What is BAP?
BAP is a pragmatic, evidence-informed, and versatile MI-consistent tool designed to support patient self-management and facilitate health behavior change.
Background & Overview
A pre-cursor of BAP, entitled “UB-PAP” (“Ultra-Brief Personal Action Planning”) was initially developed by Steven Cole, circa 2002, as a patient self-management support tool for the Health Disparities Collaboratives for chronic conditions (e.g. diabetes, heart disease, depression, and asthma) in Federally Qualified Health Centers (FQHCs). UB-PAP was published by the AMA, used in health centers, and studied in dissertation research. Together with Connie Davis, Damara Gutnick, and Kathy Reims circa 2010, UB-PAP was revised into the current formulation of Brief Action Planning (BAP). Since then, BAP has been widely used in the US and internationally (e.g.16 peer-reviewed publications and thousands of “hits” on google searches).
- A Versatile MI-consistent Tool
BAP is a pragmatic, evidence-informed, and versatile MI-consistent tool designed to support patient self-management and facilitate health behavior change. - For Patients Ready for Action Planning
BAP is especially appropriate for patients who are ready, or almost ready, for action planning. - For MI Practitioners
For MI practitioners, BAP offers an evidence-informed, efficient, and flexible roadmap from “Évocation” into and through “Planning.”
Three Core Questions
Brief Action Planning is organized around three core questions:
- “Is there anything you would like to do for your health in the next week or two?” (what, when, where, how often, etc?)
This question encourages the individual to view himself/herself as someone interested in personal health or wellness. Research tells us that once a person makes a statement that he or she is willing to do something(even in general) for health or wellness, the universal human need for “consistency” facilitates development and commitment to a concrete action plan. [2]
- “On a 0-10 scale of confidence, were 0 means no confidence and 10 means alot of confidence, about how confident are you that you will be able to carry out your plan?”
Scaling for confidence is a way to help predict or even increase the likelihood of success of a personal action plan. Kate Lorig and others have found that confidence is one of the key factors in making successful behavior changes. [1, 2, 3, 4] - “Would you like to set a specific time to check in about your plan to see how things have been going?”
The most important point of Question Three is the introduction of accountability. Any element of accountability increases the likelihood of success in action planning. [5]
Five Additional Skills
- S.M.A.R.T. Behavioral Contracting (Foundational Skill)
- Elicitation of Commitment Statement (Foundational Skill)
- Check on Progress (Follow Up) (Foundational Skills)
- Offer a Behavioral Menu (Stepped-Care Skill, for use when needed)
- Problem Solve Barriers (Stepped-Care Skill, for use when needed)
- Client-Centered Theory & Therapy
- Operant Conditioning
- Cognitive-Behavioral Theory & Therapy
- A-theoretical Psychotherapy Research
- A-theoretical Communication Research
Links & Downloads
- BAP: A Motivational Interviewing Consistent Tool for Telemedicine and Beyond (APA 2021) (PDF 8MB)
- BAP: A Roadmap from Evocation into & Through the Process of Planning (MINT Forum 2020) (PDF 3MB)
- BAP Flow Chart (PDF 1.7MB)
- BAP Guide (PDF 4000KB)
- BAP Checklist (PDF 100KB)
- MI (BAP) in Addiction Medicine, FOCUS 2011 (300KB)
- BAP Evidence Paper, JCOM 2014 (300 KB)
Brief Action Planning
This video of Mr. Carlson demonstrates the five foundational competencies of Brief Action Planning (BAP). Other core competencies of BAP include use of behavioral menus when necessary, (see Mr. Peters below), problem-solving for low confidence in an action plan, (see Mr. Weiss below), and use of nonjudgmental, affirming follow-up questions and statements to encourage continued brief action planning (not demonstrated on video; see BAP Guide and BAP Flow Chart).
BAP with Behavioral Menu
This video demonstrates the use of a behavioral menu, one of the eight core competencies, for individuals who can benefit from suggestions to help empower choice, presented in an autonomy-supportive style (MI Spirit).
BAP with Problem-Solving for Low Confidence
This video demonstrates the use of problem-solving for low confidence, as one of the eight core skills of Brief Action Planning (BAP).
[1] Lorig K, Ritter P, Stewart A, et al. Chronic disease self-management program: 2-year health status and health care utilzation outcomes. Med Care. 2001;39(11):1217-1223.
[2] Bodenheimer T, MacGregor K, Sharifi C. Helping patients manage their chronic conditions: California HealthCare Foundation; June 2005.
[3] Bandura A, Cervone D. Self-evaluative and self-efficacy mechanisms governing the motivational effects of goal systems. Jrnl Personality and Social Psychology. 1983;45(5):1017-1028.
[4] Bodenheimer T, Handley MA. Goal-setting for behavior change in primary care: an exploration and status report. Patient Educ Couns. Aug 2009;76(2):174-180
[5] Glasgow RE, Goldstein MG, Ockene JK, Pronk NP. Translating what we have learned into practice. Principles and hypotheses for interventions addressing multiple behaviors in primary care. Am J Prev Med. Aug 2004;27(2 Suppl):88-101.