INTRODUCTION: High prevalence of obesity and insufficient amounts of physical activity (PA) among school-age children have intensified the need to identify the most influential psychosocial factors that influence PA behavior so they can be addressed in intervention research. Physical activity self-efficacy (PASE) and environmental factors (e.g., rural vs. urban) have been identified as significant correlates of PA in youth, but most of the available literature focuses on adolescents. (S)Partners for Heart Health was a multilevel intervention program among 5th grade students in Michigan designed to increase the number of students who meet national PA recommendations and improve students’ PASE. PURPOSE: To examine: 1) the association of PASE with PA, 2) the effects of (S)Partners for Heart Health intervention on PA and PASE, 3) the mediation effect of PASE on PA, and 4) differences in PA and PASE between rural and urban children. METHODS: Fifth grade students (n=920) from Michigan schools who participated in (S)Partners for Heart Health from 2008 to 2013 were participants. The intervention protocol included monthly lesson plans that were taught by the school physical education or classroom teacher in addition to small group breakout meetings conducted by undergraduate kinesiology and dietetic students. Undergraduate students were also assigned with case managing ((S)Partnering) the 5th grade students through goal setting and evaluation via a web-based goal tracking and education program. The active comparison condition involved following an existing nutrition and PA curriculum. Baseline and follow-up measurements were conducted at the beginning and end of each school year. PA was assessed in two ways: 1) a single, self-report question, and 2) pedometer. PASE was assessed using four questions with a 5-point scale. Each question assessed confidence to be physically active on 1-2 days, 3-4 days, 5-6 days, and all 7 days of the week. Multiple regression analysis was used to examine the association between PASE and PA, while structural equation modeling (SEM) was used for mediation analysis. Intervention effects and rural/urban differences were examined using mixed model ANCOVA controlling for year, sex, race, school, and separately for baseline percent body fat. RESULTS: Physical activity self-efficacy was significantly associated with self-reported PA (β = .508, F(3,689) = 82.223, p < .001, R2 = .264), but not with pedometer recorded PA. There were no significant differences in self-reported PA between the Active Comparison and (S)Partners groups at follow-up. With regard to pedometer recorded PA, there was a statistically significant difference between the Active Comparison and (S)Partners groups at follow-up, Welch’s F(1,189.6) = 4.571, p < .05 (12173 ± 5457 vs 10737 ± 4040 steps/day, respectively). PASE was significantly different (F(1,553) = 3.917, p < .048) between the Active Comparison and (S)Partners groups when adjusting for year of the study, sex, race, and school (2.7 ± 1.1 vs 2.9 ± 1.0, respectively). SEM showed that follow-up PASE had a significant relationship with follow-up PA (Estimate = 0.606, S.E. = 0.031, p < .001. There were no significant differences in PA and PASE between rural and urban children, but rural vs. urban was borderline significant (Estimate = -0.117, S.E. = 0.061, p = .054) in the SEM model. CONCLUSION: PASE was identified as a predictor of PA, which is consistent with the existing literature. The (S)Partners for Heart Health intervention was effective in increasing children’s PASE, but not PA. Follow-up PASE was identified as a mediator of follow-up PA in children; however the intervention did not play a role, which is not consistent with previous literature. Differences between rural and urban children in PA and PASE were non-existent in this sample.
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