Ferrer RL, Burge S, Palmer R, Cruz I. Practical opportunities for healthy diet and physical activity: relationship to intentions, behaviors, and body-mass index. Annals of Family Medicine 2016;14:109-116. PMID: 26951585

PURPOSE 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 inten- tions 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 struc- tural equation models to con rm factor structures for a previously validated measure of practical opportunities, and then modeled achieved diet (Starting the Conversation – Diet questionnaire), physical activity (International Physical Activ- ity Questionnaire), and BMI as a function of opportunities (classi ed as either resources or conversion factors that in uence use of resources), behavioral inten- tions, 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 conver- sion 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, ef cient, and compassionate interventions.