Not a Freudian Slip: Motivation: It All Starts with a Need – Part 1

Contributor: Connie Mester, MPH
To learn more about Connie, click here.

Much of the focus directed to individuals and healthcare is about getting people to comply and adhere to treatment recommendations and make lifestyle behavior changes. Traditional tactics aim to influence motivation and encourage healthy habits by focusing on what the person should do and push for continued action by rewarding performance. 

In this two-part series, we will explore what compels a person to behave or act, the why. Then we will explore what influences, predicts, and drives behavior in our discovery of motivation.  Finally, we’ll move to explaining the how, through approaches that influence sustained behavior versus tactics that are likely short-lived. Ultimately, we will demonstrate why efforts to motivate action, affect performance, and impact health outcomes must put the individual in the driver’s seat and tailor around their unique needs. As we look at what it takes for a program to create a lasting change, we’ll consider if innovative technology approaches can truly make an impact and inspire positive health behaviors.

Many organizations provide self-management programs that include rewards or incentives to initiate action, or the opposite - they may punish participants using the stick versus carrot method. Other wellness programs entice a person’s competitive spirit through gaming. But do these approaches truly motivate individuals or produce long-term changes? Or will behavior change be short-lived and dependent on being incentivized to continue. Many argue the short-term benefit is positive regardless. Organizations working towards a culture of health that embodies true personal accountability and autonomy shouldn’t stop at satisfying short-term accomplishments.

There are multiple theories of motivation and years of research on what drives human behavior, so why does it still seem like such a mystery? And why is behavior so hard to change?  Understanding the complexities involved in motivating people is not an easy job, since human behavior is unpredictable and is the result of multiple factors. Before we think about how to motivate people, we need to look at the bigger picture of behavior.
It all starts with a need. 
People behave based on their unmet needs, wants, or desires. When individuals are not receiving what they perceive they need, they will attempt to satisfy that need (Maslow 1943). The forces that lie beneath motivation to meet our needs can be biological, social, emotional, or cognitive [psychological] in nature.
If people behave based on needs or desires, what factors influence, predict, and drive behavior?
Motivation influences behavior. It is the process that initiates, guides, and maintains goal-oriented behaviors. It’s what causes us to act, whether to grab a snack to reduce hunger or complete a certificate program to advance our career.  
Some individuals are motivated because they value an activity (intrinsic), while others are motivated because there is a strong external pressure (extrinsic) (Ryan and Deci, 2000). Understanding what internally motivates a person beyond external motivators like rewards and recognition is where real change begins. 
Intention predicts behavior. When we have a purpose or plan, we direct the mind toward that aim, otherwise we may stray without meaning or direction. Having intention helps transform fear and doubt to hope, keeping us focused ahead on driving actions towards results. Intention is deliberate and sets the tone of whatever we are about to do.  A person’s attitude, their intention, toward performing behavior will lead to an outcome, and typically the more valuable the outcome, the better the attitude.  The Self-Regulation Model provides strategies to help individuals improve their ability to act upon their intentions (Brug, et al., 2005).  It emphasizes self-control, self-awareness, and self-management (Siegert, et al., 2004).   

Autonomy drives behavior. 
The distinction between “I choose to do this” and “I have to do this” is the essence of autonomy. A person chooses to act according to his/her own values and informed decisions and takes responsibility for the choices made.  This allows the person to feel in control of their behavior, the opposite of being controlled or directed.  The most satisfying activities you can engage in, the intrinsic ones that will motivate you the most, are those that allow you to feel most in control of your behavior (Niemiec et al, 2010).  It’s important to note that intrinsic motivation decreases as autonomy decreases.  

Anyone who has ever had a goal (like wanting to lose ten pounds or wanting to run a marathon) probably realizes that simply having the need/desire to accomplish something is not enough. You have to take action and routinely practice the behavior to reach the expected outcomes.  Understanding the motivation behind our behavior can give us the insights we need to develop our own unique plan for change and path to fulfillment.

So if behaviors are based on a need that we can influence, predict, and drive, how can wellness programs get people moving towards achieving a desired outcome?  The simple answer is to activate a person to perform behaviors that achieve the outcome intended in ways that align with them specifically. In the next column, we explore more deeply how to activate and inspire people to reach their desired outcome. This exploration is important, whether you're selecting a health program for your company, designing an intervention for people, or hoping to change your own behaviors for the better, as getting to the core of why can mean all the difference between how successful and sustained the change can be. 

Contact Connie at: 
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  • Brug J et al. (2005).  Theory, evidence and intervention mapping to improve behavior nutrition and physical activity interventions.  International Journal of Behavioral Nutrition and Physical Activity, 2(2): 1-7.
  • Maslow AH. (1943). A theory of human motivation. Psychological review, 50(4), 370.
  • Murray HA et. al. (1938). Explorations in Personality. New York: Oxford University Press. 
  • Niemiec CP, Ryan, RM, and  Deci, EL. (2010). Self-determination theory and the relation of autonomy to self-regulatory processes and personality development. In R. H. Hoyle (Ed.), Handbook of Personality and Self-Regulation. Malden, MA: Blackwell Publishing.
  • Ryan RM and Deci, EL. (2000).  Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being.  American Psychologist, 55(1): 68-78.
  • Siegert, RJ et. al. (2004).  Toward a cognitive-affective model of goal-setting in rehabilitation: is self-regulation theory a key step?  Disability and Rehabilitation, 26(20): 1175-1183.