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Clinician’s Guide for Assessment and Counseling of Physical Activity, Nutrition, & Tobacco

User Guide – Action Plan for Clinician and Office Staff

The Clinician’s Guide for Assessment and Counseling of Physical Activity, Nutrition, & Tobacco is an efficient, standardized protocol to assess, counsel, and prescribe healthy lifestyle behaviors for patients. The Guide was developed by The University of Texas at Austin for the Texas Department of State Health Services. It addresses three health behaviors (physical activity, nutrition, and tobacco use) that have been linked to the prevention and control of chronic diseases. All client-related educational materials are provided in both English and Spanish.

PHYSICAL ACTIVITY: It is important to underscore the fact that the majority of patients, regardless of risk factors, can and should be encouraged to start or continue a program of regular, moderate physical activity. All individuals should accumulate 30 minutes of moderate level activity most days of the week.

NUTRITION: Increasing fruit and vegetable consumption to at least 5 or more servings every day can be an important component in chronic disease risk reduction.

SMOKING: All smokers should be encouraged to quit. If a patient uses tobacco within 30 minutes of rising in the morning and/or had difficulty quitting for more than three days, chances are he/she is addicted to nicotine and a good candidate for nicotine replacement or other pharmacotherapy.

The order listed below corresponds to how you may use these guides in your practice.

STEP 1: Administer Client Assessment Form when the client arrives at the office. Have client complete the assessment form assessing his/her current physical activity level, nutrition habits, and tobacco use.

Download Client Assessment Form (PDF, 60 kb, viewing information)

STEP 2: Use the Clinician Counseling Guide and the Client Assessment Form together to assess the client’s readiness for change. Depending on the client’s answer choices, he/she will fall into one of three stages of change.

1. If the client falls into the Precontemplation stage, he/she may realize that a change is indicated but is not willing to consider altering his/her health behavior. As a result, the goal should be to encourage patients to at least consider making a positive health behavior change in the near future.
2. If the client falls into the Contemplation stage, he/she is aware that he/she needs to change behavior and is at least thinking about it. The challenge may be that he/she does not have the skills, knowledge, or incentive to change. As a result, the goals should be to help the client make a specific plan for changing behavior and to support that change.
3. If the client falls into the Action stage, he/she already is taking steps to change behavior. The challenge is sticking with it. As a result, individuals in this stage need continued support for their behavior change. As a result, the goal is to support the client in continuing the behavior change.

Download Clinician Counseling Guide (PDF, 36 kb, viewing information)

STEP 3: Counsel the client about one of the health behaviors using the appropriate stage-based counseling. Print the stage-based educational sheet that corresponds to the client’s diagnosed stage of change. Make sure you print all Precontemplation sheets on RED paper; all Contemplation sheets on YELLOW paper; and all Action sheets on GREEN paper. These colors provide a useful means for you to remember the client’s stage and the goal of the intervention.

Educational Materials below are PDF files. Click here for viewing information.

Precontemplation Educational Materials (print on RED PAPER)
	Physical Activity Precontemplation – English (80 kb)
	Physical Activity Precontemplation – Spanish (76 kb)
	Nutrition Precontemplation – English (80 kb)
	Nutrition Precontemplation – Spanish (84 kb)
	Tobacco Precontemplation – English (72 kb)
	Tobacco Precontemplation – Spanish (73 kb)

Contemplation Educational Materials (Print on YELLOW PAPER)
	Physical Activity Contemplation – English (61 kb)
	Physical Activity Contemplation – Spanish (68 kb)
	Nutrition Contemplation – English (88 kb)
	Nutrition Contemplation – Spanish (92 kb)
	Tobacco Contemplation– English (83 kb)
	Tobacco Contemplation – Spanish (83 kb)

Action Educational Materials (Print on GREEN PAPER)
	Physical Activity Action – English (67 kb)
	Physical Activity Action – Spanish (68 kb)
	Nutrition Action – English (88 kb)
	Nutrition Action – Spanish (94 kb)
	Tobacco Action – English (76 kb)
	Tobacco Action – Spanish (81 kb)

STEP 4: Provide the client with a healthy prescription for his/her behavior change.

	Physical Activity Prescription (32 kb)
	Nutrition Prescription – English (40 kb)
	Nutrition Prescription – Spanish (46 kb)
	Tobacco Prescription (37 kb)

Additional Resources (47 kb)

Last Updated February 21, 2006