Predictors of autonomy support at diabetes summer camp: A self -determination theory approach

Diabetes is considered to be one of the most psychologically and behaviorally demanding chronic illnesses facing adolescents. To control the disease more effectively, adolescents must learn to undertake the management of their diabetes themselves. Self-determination theory has been shown to be effective in increasing motivation for diabetes self-management. Self-determination theory was used as a foundation to explore the mechanisms, within a summer camp, that led to increased perceptions of autonomy support. Research shows autonomy support to be a critical prerequisite for increased autonomous behavior.;Data were collected from 66 campers participating in a 6-day diabetes summer camp located in the Sawtooth mountains of Idaho during 2004. Two instruments were utilized to ascertain campers' autonomy, competence, and relatedness for diabetes self-management and their perceptions of autonomy support upon completion of camp activities. A two-level hierarchical linear modeling was used to analyze the data. Level 1 consisted of experience predictors (group size, nature of competition, instructional approach, and activity type) and Level 2 consisted of participant predictors (age, sex, diabetes duration, and autonomy, competence, and relatedness for diabetes self-management). Finally, an exploratory analysis was conducted to determine possible cross-level interactions between experience and participant predictors.;Analysis resulted in a significant unconstrained model. Nature of competition and instructional approach were found to be significant, indicating that a noncompetitive and camper-centered instructional approach, respectively, produced increased perceptions of autonomy support. Sports, games, and athletics were found to be significant as compared to the arts, suggesting that the activity type plays a role in increasing perceptions of autonomy support. Older campers, as well as campers indicating a higher level of relatedness for diabetes self-management, were found to have increased perceptions of autonomy support. Finally, the cross-level interactions between nature of competition and instructional approach, by sex, were significant, indicating that females were negatively influenced by competitive activities and leader-centered instructional approaches, respectively.;The findings support diabetes summer camps as an effective modality through which to influence campers' perceptions of autonomy support. Practitioners may use the information to create programs that increase perceptions of autonomy support that have been shown previously to influence self-management of diabetes.