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.
|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