Related Experiment Video
Updated: Jul 6, 2026

A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Clinician-patient communication about physical activity in an underserved population
Jennifer K Carroll1, Kevin Fiscella, Sean C Meldrum
1University of Rochester School of Medicine, Family Medicine Research Programs, 1381 South Avenue, Rochester, NY 14620, USA. Jennifer_Carroll@URMC.Rochester.edu
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.
Conclusion:
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.
Related Concept Videos
Role of Communication in the Nursing Process II: Planning and Implementation
Peripheral Artery Disease III: Interprofessional Care
Health Literacy
Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
Patient-centered Care
Therapeutic Communication
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal...