Capability Assessment for Diet and Activity (CADA) and Its Influencing Factors Among Healthcare Workers in the Jazan...

Background: Adopting a healthy lifestyle through a balanced diet and regular physical activity is essential for chronic disease prevention, but healthcare workers face occupational constraints that may limit such behaviors. This study assessed perceived capability for healthy diet and physical activity among healthcare workers in the Jazan region of Saudi Arabia using the Capability Assessment for Diet and Activity (CADA) instrument and examined associated factors. Methods: A cross-sectional analytical study was conducted in 2026 in governmental healthcare facilities in the Jazan Health Cluster. A structured electronic questionnaire collected sociodemographic, occupational, and health-related data alongside the 34-item CADA. Total, Diet and Physical Activity CADA scores (1-5) were analyzed using descriptive statistics and multivariable ordinary least squares regression adjusted for sex, education, profession, and workplace; standardized coefficients and Cohen's f² were reported. Results: A total of 601 healthcare workers participated. Internal consistency was good (Cronbach's α = 0.84 for the full scale). Mean Total CADA was 3.28 ± 0.80 (scale midpoint 3.0); perceived Diet capability (3.45 ± 0.85) was higher than perceived Physical Activity capability (3.11 ± 0.85). Female sex was independently associated with lower Physical Activity CADA (β = -0.16; 95% CI -0.32 to -0.01; p = 0.042). Bachelor's and board/doctoral qualifications were associated with higher Total CADA (β = 0.20; 95% CI 0.02 to 0.38; p = 0.026 and β = 0.33; 95% CI 0.07 to 0.58; p = 0.013, respectively). Compared with hospital-based participants, those in primary healthcare centers had lower Total (β = -0.19; 95% CI -0.32 to -0.05; p = 0.007), Diet (β = -0.17; 95% CI -0.31 to -0.02; p = 0.024) and Physical Activity (β = -0.21; 95% CI -0.35 to -0.06; p = 0.006) CADA scores. Effect sizes were small (|β*| ≤ 0.16; R² = 0.076-0.082; Cohen's f² = 0.08-0.09). Conclusions: As CADA captures perceived capability, these findings reflect self-perception rather than objectively measured behavior; longitudinal studies combining CADA with validated behavioral instruments are warranted to clarify whether perceived capability translates into actual dietary and physical-activity behaviors in healthcare workers, and to evaluate whether workplace-based interventions targeting time pressure and access to supportive environments improve both perceived capability and measured behavior.