The 5 A's model

At a glance
  • 5A's
  • The 5A's approach
  • The 5A's Model of Behaviour Change
Aim To focus the clinical encounter on assessment and management of patient risk factors for chronic disease, by counselling the patient and acknowledging their experience of living with their condition.
  • Assessment, detection, and management of risk factors
  • Behaviour change
  • General CDSM
Target Health professionals
Origin USA
Evidence-based? Yes
Training required? No, although familiarising yourself with the model is required

"..."The Five A's is a counselling model used to train health professionals in behaviour change counselling. It is an approach that offers a successful communication style that acknowledges the expertise people have in living with their condition."

Navigating self-management. A practical approach to implementation for Australian health care agencies,
Whitehorse Division of General Practice (2007), p 85.

  The Model

The 5A's model was first used to promote and support smoking cessation in a US intervention.

Since its conception, the 5A's approach has been recognised internationally as an effective approach for behaviour change, particularly in primary health care settings.

The 5A's involves a 5 step process that includes:

Assess Ask about the behaviour  
Advise Give a clear message of encouragement to change  
Agree Set goals based upon readiness to change  
Assist In acquisition of knowledge, skills, confidence and supports  
Arrange Referrals and schedule in follow-up contacts 5A Behaviour Change Model : Click Image for a larger view 

A key benefit of the 5A's approach is that is allows short consultations, such as those in the general practice setting, to be structured around detection, assessment and management of patient risk factors. The 5A's approach engages the patient by encouraging them to discuss their experience and issues, thus focusing the clinical encounter around the patient and their concerns. In addition to this, the 5A's is applicable to most health disciplines and settings, and complimentary when used with other CDSM approaches covered in this section, including the Stanford and Flinders Programs, and health coaching.

The patient should be the focus when making decisions, especially when selecting the right approaches for supporting their CDSM. This means considering their condition, lifestyle and psychosocial factors, individual capabilities and barriers. Another important step is identifying and acknowledging the patient's readiness to change, or the current stage of change they are at in order to provide a suitable treatment plan. Follow the Suggested reading links below to find some useful resources for these SMS strategies.

  Useful resources

The  website is supported by funding from the Australian Better Health Initiative: A Joint Australian, State and Territory government initiative.