Table 1.

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

Counseling ActivityDescription
Ask/assess
  • 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?

Advise
  • 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.

Agree
  • 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.

Assist
  • 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.

Arrange
  • 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).