The Healthy Youth Places (HYP) intervention targeted increased fruit and vegetable consumption (FV) and physical activity (PA) through building the environmental change skills and efficacy of adults and youth. HYP included group training for adult school site leaders, environmental change skill curriculum, and youth-led FV and PA environment change teams. Sixteen schools were randomized to either implement the HYP program or not. Participants (N = 1,582) were assessed on FV and PA and hypothesized HYP program mediators (e.g., proxy efficacy) at the end of sixth grade (baseline), seventh grade (Postintervention Year 1), and eighth grade (Postintervention Year 2). After intervention, HYP schools did not change in FV but did significantly change in PA compared to control schools. Proxy efficacy to influence school PA environments mediated the program effects. Building the skills and efficacy of adults and youth to lead school environmental change may be an effective method to promote youth PA. (Contains 3 figures and 1 table.)