Secondary prevention programs should be individualized, considering the patient s knowledge deficit. Self-efficacy and self-management skills can be developed by incorporating education and counseling techniques in either individualized or group sessions and focusing on motivational Applying technology through the use of the Internet and mobile phones can help provide education and trained peer support for CABG patients after surgery, even for those who are unable to access CR programs because of Finally, individual diaries have been shown to increase patient accountability for self-management of exercise activity after CR.360 Self-efficacy, along with an individualized plan for behavior change, is imperative to help optimize adherence to secondary prevention after CABG. Mental Health and Cognitive Impairment The negative impact of mental illness and cognitive impair- ment after CABG is well recognized, leading to greater risk of morbidity and mortality in the perioperative period and poor adherence to secondary preventative therapies in the long term. Screening for and preventing these neuropsychological conditions from developing may therefore improve outcomes after CABG. 