5 A’s Direct Observation Coding scheme (5A-DOC)

Developers: Peter J. Lawson, Susan A. Flocke, Brad Casucci

Year of publication: 2009

Date last updated: 21 October 2019

Setting in which the tool was originally developed/validated: Primary care

Restriction to setting(s): Not specified

Target group: Community-practicing, primary care physicians and their patients

Language(s): English

Specific constructs/behaviours:

Implementation of the 5A's framework for smoking cessation (Ask, Advice, assess, Assist, and Arrange) in primary care outpatient visits

Ask: Is tobacco use identified in any way during the encounter?
Advise: Are specific reasons to quit given that are intended to be relevant to the patient? Is there a clear message to quit smoking?
Assess: Is the patientНs readiness to make a quit attempt in the near future determined?
Assist: Are attempts made to construct a plan of action for tobacco cessation? Are specific strategies suggested or explained? Is the patient referred to an outside source for assistance in cessation?
Arrange: Is there a follow-up appointment scheduled with the stated purpose of monitoring tobacco-cessation efforts?

Tool topics:

Intended application: Research

Reference(s) to development/validation paper(s):

Lawson PJ, Flocke SA, Casucci B. Development of an instrument to document the 5A's for smoking cessation. Am J Prev Med. 2009 Sep;37(3):248-254

Carroll, J. K., Antognoli, E., & Flocke, S. A. (2011). Evaluation of physical activity counseling in primary care using direct observation of the 5As. The Annals of Family Medicine, 9(5), 416-422.

• Lawson et al. (2009)

Tool/manual available: No.

Contact: Susan A. Flocke