Many health professionals are familiar with the NHS Future Forum's 'Making Every Contact Count' message. However, it can sometimes be difficult to start a conversation with a patient about their weight or lifestyle choices.

We know that health behaviour advice from professionals has a positive impact on people. In one study of cancer survivors, about 90 per cent of people thought it was the "doctor’s duty" to provide advice on diet, activity and weight and they found information beneficial, helpful and encouraging1.

A pilot by the National Obesity Forum found that sales of fruit in supermarkets increased by 20 per cent when life-size cut-outs of local health workers were displayed alongside to encourage shoppers to eat more healthily2. So it's important that health professionals encourage and help people to make healthy choices that will benefit their long-term health.

But how should you go about starting that vital conversation? It's necessary to understand an individual's needs and identify the right course of action at the appropriate time. Everyone is different, with multiple and complex needs, so the contact needs to be tailored accordingly3. Here are some top tips for effective conversations4:

  • Take a non-judgemental and holistic approach
  • Use active listening (listen and rephrase client’s answers)
  • Ask open questions
  • Gain trust
  • Provide accurate and up-to-date information to allow people to make informed choices
  • Signpost to services if appropriate

Even if the conversation does not result in behaviour change straight away, it may help someone to change their lifestyle when they are ready. This is why it is important to keep making every contact count.

The five A's

Brief interventions are also useful when approaching the topic of health. The FIVE A’s can be applied to most lifestyle issues such as obesity, smoking and alcohol.

ASK: Ask permission to discuss the topic. For example, ‘Would it be alright if we discussed your weight?’

ASSESS: eg. Measuring BMI or alcohol intake

ADVISE: Give accurate and up-to-date information about the health risks associated with the behaviour and the benefits of change

AGREE: Agree on SMART goals (Specific, Measurable, Attainable, Realistic, Timely)

ASSIST: Signpost to support where necessary, addressing any barriers and suggesting coping strategies

Published in Winter 2014 issue


  1. Williams K et al. Health behaviour advice to cancer patients: the perspective of social network members, British Journal of Cancer, 2013.
  2. National Obesity Forum. Let’s Shop Healthier, 2014.
  3. Anderson A. How to make every contact count: starting the journey to better health. Presented at the World Cancer Research Fund Busting the Cancer Myth conference 2014.
  4. Thomas K. The language of change. Presented at the World Cancer Research Fund Busting the Cancer Myth conference 2014.