Red Book - SNAP

Question 1

What are the 5 As?

Answer 1

Ask
Assess
Advise / agree
Assist
Arrange

Question 2

Smoking - 5 As

Answer 2

ASK about smoking (in everyone >10yo)
ASSESS amount smoked, dependence, readiness to change
ADVISE/AGREE use motivational interviewing and set a quit date
ASSIST with a quit plan, offer pharmacotherapy if >10/day
ARRANGE Quitline referral and follow up visits at 1w and 1m

Question 3

How to assess nicotine dependence?

Answer 3

Number of minutes between waking and first cigarette
Number of cigarettes per day
Type of craving or withdrawal Sx experienced

Question 4

Obesity - 5 As

Answer 4

ASK about weight concerns and previous weight loss attempts
ASSESS BMI, waist circ, other CVD RFs
ADVISE/AGREE on benefits of weight loss, set goals for 5-10% LoW
ASSIST by providing tailored weight management plan
ARRANGE referrals to dietitian/exercise physiologist and follow up visit at 2w then yearly

Question 5

Diet - 5 As

Answer 5

ASK about diet at least every 2 years (6 monthly if high risk)
ASSESS intake of fruits/vegetables , salt, processed foods, sugary drinks
ADVISE/AGREE on portions of fruits (2)/vegetables (5+) and reducing saturated fat and salt (<4g)
ASSIST by providing an individualised guideline-based diet plan
ARRANGE referrals to dietitian and follow up every 2-3m

Question 6

EtOH - 5 As

Answer 6

ASK about drinking at least every 2-4 years
ASSESS EtOH intake (AUDIT-C) and readiness to change
ADVISE/AGREE use motivational interviewing and recommend safe drinking limits (<10/week and <4/day)
ASSIST by considering pharmacotherapy
ARRANGE referrals to AOD and follow up visit in 1-3m

Question 7

Physical Activity - 5 As

Answer 7

ASK about physical activity at least every 2 years
ASSESS amount, type and frequency
of activity and sedentary time
ADVISE/AGREE on goals for increasing activity (most, preferably all days to a total of 2.5-5hrs of moderate intensity or 1.25-2.5hrs of vigorous intensity) and reducing sedentary time
ASSIST by providing a physical activity prescription
ARRANGE referrals to exercise physiologist/physiotherapist/lifestyle modification program and follow up every 3-6m

Question 8

How often should we check BMI + waist circ?

Answer 8

Average risk adults - 2 yearly
Increased risk adults (ATSI, existing comorbidity) - annually
Existing obesity - 6 monthly

Question 9

What are the increased and high risk waist circ measurements?

Answer 9

Increased risk if ≥94cm in men or ≥80cm in women

High risk if ≥102cm in men or ≥88cm in women

Question 10

What questions are on the AUDIT-C?

Answer 10

In the past year:
How often did you have a drink containing EtOH?
(never 0, monthly or less 1, 2-4/month 2, 2-3/week 3, 4+/week 4)

How many EtOH drinks did you have on a typical day of drinking?
(1-2 0, 3-4 1, 5-6 2, 7-9 3, 10+ 4)

How often did you have 6+ drinks on one occasion?
(never 0, <monthly 1, monthly 2, weekly 3, daily or almost daily 4)