CCFP priority topic 60 of 105
Lifestyle on the CCFP exam
5 key features, the mistakes that cost marks, and a practice question.
Checked by a Canadian family physician, MD, CCFP. Updated October 20, 2026.
What the exam tests
Key features
The CFPC’s 5 key features for Lifestyle. Each one below has how the exam asks it, the common mistakes and the approach.
Practice question
Try one before you read
A real case from the bank, in the new short-menu format. Answer it first. Then read the key features.
Key feature 1 of 5
Ask about habits
As you follow patients over time, ask about habits that could change their health.
CFPC skill Patient-centred approach, communicationPhase HistorySources Canadian Task Force on Preventive Health Care
On the exam
A 9-year-old whose body mass index (BMI) climbed in a year. Expect a short menu (pick several from a list) of history to take.
Pick the history that explains the change.
Common mistakes
Asking a 9-year-old about drugs and sex because they top the adult list. Or asking only about food, and missing screens, sleep and activity.
Approach
- Ask about food and drinks, activity, screen time, sleep, tobacco and vaping, alcohol, cannabis and other drugs, sex, and safety.
- Match the questions to age. The table below gives a starting set.
- Ask children and teens aged 5 to 18 about tobacco. At a suitable visit, give brief advice on its risks, taking up to 5 minutes. The Task Force rates this as weak.
- Know whether each adult smokes. Encourage everyone who smokes to stop.
- See teens alone for part of the visit. Explain what stays private and what does not.
- Ask about seatbelts, helmets, car and booster seats, and safe storage of medicines and guns, where they apply.
| Age | Habits | Safety |
|---|---|---|
| Infants and young children | Feeding, sleep, screen time, smoke in the home | Car seat, safe sleep, poisons, stairs |
| School-age children | Food and sugary drinks, activity, screens, sleep, tobacco | Booster seat, bike helmet, water safety |
| Teens | Tobacco and vaping, alcohol, cannabis, sex, activity, sleep | Seatbelt, driving after drinking or cannabis, helmet |
| Adults | Food, activity, alcohol, tobacco, drugs, sexual health | Seatbelt, helmet, phone use while driving |
| Older adults | Activity, food, alcohol with medicines, social contact | Falls, driving, hazards at home |
Key feature 2 of 5
How ready they are
Learn how ready the patient is before suggesting change, and let that shape advice.
CFPC skill Patient-centred approachPhase Treatment, history
On the exam
A mother worried about her son's weight gain wants to start now. Expect one best answer for your next step.
Pick the step that matches her readiness.
Common mistakes
Waiting a year to see if the weight settles, when the mother is ready now. Or handing a full plan to someone not yet ready.
Approach
- Ask how much the change matters to the patient, and how sure they feel they can make it.
- Not ready: give brief advice, ask permission to come back to it, and leave the door open.
- Unsure: ask what they like about the habit and what worries them. Let them name their own reasons to change.
- Ready: act now. Agree on one or two small, clear steps and a date to follow up.
- This guiding style is motivational interviewing: you draw out the patient's own reasons rather than lecture.
- With a child, plan with the parent and, when old enough, the child. Aim the changes at the whole family.
| Stage | What you hear | What to do |
|---|---|---|
| Not ready (precontemplation) | “I don't see a problem.” | Brief advice; ask to raise it again |
| Thinking about it (contemplation) | “I should, but…” | Weigh pros and cons; draw out their reasons |
| Getting ready (preparation) | “I want to start soon.” | One or two small steps and a date |
| Doing it (action) | “I started last month.” | Praise, solve problems, plan for slips |
| Keeping it up, or slipped (maintenance, relapse) | “I was doing well until…” | Treat the slip as normal; restart the plan |
Key feature 3 of 5
Fit advice to their life
Learn the patient's circumstances, such as income, before advising change, so the plan is workable.
CFPC skill Patient-centred approachPhase Treatment, history
On the exam
The family lost income this spring and dropped paid sports. Expect a short menu (pick several from a list) of activity advice.
Pick the advice this family can afford.
Common mistakes
Restarting last year's hockey, an after-school program with fees, or a home exercise bike. Each costs money the family no longer has.
Approach
- Before advising, ask about money, food at home, housing, work hours, transport and who minds the children.
- Ask in a neutral way, such as whether money for food ever runs short. Families may not raise it themselves.
- Offer free or low-cost activity: walking or biking to school, outdoor play, free school or community programs.
- Suggest food changes that cost less: water instead of sugary drinks, frozen or canned vegetables, cooking at home together.
- Ask about culture, beliefs and family routines. Build the plan around what the family already does.
- Link to local help where it exists: food programs, funding for children's sport, a social worker.
Key feature 4 of 5
Check habits again
Check habits again at later visits, since they shift as a patient's life changes.
