Active Projects

Practical Opportunities for Healthy Behaviors

Our program of study seeks to understand and effectively address the social and environmental contexts that shape primary care patients’ health behaviors. The research program is guided by the “capability approach”, a human development framework from welfare economics.5 Capability can be defined as people’s substantive freedom to achieve a desired lifestyle: what real opportunities (“capabilities”) they have, given their resources.6 Capability addresses the gap between what people know that they should do and what they are actually able to do. Its relevance for practice is that assessing practical opportunities around health behaviors reveals the contextual constraints on individual choices -- limits on the freedom to choose or the range of available options.

Our specific aims include the following:

  1. To assess capabilities for healthy diet and physical activity among a sample of patients receiving care at one of ten health clinics in the Residence Research Network of Texas (RRNET)
  2. To evaluate differences in capabilities among different adult patient sub-groups (e.g., women compared to men), relationships among capabilities to different related health outcomes in addition to predictors of capabilities.
  3. To conduct a confirmatory factor analysis on the capability questionnaire in a sample distinct from the derivation sample to assess reliability.
  4. To evaluate concurrent validity of the capability instrument for diet and physical activity behaviors in a sample of primary care patients with and without obesity from a disadvantaged, largely Latino population. We hypothesize that scores on the capability questionnaire will be significantly associated with validated measures of diet and physical activity behavior, adjusting for other relevant variables such as educational attainment, income, race/ethnicity, health literacy, and self-efficacy.