The long and winding road to physical activity maintenance

A. Lauren Crain, Brian C. Martinson, Nancy E. Sherwood, Patrick J. O'Connor

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Objectives: To build upon stateof- 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 (β=.052, P=.13) of the effect of KAM on MVPA (β=.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.

Original languageEnglish (US)
Pages (from-to)764-775
Number of pages12
JournalAmerican journal of health behavior
Issue number6
StatePublished - 2010


  • Behavioral intervention
  • Maintenance
  • Multiple mediation
  • Physical activity
  • Structural equation modeling


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