The purpose of this study was to assess the importance of patients' abilities and motivation to reduce their excess morbidity by benefiting from patient education designed to effect such change. The course consisted of a 4 week full-time program and 4 day refresher course 1 year later. The 295 consecutive patients (60%) who returned for the refresher had substantially reduced their overrisk for stroke or coronary heart disease. Personal ability to accomplish the desired change, such as standard of education, was found to be unimportant, whereas motives like having other people dependent on one were deemed important. One reason why resources such as education were found not to be important could be that the course was lengthy, requiring nearly 5 weeks, and practically oriented.