A 45-year-old man with newly diagnosed type 2 diabetes mellitus and a body mass index of presents for a follow-up visit. The physician intends to use the evidence-based "5 A's" behavioral counseling framework (Assess, Advise, Agree, Assist, Arrange) to initiate weight management counseling. Arrange the following physician statements in the correct chronological sequence according to this framework.
- 1"Would it be okay if we spent a few minutes discussing your weight and how it affects your diabetes?"
- 2"I strongly recommend a goal of losing 5% to 7% of your body weight to help improve your blood sugar control."
- 3"Let us collaborate to set a realistic target of replacing your daily soda with water and walking 15 minutes every evening."
- 4"I will refer you to our clinic's diabetes educator and provide a logbook to help you track your daily steps."
- 5"Our team will call you next week to check in, and I will see you back in the clinic in exactly one month."
Answer
The correct sequence is: 1) Assess readiness, 2) Advise on health benefits, 3) Agree on collaborative goals, 4) Assist with resources, and 5) Arrange follow-up.
The 5 A's model is a structured, evidence-based approach to health behavior counseling, particularly for weight management and smoking cessation. It begins with 'Assess' to ask permission and evaluate readiness. This is followed by 'Advise' to provide clear, personalized medical recommendations. Next, 'Agree' involves collaborative goal setting based on the patient's capacity and interests. 'Assist' provides practical resources, referrals, or tools to overcome barriers. Finally, 'Arrange' ensures accountability and ongoing support through scheduled follow-up.
Step-by-Step Solution
Key Concept
The 5 A's Behavioral Counseling Framework (Assess, Advise, Agree, Assist, Arrange)