Dear Mr. Hiddink,
I've been working on Health Promotion and Disease Prevention since 2003 and, since then, I've adopted 5A and Transtheoretical Model (TTM) as my Counseling underpinning in order to help people make healthy choices, based on their knowledge, skills, motivation and opportunities. My main experience in their utilization relies on in company programs, educational groups and outpatients care. I think 5A's Model (5A) allows a more interprofessional dialogue and organization of care delivery. Handlets, booklets, environmental changes, advertising, rewards policies and so on.
5A renders an important approach to tackle health determinants focused on individual level (however, we try to understand social determinants' influences on person's choices) and we put it into practice considering that:
1. Ask: could include motivational (e.g., stages of change) and holistic questions.
2. Advise: evidence-based practice following Agency for Healthcare Research and Quality adapted to Brazilian National Healthcare System (as known as SUS). We prefer to incorporate A and B recommendations in our protocols and activities.
3. Assess: probably the "more important" step once it requires a person-centered approach and defines sharing goals derived on people's context. This could avoid prescritive and authoritharian attitudes from healthcare professionals toward individuals in their own possibilites, desires and assets.
4. Assist: our staff and I try to identify barriers and facilitators in fostering health lifestyle . Besides, we could provide a wide array of alternatives and explore individuals' own real options.
5. Arrange: we try to blend presential and distance care and monitoring. Furthermore, assuring continuity is a great and complex challenge and must engage different stakeholders in order to achieve more effective outcomes.
Thus, 5A helps a lot to give us an easy logistics and allows place other behavioural and educational theories and models in a rational mode after offer brief counseling. I've enclosed a resourceful paper too. I guess 2002 had a good harvest on this theme.
Best regards,
Alfredo Pina-Oliveira
Dear Mr Almeira Pino-Oliveira,
Looking into the answers on the questions I raised in ResearchGate, I saw I did not answer you.( I thought I had). I apologize sincerely for this. Thank you very much for your answer, and for enclosing a resourcefull paper, also from 2002!
I too use the 5A framework in my resarch, and I am always curious to hear the experiences of colleaugues.
Best regards,
Gerrit J Hiddink
Dear Mr Almeira Pino-Oliveira,
I enclose the article of my colleague Dr Sonja van Dillen in which the 5A framework is used (van Dillen SM, Noordman J, van Dulmen S, Hiddink GJ (2014). Quality of weight-loss counseling by Dutch practice nurses in primary care: an observational study. Eur J Clin Nutr. 2014 Jul 2. doi: 10.1038/ejcn.2014.129. [Epub ahead of print]
Best regards,
Gerrit J Hiddink
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