CFPC skill Clinical reasoningPhase Hypothesis generation, follow-upSources Choosing Wisely Canada
On the exam
A child on an inhaled steroid gains weight while height stays on track. Expect a short menu (pick several from a list) of history and tests.
Pick what to ask, and which tests to skip.
Common mistakes
Ordering thyroid tests or blaming the low-dose steroid puffer while height holds its line. Or trusting the chart's routine from last year instead of asking again.
Approach
- Ask again, even when the chart holds an answer. Habits shift with a new job, job loss, a move, a birth, a death, puberty or retirement.
- Ask what has changed since the last visit: routine, school, work, money, mood and sleep.
- Read a weight change against the life story before you reach for tests.
- In a child whose height keeps its line, a hormone cause of weight gain is unlikely. Low thyroid and steroid excess slow growth in height.
- Choose blood tests by age, sex and risk factors. Choosing Wisely Canada advises against yearly screening blood tests unless the patient's risk profile calls for them.
- A well adult with no significant risk factors does not need a yearly physical. Habits can be reviewed at ordinary visits too.
Key feature 5 of 5
Repeat the advice
Keep coming back to the advice at each follow-up, after success and after a slip.
CFPC skill Clinical reasoningPhase Treatment, follow-upSources Canadian Task Force on Preventive Health Care
On the exam
After a good autumn, the child slipped over winter and the percentile has stalled. Expect one best answer for the plan.
Pick the plan for this visit.
Common mistakes
Praising the autumn, then dropping the topic for a year. Or calling a stalled percentile failure and adding a drug or a specialist.
Approach
- Raise the plan again at each visit, briefly and without blame.
- Praise what went well, even a small step.
- Treat a slip as normal. Find what got in the way, such as winter or cost, and adjust the plan.
- In a growing child with overweight, a BMI percentile that stops rising is progress. Judge it by the trend over several visits.
- Encourage every adult who smokes to stop. Outside pregnancy and breastfeeding, offer advice or counselling, nicotine replacement, varenicline, bupropion or cytisine, and choose together.
- Book the next follow-up before the patient leaves.
Flashcards
Answer it first, then check.
KF 1A 15-year-old comes in for acne. Which habits do you ask about?
Tobacco and vaping, alcohol, cannabis and other drugs, sex, seatbelts and driving. See the teen alone for part of it.
KF 1A 12-year-old has never smoked. What does the Task Force suggest?
Ask about tobacco and give brief advice on its risks at a suitable visit. It is a weak recommendation. Source: Canadian Task Force on Preventive Health Care
KF 2He says he is not ready to cut back on drinking. What now?
Give brief advice, respect his choice, and ask if you can raise it next time. Do not push a plan.
KF 3A family has lost income. Their child needs more activity. What fits?
Free options: walking or biking to school, outdoor play, free community programs. Not paid leagues or new equipment.
KF 4The chart says she walks daily, but the note is two years old. What now?
Ask again. Habits shift with work, seasons, moves, illness and loss.
KF 4A healthy 45-year-old wants yearly blood work to check everything. What do you say?
Choosing Wisely Canada advises against it. Pick tests by age, sex and risk factors, not by the calendar. Source: Choosing Wisely Canada
KF 5A 50-year-old turned down help to quit smoking last visit. What now?
Encourage quitting again. Offer advice, counselling, or medicines such as nicotine replacement or varenicline, and decide together. Source: Canadian Task Force on Preventive Health Care
KF 5A child's BMI percentile stopped rising but did not fall. Is the plan failing?
No. A BMI percentile that stops rising while he grows is progress. Praise it and keep the plan going.
FAQ
Do I ask about every habit at every visit?
No. Pick what fits the patient's age and the reason for the visit, and come back to the rest over time. Asking, then asking again later, is what earns marks.
Do I need to name the stage of change?
Rarely. Marks go to what you do with it. Knowing the stages helps you choose: brief advice for someone not ready, a clear plan for someone ready now.
Is the yearly physical still the place for this?
Choosing Wisely Canada advises against yearly physicals for well adults with no significant risk factors. Habits can be reviewed at ordinary visits too. Preventive visits still raise uptake of screening, such as Pap tests.
What if the patient never changes?
Keep raising it, briefly and without blame. Readiness can shift with a new diagnosis, a birth or a scare. The exam rewards repeating the advice even when nothing has changed.
Sources
Written from the CFPC Assessment Objectives and Canadian guidelines first. Checked by a Canadian family physician, MD, CCFP.
Last reviewed October 20, 2026For exam study. Not advice for a patient in front of you.
- Assessment Objectives for Certification in Family Medicine, 2nd editionCollege of Family Physicians of Canada · 2020
- Published prevention guidelinesCanadian Task Force on Preventive Health Care
- Choosing Wisely recommendationsChoosing Wisely Canada