Physical Activity/Healthy Food Efficacy Scale for Children (PAHFE-C)

Abstract

The Physical Activity/Healthy Food Efficacy Scale for Children (PAHFE-C) is a specialized psychometric instrument designed to assess the self-efficacy beliefs of upper elementary students regarding their ability to engage in health-promoting behaviors. Developed and validated by Perry and colleagues in 2008, the scale measures confidence across two primary behavioral domains: maintaining physical activity and making appropriate healthy eating choices. Crucially, the PAHFE-C differentiates between confidence in basic goal-setting and confidence in maintaining these behaviors in challenging or distracting emotional and environmental contexts. Its robust structure supports its utility in health promotion and intervention programs targeting pre-adolescent populations.

Keywords

Self-efficacy, Children, Physical activity, Healthy eating, Goal-setting, Decision-making, Health behavior, Elementary students, Psychometric scale.

Authors

Perry, C. M., De Ayala, R. J., Lebow, R., Haydon, E.

Purpose

The primary purpose of the PAHFE-C is to quantitatively measure the degree of perceived self-efficacy among children concerning two vital health behaviors: maintaining regular physical activity and making appropriate healthy eating choices. This measurement is critical for identifying specific areas where children may lack confidence, enabling researchers and clinicians to tailor educational or behavioral interventions effectively.

The scale aims to assess the child’s belief in their capability to execute actions necessary to achieve their health goals, particularly when faced with common barriers such as unfavorable weather, distraction from friends, a bad mood, or the presence of tempting junk food. By focusing on situational challenges, the PAHFE-C provides a nuanced understanding of behavioral maintenance confidence.

Construct

The PAHFE-C primarily measures the psychological construct of Self-Efficacy, a core component of Social Cognitive Theory. It operationalizes this construct into four distinct, empirically supported sub-domains relevant to pediatric health behaviors:

• Goal-Setting for Physical Activity
• Goal-Setting for Healthy Food Choices
• Decision-Making for Physical Activity (efficacy in challenging situations)
• Decision-Making for Healthy Food Choices (efficacy in challenging situations)

This multi-factor structure ensures that the instrument captures both the child’s confidence in initiating health goals (goal-setting) and their confidence in sustaining those goals when faced with internal or external obstacles (decision-making/maintenance efficacy).

Validity

The validation study conducted by Perry et al. (2008) established the psychometric soundness of the PAHFE-C. Evidence of validity was assessed through construct validity, primarily demonstrated through statistical analysis confirming the hypothesized four-factor structure.

The distinct separation between the goal-setting items and the decision-making items, as well as the clear differentiation between the physical activity and healthy food domains, supports the instrument’s ability to accurately measure the intended, separate constructs. This strong empirical foundation suggests that the scores derived from the PAHFE-C are meaningful indicators of domain-specific self-efficacy beliefs in children.

Reliability

Reliability estimates for the PAHFE-C were reported as favorable in the 2008 validation study. Internal consistency, typically measured using Cronbach’s alpha, was high across the four subscales, suggesting that the items within each factor are highly correlated and consistently measure the same underlying dimension of self-efficacy.

High reliability indicates that the scale provides stable and consistent measurements of children’s perceived efficacy regarding their health behaviors, making it a dependable tool for both cross-sectional assessment and longitudinal tracking of intervention effectiveness.

Factor Analysis

The underlying structure of the PAHFE-C was confirmed using factor analysis, which supported a multi-dimensional model rather than a single, unified efficacy score. The analysis successfully identified the four hypothesized distinct factors:

1. Goal-Setting for Physical Activity
2. Goal-Setting for Healthy Food Choices
3. Decision-Making for Physical Activity
4. Decision-Making for Healthy Food Choices

This statistical confirmation is vital as it allows researchers to analyze efficacy beliefs separately for goal initiation versus behavioral maintenance, and independently for the two primary health domains (physical activity vs. healthy eating), thereby maximizing the diagnostic utility of the instrument for targeted interventions.

Instrument

Test Type: Self-report self-efficacy questionnaire.

Format: A 5-point Likert scale response format is utilized. The scoring anchors are: 1=Not Sure, 2= Not Too Sure, 3=Sure, 4=Very Sure, 5=Completely Sure.

Language Available: English (Original research).

Population Group: Children.

Age Group: Upper elementary students (typically corresponding to pre-adolescent ages).

Population Details: Specifically designed for assessment in educational and community settings focused on pediatric health promotion.

Test Methodology: Respondents indicate their level of certainty (self-efficacy) in performing specific health behaviors, both in general goal-setting contexts and under various challenging or distracting environmental and emotional conditions.

Keywords

Self-efficacy scale, Child health, Behavioral assessment, Psychometrics, Health promotion, Social cognitive theory, Likert scale, Elementary school, Efficacy beliefs.

Authors

Author ORCID Identifier: Not provided in source.

Affiliation Email addresses: Not provided in source.

Correspondence Address: Not provided in source.

Permissions & Fee and Test Year

The primary validation study was published in 2008. The instrument itself was subsequently compiled and published in the 2013 book, “Tools for strengths-based assessment and evaluation,” edited by Simmons and Lehmann. Permissions for use should be obtained from the original authors (Perry et al.) or the publisher (Springer) of the 2013 compilation.

Test Year (Validation): 2008

Reference’s

Perry, C. M., De Ayala, R. J., Lebow, R., & Haydon, E. (2008). A validation and reliability study of the physical activity and healthy food efficacy scale for children (PAHFE-C). Health Education and Behavior, 35, 346–360.

Perry et al. (2008). Physical Activity/Healthy Food Efficacy Scale for Children. In: Simmons C. A., Lehmann P. (eds). Tools for strengths-based assessment and evaluation, New York, NY: Springer, pp. 494-497. The Google Scholar citation for this work is available here.

Items of the Physical Activity/Healthy Food Efficacy Scale for Children (PAHFE-C)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

PHYSICAL ACTIVITY

1. How sure are you that you can set goals for yourself to be more physically active?
2. How sure are you that you can set physical activity goals for yourself with little help from others?
3. How sure are you that you can be physically active:
   1. Everyday?
   2. When with your friends?
   3. In cold weather?
   4. In hot weather?
   5. When in a bad mood?
   6. When you feel lazy?
   7. When you don’t feel like it?
   8. When you have homework?

HEALTHY EATING

1. How sure are you that you can set goals for yourself to eat healthy foods (like fruit and vegetables)?
2. How sure are you that you can set healthy eating goals for yourself with little help from others?
3. How sure are you that you can choose a healthy food to eat:
   1. Every day?
   2. For an after school snack?
   3. When watching TV or DVDs?
   4. When playing video games?
   5. When your friends are around?
   6. When you are bored?
   7. When you are in a bad mood?
   8. When junk food is around?

*Designed for upper elementary students

Goal-Setting for Physical Activity, Goal-Setting for Healthy Food Choices, Decision-Making for Physical Activity, and Decision-Making for Healthy Food Choices

1=Not Sure, 2= Not Too Sure, 3=Sure, 4=Very Sure, 5=Completely Sure