The Real 5As Project

Improving Type 2 diabetes management in general practice: A realist evaluation of the 5As framework


Type 2 diabetes (T2DM) management and prevention is an important part of everyday general practice. T2DM outcomes are improved when patients follow healthy nutrition and active lifestyle recommendations. Currently, the 5As framework is the preferred model for clinicians for assisting patients with T2DM to engage in healthy behaviours and is recommended by guidelines across Australia. The framework, “Ask, Assess, Advise/Agree, Assist, Arrange” gives structure to the behaviour change consultation. However, there is widespread variation in the effectiveness of the 5As framework to translate into sufficient behavioural change and clinical benefits.


The Real 5As project will develop in-depth and nuanced knowledge of how and why the 5As work in general practice for patients with T2DM. Through a series of in depth qualitative interviews with patients with T2DM, their GPs and behavioural change experts, this project will:

  1. Identify important factors that are missing from current general practice guidelines for lifestyle change for patients living with T2DM;
  2. Inform specialty training and continuing professional development for GPs and practice nurses.


The findings of this study have the potential to influence the care received by people living with T2DM to improve their quality of life, health outcomes, and overall mortality. The findings will inform future policies relating to T2DM management in Australia, while helping to reduce the $292 million spent each year in health care costs attributed to diabetes-related complications.


This project is funded by the Royal Australian College of General Practitioners Foundation, Diabetes Australia Research Grant.

Contact us

For enquires, please contact:
Dr Liz Sturgiss

Our investigators