Associations among measures of energy balance related behaviors and psychosocial determinants in urban upper elementary school children.

BACKGROUND
Childhood obesity prevention is a pressing issue.Understanding the relationships among eating and physical activity behaviors and potential psychosocial determinants of behavior will help us design more effective interventions. This study aimed to examine such relationships in a large sample of urban elementary school children.

METHODS
Fifth grade students in 20 recruited New York City public schools completed a validated questionnaire on six "do more" (fruits and vegetable and physical activity) and "do less" (sweetened beverage, processed packaged snacks, fast food and sedentary behavior) energy balance related behaviors (EBRBs) and psychosocial determinants of behavior from social cognitive and self-determination theories. Correlations among behaviors and hierarchical linear model analyses of the relationship between psychosocial determinants and behaviors were conducted for those with complete data (n = 952).

RESULTS
The "do more" and the "do less" behaviors were significantly correlated within categories (p < 0.01). "Do more" food-related behaviors were correlated with physical activity but so were sports drinks, while the "do less" food-related behaviors tended to be correlated to sedentary behavior (p < 0.01). "Do more" behaviors were associated with self-efficacy and habit strength, and "do less" behaviors with outcome expectations, self-efficacy, habit strength, and behavioral intention.

CONCLUSIONS
Interventions can address the healthy and less healthy clusters of behaviors together, focusing on strategies to enhance their self-efficacy and habit strength for the "do more" behaviors and outcome expectations to motivate intention to choose fewer "do less" behaviors, along with enhancing self-efficacy and habit. Research can examine these determinants as potential mediators of change in intervention.