PMID- 35079780
OWN - NLM
STAT- MEDLINE
DCOM- 20220928
LR  - 20221016
IS  - 1460-2229 (Electronic)
IS  - 0263-2136 (Linking)
VI  - 39
IP  - 5
DP  - 2022 Sep 24
TI  - Behaviour change for type 2 diabetes: perspectives of general practitioners, 
      primary care academics, and behaviour change experts on the use of the 5As 
      framework.
PG  - 891-896
LID - 10.1093/fampra/cmab182 [doi]
AB  - BACKGROUND: The 5As framework is a recognized underpinning of behaviour change 
      guidelines, teaching, and research in primary care. Supporting patients to 
      improve their lifestyle behaviours, including diet and physical activity, is a 
      common aspect of type 2 diabetes mellitus (T2DM) management. The 5As framework 
      often informs behaviour change for patients with T2DM. OBJECTIVE: To explore the 
      experience and perspectives of general practitioners (GPs) and primary care 
      academics and behaviour change experts regarding using the 5As framework when 
      caring for patients with T2DM to better understand how and why the 5As are 
      effective in practice. METHODS: We recruited 20 practising GPs, primary care 
      academics, and behaviour change experts for an individual semistructured 
      interview and analysed the data using a realist evaluation approach. RESULTS: 
      There were diverse accounts of how GPs use the 5As in practice and few of the 
      participants could name each "A." The 5As were commonly regarded as a framework 
      best suited to beginners and although GPs expressed they followed the broad 
      direction of the 5As, they did not consciously follow the framework in an 
      instructive manner. Elements that could enhance the 5As included more emphasis on 
      motivational interviewing, changing how "Ask" is included in the consultation, 
      and increased person-centredness. CONCLUSION: Although it is a ubiquitous 
      framework in primary care, the 5As are understood in diverse ways and applied 
      variably in practice. There is room to enhance how the 5As support behaviour 
      change consultations to optimize outcomes in primary care.
CI  - (c) The Author(s) 2022. Published by Oxford University Press. All rights reserved. 
      For permissions, please e-mail: journals.permissions@oup.com.
FAU - Sturgiss, Elizabeth
AU  - Sturgiss E
AUID- ORCID: 0000-0003-4428-4060
AD  - School of Primary and Allied Health Care, Monash University, Melbourne, 
      Australia.
FAU - Advocat, Jenny
AU  - Advocat J
AUID- ORCID: 0000-0001-7965-2244
AD  - School of Primary and Allied Health Care, Monash University, Melbourne, 
      Australia.
FAU - Ball, Lauren
AU  - Ball L
AUID- ORCID: 0000-0002-5394-0931
AD  - Menzies Health Institute Queensland and School of Health Sciences and Social 
      Work, Griffith University, Brisbane, Australia.
FAU - Williams, Lauren T
AU  - Williams LT
AUID- ORCID: 0000-0002-7860-0319
AD  - Menzies Health Institute Queensland and School of Health Sciences and Social 
      Work, Griffith University, Brisbane, Australia.
FAU - Prathivadi, Pallavi
AU  - Prathivadi P
AUID- ORCID: 0000-0001-7909-6962
AD  - Department of General Practice, School of Primary and Allied Health Care, Monash 
      University, MelbourneAustralia.
FAU - Clark, Alexander M
AU  - Clark AM
AUID- ORCID: 0000-0002-2860-0492
AD  - University of Athabasca, Athabasca, AB, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Fam Pract
JT  - Family practice
JID - 8500875
SB  - IM
MH  - *Diabetes Mellitus, Type 2/therapy
MH  - *General Practitioners
MH  - Humans
MH  - Life Style
MH  - *Motivational Interviewing/methods
MH  - Primary Health Care/methods
OAB - General practitioners (GPs) are usually involved in helping patients with 
      diabetes to improve their diet, physical activity, and other lifestyle 
      behaviours. The 5As are a framework designed to be used to structure behaviour 
      change conversations-5As stand for Ask, Assess, Advise, Assist, and Arrange. We 
      interviewed 20 people who were either GPs or experts in behaviour change. They 
      had different ways of explaining the intent and usage of the 5As but consistently 
      saw them as a framework for new practitioners. No one used the 5As consciously in 
      their consultations with patients. The participants had multiple suggestions for 
      how the 5As could be enhanced to support better care for patients living with 
      diabetes. These included: more focus on motivational interviewing techniques, 
      changing the number or order of the 5As steps, more focus on teamwork as well as 
      the individual cultural needs of the patients. This work can inform further 
      research on how patients can be better supported by GPs through evidence-based 
      behaviour change care.
OABL- eng
OTO - NOTNLM
OT  - behaviour
OT  - communication
OT  - doctor-patient relationship
OT  - lifestyle
OT  - patient-centred care
OT  - physicians
OT  - primary care
OT  - primary health care
EDAT- 2022/01/27 06:00
MHDA- 2022/09/28 06:00
CRDT- 2022/01/26 05:32
PHST- 2022/01/27 06:00 [pubmed]
PHST- 2022/09/28 06:00 [medline]
PHST- 2022/01/26 05:32 [entrez]
AID - 6515350 [pii]
AID - 10.1093/fampra/cmab182 [doi]
PST - ppublish
SO  - Fam Pract. 2022 Sep 24;39(5):891-896. doi: 10.1093/fampra/cmab182.