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BHC tool


The BHC approach uses the 5 A’s – Ask, Advise, Assess, Assist, Arrange, regardless of the type of health behaviour change the client might attempt.


BHC starts with a few tactful questions.

PHAC videos

ASK: Begin the client intervention:

Goal: To mutually identify with the client a behavior or issue that might warrant change. Through your knowledge of the client, this may be evident.

Open with a question to begin the dialogue.

  • Ask: How often do you drink alcoholic beverages?
  • Ask: Have you compared your food intake with Canada’s Food Guide?
  • Ask: How do you stay physically active?
  • Ask: Have you used any tobacco products in the last six months?

Depending on the answer(s), ask follow-up questions:

  • On a typical day, how many drinks do you have? Have you felt that you should cut down?
  • Have you considered eating more fruits and vegetables each day?
  • Have you considered a more regular exercise program? What kind of activities do you enjoy?
  • Are you thinking about reducing your tobacco use or quitting in the next month?


ADVISE: Give your opinion 

Provide your insight as a health professional, based on what you identified.  Clients value and respect your opinion.

  • Advise: It is important to limit alcohol consumption, as it is linked to many chronic health conditions such as cancer, heart disease and stroke.
  • Advise: It is important to eat a healthy balanced diet, as it can reduce your risk of heart disease, stroke, diabetes and some cancers.
  • Advise: Regular exercise will increase your energy levels and contribute to achieving and maintaining a healthy weight.
  • Advise: The most important thing that you can do for your health is to quit using tobacco. The benefits of quitting are immediate - within 20 minutes your oxygen levels increase and your blood pressure starts to normalize.


ASSESS: determine the clients’ phase of readiness

With the client’s responses, you should be able to deduce how ready the client is to change.

Goal: Try to nudge the client to the next stage of change

Stages of Change:

  • Pre-contemplation: awaken them to the issue
    • Contemplation: motivate them to make a workable plan
    • Preparation:  encourage them to engage their plan
    • Action:  affirm the decision and support resiliency
    • Maintenance:  provide ongoing support


ASSIST: provide some specific strategies for moving ahead.


  • Assist: Here is a pamphlet that outlines the low-risk drinking guidelines. 

Contemplation or Preparation 

  • Assist: There is a walking club here in town that uses the local trails. Here is contact information.
  • Assist: Health Connection can direct you to local tobacco cessation supports.  You can also call Smokers’ Helpline at 1-877-513-5333.  


  • Assist: It’s good that we keep talking about the positive changes you’ve been making. Tell me what’s been working.  


  • Assist: We learn a lot in life from our challenges, and this is totally normal.  You’ll be better prepared to succeed the next time.  Let’s talk about a plan to try some different cessation aids.


ARRANGE: Follow-up with the client. The goal is continuity.
  • Arrange: When you come in next, I’ll see how you are doing
  • Arrange: They can contact you to set up an appointment or provide support
  • Arrange: Take this referral and contact them
  • Arrange: Let me know who you spoke to and how it went


overview stages of Change 5 A's Web Resources