This study will measure the effects of educational intervention directed at patients and their families with factors of high-risk for cardiovascular and cerebrovascular disease. Four separate controlled education studies will be performed. A carotid artery disease detection study will assess the effect of a behavioral education program directed at (I) patients with Doppler-identified asymptomatic extracranial carotid occlusive disease, focusing on transient ischemic attacks. Three family cardiovascular risk factor screening/education studies will assess the effect of behavioral education programs directed at high-risk patients/families with (ii) hypertension, focusing on reduction of salt intake, (III) others with coronary artery disease focusing on a prudent diet, and (IV) others with coronary artery disease, focusing on smoking cessation. The studies will be performed in MCV's five Family Practice Centers located in demographically diverse communities in Virginia. The outcomes of interventions will be a recorded and analysed, taking advantage of the Virginia Family Practice Data System, a unique computer data system for studying medical practice. The evaluation of studies will be both comprehensive and multifaceted, with tests at several different levels and times. The purposes of evaluation will be both formative, to collect specific descriptive program data, and summative, to develop cumulative program assessments for use by other audiences and settings.
