Exploration of individual and context features of a bicycle skills program for riding injury prevention knowledge and self-efficacy among children

Bicycle education programs teach injury prevention skills among children in their formative years for developing lifelong safety behaviors. Program success measures, such as knowledge of skills, show mixed findings for use of these behaviors. Self-efficacy, a construct of Social Cognitive Theory (SCT), is theorized to predict behavioral intent. This study used SCT to explore individual and external factors as predictors of pre-program to post-program change from a program and compare outcomes of knowledge and self-efficacy for bicycle riding injury prevention skills. A school-based program was implemented at 13 sites among 2,260 students. Students and instructors completed survey items for individual-level characteristics and program external context factors. Multilevel models examined the association of individual-level and context predictors with both outcomes. Results showed more consistent change in self-efficacy than knowledge. Students with behavioral capability through riding a bicycle as part of the program showed a greater increase in self-efficacy, as did those with positive expectations. Contexts with a greater percentage of students who could already ride were associated with less increase in both outcomes. Injuries among children are preventable with learning of injury prevention skills and translation into behaviors. Practice riding a bicycle, use of self-efficacy as an outcome, attention to the composition of skill levels, and recognition of individual differences are identified highlights. Bicycle safety education programs may serve as an avenue to both reduce childhood injuries and improve equity in childhood injuries through beginning with an understanding of individual-level factors and incorporating them into effective programming. • Novel comparison of knowledge and self-efficacy outcomes for bicycle skill programs. • Students tend to show more self-efficacy change than knowledge change. • Practice and individualized approaches may be necessary within interventions. • Effective programming can improve health and reduce childhood injuries.