The long and winding road to physical activity maintenance.
OBJECTIVE
To build upon state-of-the-art theory and empirical data to estimate the strength of multiple mediators of the efficacious Keep Active Minnesota (KAM) physical activity (PA) maintenance intervention.


METHODS
The total, direct, and indirect effects through which KAM helped randomized participants (KAM n = 523; UC n = 526) maintain moderate or vigorous PA (MVPA) for up to 2 years were estimated using structural equation modeling.


RESULTS
Multiple mediators explained half (beta = .052, P = .13) of the effect of KAM on MVPA (beta = .105, P = .004). Self-efficacy was the upstream variable in 2 endogenously mediated effects, and the self-concept mediator emerged as the strongest predictor of MVPA.


CONCLUSIONS
KAM positively impacted self-efficacy, which was associated with PA enjoyment, integration into the self-concept, and PA maintenance. Successful long-term PA maintenance appears to be influenced by multiple small interrelated mediational pathways. Future research evaluating maintenance models should specify recursive relationships among mediators and outcomes.
Crain
A Lauren
AL
HealthPartners Research Foundation, Minneapolis, MN 55440-1524, USA. Lauren.A.Crain@HealthPartners.com
Martinson
Brian C
BC
Sherwood
Nancy E
NE
O'Connor
Patrick J
PJ
D000368:Aged; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009043:Motor Activity; D020377:Self Efficacy; D012944:Social Support