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Autonomous Motivation Trajectory Following Adoption of a Team-Based Gamification App Among Adults With Diabetes:
Satoshi Inagaki1,2, Kenji Kato3, Tomokazu Matsuda4
1School of Data Science, Nagoya City University, Nagoya, Aichi, Japan.
JMIR Formative Research
|February 19, 2026
Summary
Autonomous motivation in diabetes care follows an inverted U-shaped 1-year trajectory, peaking at 6 months with team-based app use. This finding highlights the need for adaptive interventions to sustain engagement and self-care behaviors.
Area of Science:
- Behavioral Science
- Digital Health
- Endocrinology
Background:
- Autonomous motivation is crucial for sustained diabetes self-care.
- Mobile health, gamification, and peer support are used to enhance motivation, but temporal patterns are unclear.
- Understanding motivation's evolution is key for adaptive diabetes intervention design.
Purpose of the Study:
- To characterize the 1-year developmental trajectory of autonomous motivation.
- To assess changes following the introduction of a team-based gamification app for diabetes self-care.
Main Methods:
- Prospective, single-arm longitudinal study of adults with diabetes (predominantly type 2).
- Participants used a team-based gamification app for at least 7 days.
- Autonomous motivation (TSRQ-AM) assessed at baseline, 6 weeks, 6 months, and 1 year; analyzed using linear mixed-effects models.
Main Results:
- Autonomous motivation showed a significant nonlinear, inverted U-shaped trajectory, peaking at 6 months.
- Mean motivation scores increased from baseline to 6 months (Cohen d=0.47).
- Body weight significantly decreased over 1 year; HbA1c and triglycerides showed no significant changes.
Conclusions:
- Preliminary evidence suggests a nonlinear, 1-year trajectory for autonomous motivation with app use.
- Motivation may peak around 6 months, emphasizing the need for adaptive designs to maintain engagement.
- Observed body weight reduction warrants further investigation in controlled studies.
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