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Health Promotion International Advance Access published online on June 2, 2006
Health Promotion International, doi:10.1093/heapro/dal017
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

Assessing delivery of the five ‘As’ for patient-centered counseling

RUSSELL E. GLASGOW 1 *, SETH EMONT 2, and DORIANE C. MILLER 3

1 Clinical Research Unit, Kaiser Permanente Colorado, Denver, CO, USA
2 White Mountain Research Associates, L.L.C., Danbury, NH, USA
3 Rush Medical College, Chicago, IL, USA

* To whom correspondence should be addressed.
RUSSELL E. GLASGOW, E-mail: russg{at}ris.net


  Abstract

SUMMARY The ‘5As’ model of behavior change provides a sequence of evidence-based clinician and office practice behaviors (Assess, Advise, Agree, Assist, Arrange) that can be applied in primary care settings to address a broad range of behaviors and health conditions. Although the 5As approach is becoming more widely adopted as a strategy for health behavior change counseling, practical and standardized assessments of 5As delivery are not widely available. This article provides clinicians and researchers with alternatives for assessment of 5As implementation for both quality improvement, and for research and evaluation purposes, and presents several practical tools they may wish to use. Sample instruments for tracking delivery of the 5As and related tools that are in the public domain are provided to facilitate integration of self-management support into clinical care. We discuss the strengths and limitations of the various assessment approaches. Promising and practical measures to assess the 5As exist for both quality improvement and research purposes. Additional validation is needed on almost all current procedures, and both clinicians and researchers are encouraged to use these instruments and share the resulting data.

Keywords: assessment; primary care; behavior change.
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