The Heart Smart Family Health Promotion program is a unique approach to education and skills development aimed at improving the cardiovascular health of entire families. By including the entire family system, rather than singling out one individual for behavior change, social support and self-confidence are enhanced and the probability for maintenance of behavioral skills is increased. The Family Health Promotion program uses a format that minimizes lecture and maximizes awareness, skills development, problem-solving, and real-life application over a 12- to 16-week agenda. Behavioral counseling and contingency contracting provide opportunities for the practice and reinforcement of new behaviors. Initial evaluations of the program model developed with cardiovascular high-risk children and their parents indicated that parents significantly increased health knowledge, lowered blood pressure, became more physically active, and decreased their intake of total fat, saturated fat, and sodium. A clinically significant reduction in children's blood pressure also was observed. Children's weight (adjusted for height) remained stable. The Family Health Promotion program resulted in positive changes in cardiovascular risk factors and can be adapted to any clinical or health-promotion setting.