title: Practical Opportunities for Healthy Diet and Physical Activity: Relationship to Intentions, Behaviors, and Body Mass Index.
abstract: OBJECTIVE
  Current strategies for improving diet and activity patterns focus on encouraging patients to make better choices, but they meet with limited success. Because the choices people make depend on the choices they have, we examined how practical opportunities for diet and physical activity shape behavioral intentions and achieved behaviors.
  
  
  METHODS
  Participants included 746 adults who visited 8 large primary care practices in the Residency Research Network of Texas in 2012. We used structural equation models to confirm factor structures for a previously validated measure of practical opportunities, and then modeled achieved diet (Starting the Conversation - Diet questionnaire), physical activity (International Physical Activity Questionnaire), and BMI as a function of opportunities (classified as either resources or conversion factors that influence use of resources), behavioral intentions, and demographic covariates.
  
  
  RESULTS
  In path models, resources (P <.001) and conversion factors (P = .005) predicted behavioral intentions for activity. Conversion factors (P <.001), but not resources, predicted diet intentions. Both activity resources (P = .01) and conversion factors (P <.001) were positively associated with weekly activity minutes. Diet conversion factors (P <.001), but not diet resources (P = .08), were positively associated with diet quality. The same patterns were observed for body mass index (BMI). Socioeconomic gradients in resources and conversion factors were evident.
  
  
  CONCLUSIONS
  Individuals' feasible opportunities for healthy diet and activity have clinically meaningful associations with intentions, achieved behaviors, and BMI. Assessing opportunities as part of health behavior management could lead to more effective, efficient, and compassionate interventions.
authors.affiliation: Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas FerrerR@uthscsa.edu.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferrer
authors.affiliation: Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Burge
authors.affiliation: Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Palmer
authors.affiliation: Department of Family and Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Inez
authors.initials: I
authors.lastname: Cruz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D000072001:Diet, Healthy; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013781:Texas; D055815:Young Adult
keywords: capability approach; diet; physical activity; socioeconomic factors