Innovative approaches to comprehensive cardiovascular disease risk reduction in clinical and community-based settings.

We have developed, tested, and successfully implemented an affordable, evidence-based, comprehensive cardiovascular disease risk-reduction program for use in primary and secondary prevention settings. The program is administered at hospitals, physician practices, cardiac rehabilitation programs, work sites, shopping malls, and health clubs. The program is also delivered from a call center using the telephone and the Internet. Program staff are guided by a computerized participant management and tracking system. Lifestyle management interventions are based on several behavior change models, primarily social learning theory, the stages of change model, and single concept learning theory. Typically, the program is administered entirely by non-physician healthcare professionals whose services are integrated with the care provided by the participants' physicians. Outcome data have documented the clinical effectiveness of this innovative approach.