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基层医疗中促进营养咨询的5A法

The 5 A's Approach to Promoting Nutrition Counseling in Primary Care.

作者信息

Mehrtash Farhad, Manson JoAnn E

机构信息

Harvard T.H. Chan School of Public Health, Department of Nutrition, Boston, MA, USA.

Harvard T.H. Chan School of Public Health, Department of Epidemiology, Boston, MA, USA.

出版信息

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251338566. doi: 10.1177/21501319251338566. Epub 2025 May 23.


DOI:10.1177/21501319251338566
PMID:40408085
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12102564/
Abstract

Poor dietary habits are a major contributor to chronic disease burden, yet nutrition counseling remains underutilized in primary care settings despite proven effectiveness. This article presents a novel adaptation of the 5 A's framework (Assess, Advise, Agree, Assist, Arrange) titled 'The 5 A's Approach to Promoting Nutrition Counseling in Primary Care', by incorporating validated assessment tools and evidence-based strategies to support implementation in clinical settings. To address practical challenges, implementation approaches are proposed including alternative delivery and payment models. The 5 A's adaptation can be a tool used to address the critical need for standardized nutrition counseling in primary care.

摘要

不良饮食习惯是慢性病负担的主要促成因素,然而,尽管营养咨询已被证明有效,但在初级保健环境中其利用率仍然很低。本文提出了一种对5A框架(评估、建议、商定、协助、安排)的新颖改编,名为“初级保健中促进营养咨询的5A方法”,通过纳入经过验证的评估工具和基于证据的策略来支持在临床环境中的实施。为应对实际挑战,提出了包括替代交付和支付模式在内的实施方法。5A改编版可以作为一种工具,用于满足初级保健中对标准化营养咨询的迫切需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/7b0f5d20459b/10.1177_21501319251338566-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/588098bb9914/10.1177_21501319251338566-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/a7f320a0d32e/10.1177_21501319251338566-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/7b0f5d20459b/10.1177_21501319251338566-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/588098bb9914/10.1177_21501319251338566-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/a7f320a0d32e/10.1177_21501319251338566-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66a3/12102564/7b0f5d20459b/10.1177_21501319251338566-fig3.jpg

相似文献

[1]
The 5 A's Approach to Promoting Nutrition Counseling in Primary Care.

J Prim Care Community Health. 2025

[2]
A review of the use of the 5 A's model for weight loss counselling: differences between physician practice and patient demand.

Fam Pract. 2014-8

[3]
Do the five A's work when physicians counsel about weight loss?

Fam Med. 2011-3

[4]
Dietary counselling for cardiovascular disease prevention in primary care settings: results from a German physician survey.

Fam Pract. 2014-6

[5]
Teaching primary care physicians the 5 A's for discussing weight with overweight and obese adolescents.

Patient Educ Couns. 2016-10

[6]
Evaluating primary care behavioral counseling interventions: an evidence-based approach.

Am J Prev Med. 2002-5

[7]
Physical activity counseling by primary care physicians: attitudes, knowledge, implementation, and perceived success.

J Phys Act Health. 2015-2

[8]
Quality of weight-loss counseling by Dutch practice nurses in primary care: an observational study.

Eur J Clin Nutr. 2015-1

[9]
Factors influencing implementation of smoking cessation treatment within community mental health centers.

J Dual Diagn. 2015

[10]
Clinical review: modified 5 As: minimal intervention for obesity counseling in primary care.

Can Fam Physician. 2013-1

本文引用的文献

[1]
Integration of the 5A's Framework in Research on Obesity and Weight Counseling: Systematic Review of Literature.

Am J Lifestyle Med. 2024-12-9

[2]
Proposed Nutrition Competencies for Medical Students and Physician Trainees: A Consensus Statement.

JAMA Netw Open. 2024-9-3

[3]
GLP-1 Agonists for Obesity-A New Recipe for Success?

JAMA. 2024-3-26

[4]
"Food Is Medicine" Strategies for Nutrition Security and Cardiometabolic Health Equity: JACC State-of-the-Art Review.

J Am Coll Cardiol. 2024-2-27

[5]
Association Between Capitated Payments and Preventive Care Among U.S. Adults.

AJPM Focus. 2023-6-1

[6]
Validation and reliability for the updated REAP-S dietary screener, (Rapid Eating Assessment of Participants, Short Version, v.2).

BMC Nutr. 2023-7-19

[7]
Design and Implementation of a Culturally-Tailored Randomized Pilot Trial: Puerto Rican Optimized Mediterranean-Like Diet.

Curr Dev Nutr. 2022-12-23

[8]
Medical Nutrition Therapy Provided by Dietitians is Effective and Saves Healthcare Costs in the Management of Adults with Dyslipidemia.

Curr Atheroscler Rep. 2023-6

[9]
Association of Primary Care Visit Length With Potentially Inappropriate Prescribing.

JAMA Health Forum. 2023-3-3

[10]
Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guideline.

J Acad Nutr Diet. 2023-3

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