Glasgow Russell E, Emont Seth, Miller Doriane C
Clinical Research Unit, Kaiser Permanente Colorado, Penrose, CO, USA.
Health Promot Int. 2006 Sep;21(3):245-55. doi: 10.1093/heapro/dal017. Epub 2006 Jun 2.
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.
行为改变的“5A”模型提供了一系列基于证据的临床医生和办公室实践行为（评估、建议、商定、协助、安排），可应用于初级保健环境，以解决广泛的行为和健康状况。尽管“5A”方法作为一种健康行为改变咨询策略正被越来越广泛地采用，但对“5A”实施情况进行实用且标准化的评估却并不常见。本文为临床医生和研究人员提供了用于评估“5A”实施情况的替代方法，以用于质量改进以及研究和评估目的，并介绍了他们可能希望使用的几种实用工具。提供了用于跟踪“5A”实施情况的示例工具以及公共领域中的相关工具，以促进将自我管理支持融入临床护理。我们讨论了各种评估方法的优缺点。存在用于质量改进和研究目的的评估“5A”的有前景且实用的措施。几乎所有当前程序都需要进一步验证，鼓励临床医生和研究人员使用这些工具并分享所得数据。
