The mnemonic “5As” refers to a reputable counselling framework that encourages brief, client-centred conversations to occur in a deliberative sequence that can be easily remembered. Specific to the behaviour of physical activity, the health care professional is encouraged to:

Assess

Assess involves asking the client about their physical activity level (type, frequency, duration and intensity), beliefs and knowledge, readiness for change, and self-efficacy for change and physical activity/exercise.

Advise

Advise involves giving the client individualized behaviour change guidance, including information about the health risks of not changing and benefits of implementing change, and relevant physical activity guidelines/recommendations.

Agree

Agree involves working with the client to develop an action plan based on their willingness and confidence to change and interests/goals.

Assist

Assist involves helping the client achieve their action plan by facilitating the needed skills (e.g., identifying potential barriers and solutions) and identifying relevant resources.

Arrange

Arrange involves working with the client to establish a plan for follow-up (e.g., visits or telephone calls) to provide ongoing support and modify the action plan as needed.

The mnemonic “ABCDs” is another counseling framework designed specifically for busy health care professionals wishing to help their clients make changes to their diet and/or physical activity. Like the 5As, the framework provides recommended discussion points to have with the client, and heavily encourages listening to the client rather than dictating what should be done (‘telling’ typically leads to resistance and avoidance from the client):

Assess

Assess involves asking the client about their physical activity level (type, frequency, duration and intensity), beliefs and knowledge, readiness for change, and self-efficacy for change and physical activity/exercise.

Barriers

Barriers involves asking the client to identify potential barriers to successfully changing their physical activity behaviour.

Commit

Commit involves working with the client to create strategies to address their perceived barriers and an action plan to change their physical activity behaviour.

Demonstrate

Demonstrate involves encouraging the client to monitor progress on their action plan facilitating demonstration of change and provision of ongoing support.

Motivational Interviewing, or MI, is a client-centred collaborative counselling style that strives to help clients bolster their personal motivation and commitment to change (Rollnick & Miler, 2013).

To help empower the client and resolve any ambivalence they may have about making changes to their physical activity behaviour, an MI-counselling approach focuses on the quality of the interaction between the client and the health care professional. It is important to note that improving the quality of this conversation does not mean increasing the quanitity of time spent with the client. The relationship between client and health care professional is built through the following four processes:

1. Engaging with the client
2. Creating specific goals by focusing the conversation
3. Evoking a client's personal reasons and motivation for change
4. Planning specific actions to take

Overarching communication skills that are evidenced to foster the relationship are: asking open-ended questions, affirming changes the client has taken, reflecting as a way to demonstrate listening, and providing summaries of what was collaboratively discussed. Relatedly, underlying all conversations using an MI-counselling approach means acting and listening with genuine care and empathy for the client, accepting and respecting that they have the right to change or not to change (with valid reasons behind their decision), and partnering with the client to work together in which the client is the expert. Ways in which a relationship between client and health care professional are often undermined are:

1. Righting reflex (attempting to ‘fix’ a client's unhealthy behaviours)
2. Expert trap (health care professional assumes they have the best and only answers to a client's problems)

Culturally Connected (BC Children’s Hospital & Women’s Hospital, Canada)

Health Literacy Umbrella (Centre for Collaboration, Motivation & Innovation, Canada)

Introdution to Motivational Interviewing (Centre for Collaboration, Motivation & Innovation, Canada)

Supporting People to Change their Health Behaviour (Motivate2Move, United Kingdom)

Start Where the Client Is: Assessment to Support Behavior Change (American College of Sports Medicine, USA)

Health Care Providers’ Action Guide (Exercise is Medicine, USA)

Physical Activity Counselling Toolkit (University of Alberta, Canada)

Supporting Healthy Decision Making (American College of Sports Medicine, USA)

Building Motivation From Basic Needs: Choose, Accomplish, Connect (American College of Sports Medicine, USA)

Motivational Interviewing for Promoting Healthy Behaviors (UComm Rudd Center for Food Policy & Obesity, USA)

Motivational Interviewing: Example Scripts (UComm Rudd Center for Food Policy & Obesity, USA)

Ask-Tell-Ask (Centre for Collaboration, Motivation & Innovation, Canada)

Ask-Tell-Ask Skills Checklist (Centre for Collaboration, Motivation & Innovation, Canada)

Teach-Back (Centre for Collaboration, Motivation & Innovation, Canada)

Brief Action Planning Guide (Centre for Collaboration, Motivation & Innovation, Canada)

Brief Action Planning Flow Chart (Centre for Collaboration, Motivation & Innovation, Canada)

Brief Action Planning Skills Checklist (Centre for Collaboration, Motivation & Innovation, Canada)

Brief Action Planning: Exercise (Swimming) (Centre for Collaboration, Motivation & Innovation, Canada)

Brief Action Planning: Exercise (Stationary Bike) (Centre for Collaboration, Motivation & Innovation, Canada)

Setting Strategic Goals (American College of Sports Medicine, USA)

Staying on Track: Creating a Practical Plan B (American College of Sports Medicine, USA)

Identifying and Managing Relapse Risk (American College of Sports Medicine, USA)

Promoting Self-Efficacy for Healthy Behaviors (American College of Sports Medicine, USA)

Evaluating and Enhancing Self-Efficay for Physical Activity (American College of Sports Medicine, USA)

Self-Monitoring for Supporting Change (American College of Sports Medicine, USA)