The 5 A’s in CDSM Support

Assess • Knowledge, skills, confidence, the importance the client assigns to a health issue,
their supports, the presence of barriers and risk factors.
• To assess importance, for example, ask “How important do you think it is to
check your blood glucose before breakfast each day?” Use a 1–10 scale, from not
at all important to very important.
• To assess confidence, for example, ask “How confident are you that you can
control any symptoms or health problems you have so that they do not interfere
with the things you want to do?” Use a 1–10 scale, from not at all important to
very important.

Advise • Provide specific personalized information about health risks and benefits of
change.
• Make the source of the advice clear.
• Personalize lab values, health status and how choices affect outcomes.
• Provide the level of information clients need to make decisions.
• Ask the client to restate what you said.

Agree • Collaboratively set goals based on the client’s interests and confidence in their
ability to change the behaviour.
• If their self-rated confidence is low, the goal may need to be changed: e.g., select
one aspect of the goal that the client feels more confident about attaining.

Assist • Assist the client in achieving agreed upon goals by offering encouragement and
by developing social/environmental supports.
• Avoid telling clients what to do.
• Use other clients’ experiences as examples (while maintaining confidentiality).

Arrange
• Schedule follow-up contact to provide ongoing assistance and support to adjust
the plan as needed. Use whatever method of contact the client prefers, such as
in person, by email or phone. Make sure follow-up happens, to preserve trust in
the relationship.