Table 1.

Elements of the 5A Model and Definition of 5As Used in the Coding of Audio-Recorded Office Visits

Counseling ActivityDescription
  • Inquire about health behaviors, self-efficacy

  • Did the clinician ask about the patients exercise or physical activity habit in any way? Was there any discussion about initiating, maintaining, or changing physical activity levels in any way?

  • Discuss health risks; benefits of change; review appropriate amount, intensity, and frequency of behavior

  • A clear statement that the clinician makes to the patient recommending the patient do regular physical activity. The clinician gives clear, personalized, and specific advice to change physical activity/exercise habits, which may or may not include information about personal benefits to health.

  • Collaboratively set physical activity goals based on patient's interest and confidence

  • The clinician and patient collaboratively select appropriate treatment goals and tasks based on the patient's interest and willingness to change the behavior.

  • Identify personal barriers and problem-solving techniques; community opportunities for physical activity and social support

  • The clinician assists the patient to aid them in changing their physical activity/exercise plans by addressing any challenges or barriers that the patient may face. This category also refers to the clinician helping the patient strategize or come up with a plan on how the patient might actually change their exercise level to meet their goals. The clinician might also mention available community resources, programs, or referral options for physical activity/exercise programs in this step.

  • Help the patient complete the plan by providing referrals, reminders, access to resources; specify future arrangements (follow-up visit, call, reminder) to follow-up on progress

  • The clinician and patient explicitly discuss a follow up plan. This means that the doctor schedules a follow up appointment to provide ongoing assistance and support to the patient for helping them change their exercise level. This step may also involve a referral to a program or specialist to help the patient with the exercise program (in this sense may overlap somewhat with the Assist step).