Past research suggests a positive correlation between self-efficacy (SE) and adherence to behavioral interventions. Less is known about SE and adherence in behavioral programs that are preventive in nature and specific to urinary incontinence (UI). Using treatment-group data from a previously reported randomized controlled trial. the authors assess the role of SE in predicting adherence to pelvic-floor muscle training (PFMT) for UI prevention in a sample of postmenopausal women. Results indicate that at 12 months follow-up, nearly 70% of participants reported medium or high adherence, performing the recommended PFMT regimen 2 to 3 times per week or more. Summary scores of both Task SE, beta = .25, SE (beta) = .08, p < .01, and Regulatory SE, beta = .43. SE (beta) = .06, p < .0001, predict adherence. Also, the authors found a modest decline in self-efficacy scores over time. These findings highlight the importance of SE in sustained behavioral change.