Smoking, nutrition, alcohol, physical activity (SNAP)

The 5As
☰ Table of contents

The 5As is a key framework for organising the provision of preventive care in primary healthcare.18,19 This includes the actions taken by healthcare providers in supporting their patients to change their risk (refer to Table 2).

Table 2. The 5As


  • identify patients with risk factors


  • level of risk factor and its relevance to the individual in terms of health
  • readiness to change
  • health literacy


  • provide written information
  • brief advice and motivational interviewing
  • negotiate goals and targets (including a lifestyle prescription)


  • develop a risk factor management plan that may include lifestyle education tailored to the individual (eg. based on severity of risk factors, comorbidities) and pharmacotherapies
  • support for self-monitoring


  • referral to allied health services or community programs
  • phone information/counselling services
  • follow-up, prevention and management of relapse


Using the 5As

  1. Dosh SA, Holtrop JS, Torres T, Arnold AK, Baumann J, White LL. Changing organizational constructs into functional tools: an assessment of the 5 A’s in primary care practices. Ann Fam Med 2005;3 Suppl 2:S50–2.
  2. Hung DY, Rundall TG, Tallia AF, Cohen DJ, Halpin HA, Crabtree BF. Rethinking prevention in primary care: applying the chronic care model to address health risk behaviors. Milbank Q 2007;85(1):69–91.