This issue of the Journal of Cardiovascular Nursing is the second of a 2-part series addressing prevention of cardiovascular disease. The first issue Volume 18(2) focused on Emerging Issues in Prevention. This issue examines specific strategies for cardiovascular risk reduction. As noted by Dr Franklin in his foreword for the first issue, the responsibility for prevention rests on the shoulders of many, from the individual patient, the health care professional(s), to society as a whole. As such, prevention strategies must consider the knowledge, skills, beliefs, habits, cultures, and environments of many. In this issue, important factors related to culture, gender, and environment and importantly the myriad of skills needed to facilitate prevention are addressed.

While there are stellar research examples clearly demonstrating the effectiveness of lifestyle interventions to prevent or delay the onset of coronary heart disease (CHD), the translation of prevention research into the practice setting has received markedly less attention. Often, prevention is considered in the context of simple steps; however, it is clear that facilitating prevention is complex and complicated. Not only are many persons involved, but many risk factors, many organizations, and systems. It is time to recognize that prevention is not easy, and that the processes and procedures are complex. Despite the complexities, providing the highest quality of health care requires utilizing the most efficacious interventions, and thus, lifestyle interventions must be offered as a part of the health care management for every coronary patient.

Who should provide prevention and lifestyle interventions for coronary disease? Rather than debate the issues of responsibility, we should focus our attention to the fact that all health care disciplines bring their own unique skills and knowledge to risk reduction. This said, it is important to note that research examples have demonstrated the success of nurse-case managed models in the delivery of prevention and treatment interventions for coronary heart disease, diabetes, and heart failure. Providing the highest quality of health care requires utilizing the most efficacious interventions; therefore, nurse-case managed models should be used for the delivery of prevention interventions for the coronary patient.

There are many barriers that impede the delivery of prevention interventions. This edition addresses some factors related to skills, knowledge, and personal attributes that will assist the health care provider in the delivery of prevention interventions. However, as pointed out earlier, the responsibility of prevention rests on the shoulders of many. Health care organizations and systems need to participate in these efforts and so quality care includes prevention programs. Clearly, there is a need for nurses (and other care providers) to be reimbursed for delivery of prevention interventions and it is time for us to advocate for such reimbursement.