title: Clinician-patient communication about physical activity in an underserved population.
abstract: BACKGROUND
  The 5A (Ask, Advise, Agree, Assist, Arrange) model, used to promote patient behavior changes in primary care, can also be applied to physical activity. Our goal was to assess primary care physicians' use of the 5A model in discussions with underserved populations about physical activity.
  
  
  METHODS
  We analyzed 51 audio-recorded, transcribed office visits on randomly selected patient care days and after-visit patient surveys with adults in 2 community health centers in Rochester, New York.
  
  
  RESULTS
  The patient sample was 51% African-American and predominantly female (70%), with the majority having a high school-level education or less (66%) and an annual household income < dollars 39,000 (57%). Physical activity was discussed during 19 of the 51 visits, which included 16 (84%) visits with "Ask"; 10 (53%) with "Advise"; 4 (21%) with "Agree"; 5 (26%) with "Assist"; and 0 with "Arrange" statements. Most discussions of physical activity contained several Ask or Advise statements but few Agree, Assist, or Arrange statements.
  
  
  CONCLUSIONS
  Communication about physical activity that included Agree, Arrange, and Assist statements of the 5A model was infrequent. Health promotion interventions in underserved populations should target these steps and prompt patients to initiate communication to improve physical activity.
authors.affiliation: University of Rochester School of Medicine, Family Medicine Research Programs, 1381 South Avenue, Rochester, NY 14620, USA. Jennifer_Carroll@URMC.Rochester.edu
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Carroll
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Sean C
authors.initials: SC
authors.lastname: Meldrum
authors.forename: Geoffrey C
authors.initials: GC
authors.lastname: Williams
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Sciamanna
authors.forename: Pascal
authors.initials: P
authors.lastname: Jean-Pierre
authors.forename: Gary R
authors.initials: GR
authors.lastname: Morrow
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003142:Communication; D003376:Counseling / Q000379:methods; D015444:Exercise; D005260:Female; D019983:Guideline Adherence; D006266:Health Education / Q000379:methods; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D010817:Physician-Patient Relations; D010821:Physicians, Family; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D014504:Urban Health