.…”

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