Walk Texas! - Clinical Guide

Clinician’s Guide for Assessment and Counseling of Physical Activity, Nutrition, & Tobacco

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Walk Texas!

User Guide – Action Plan for Clinician and Office Staff

The Clinician’s Guide for Assessment and Counseling of Physical Activity, Nutrition, & Tobacco is an efficient, standardized protocol to assess, counsel, and prescribe healthy lifestyle behaviors for patients. The Guide was developed by The University of Texas at Austin for the Texas Department of State Health Services. It addresses three health behaviors (physical activity, nutrition, and tobacco use) that have been linked to the prevention and control of chronic diseases. All client-related educational materials are provided in both English and Spanish.

PHYSICAL ACTIVITY: It is important to underscore the fact that the majority of patients, regardless of risk factors, can and should be encouraged to start or continue a program of regular, moderate physical activity. All individuals should accumulate 30 minutes of moderate level activity most days of the week.

NUTRITION: Increasing fruit and vegetable consumption to at least 5 or more servings every day can be an important component in chronic disease risk reduction.

SMOKING: All smokers should be encouraged to quit. If a patient uses tobacco within 30 minutes of rising in the morning and/or had difficulty quitting for more than three days, chances are he/she is addicted to nicotine and a good candidate for nicotine replacement or other pharmacotherapy.

The order listed below corresponds to how you may use these guides in your practice.

STEP 1: Administer Client Assessment Form when the client arrives at the office. Have client complete the assessment form assessing his/her current physical activity level, nutrition habits, and tobacco use.

Download Client Assessment Form (PDF, 60 kb, viewing information

STEP 2: Use the Clinician Counseling Guide and the Client Assessment Form together to assess the client’s readiness for change. Depending on the client’s answer choices, he/she will fall into one of three stages of change.

  1. If the client falls into the Precontemplation stage, he/she may realize that a change is indicated but is not willing to consider altering his/her health behavior. As a result, the goal should be to encourage patients to at least consider making a positive health behavior change in the near future.
  2. If the client falls into the Contemplation stage, he/she is aware that he/she needs to change behavior and is at least thinking about it. The challenge may be that he/she does not have the skills, knowledge, or incentive to change. As a result, the goals should be to help the client make a specific plan for changing behavior and to support that change.
  3. If the client falls into the Action stage, he/she already is taking steps to change behavior. The challenge is sticking with it. As a result, individuals in this stage need continued support for their behavior change. As a result, the goal is to support the client in continuing the behavior change.

Download Clinician Counseling Guide (PDF, 36 kb, viewing information

STEP 3: Counsel the client about one of the health behaviors using the appropriate stage-based counseling. Print the stage-based educational sheet that corresponds to the client’s diagnosed stage of change. Make sure you print sheets on the paper colors noted:

  • Precontemplation sheets on RED paper
  • Contemplation sheets on YELLOW paper
  • Action sheets on GREEN paper

These colors provide a way for you to remember the client's stage and the goal of the intervention.

Educational Materials below are PDF files. Click here for viewing information.

Precontemplation Educational Materials (print on RED paper)

Contemplation Educational Materials (Print on YELLOW paper)

Action Educational Materials (Print on GREEN paper)

STEP 4: Provide the client with a healthy prescription for his/her behavior change.

Additional Resources (47 kb) 

Last updated November 16, 2017