This study, Re-thinking the role of Peers And Training Patients [RePeAT], is designed to test the feasibility of training peer-coaches to prepare limited health literacy (LHL) patients to engage in shared-decision making (SDM) for cardiovascular disease (CVD) risk-reduction.

The investigators will use a 2-arm pilot RCT design to assess the feasibility, and acceptability of the intervention. Up to 60 primary care patients will be randomly assigned to participate in the peer-coaching or control group. Patients will be randomized at a 1:1 ratio, stratified by the clinician. Half of the subjects (n=30) will be assigned to the peer-coaching intervention, and the other half will be assigned to the control group.

Inclusion Criteria:

• A patient of Highland Family Medicine practice
• At least 40 years old and no more than 75 years old
• Be at ≥10% risk for CVD as calculated using the ASCVD Risk Estimator Plus
• No plans to leave the practice in the next 12 months
• English speaking
• Limited Health Literacy (self-report)

Exclusion Criteria:

• Have experienced a prior cardiac or vascular event such as myocardial infarction (MI) or cerebrovascular accident (CVA) or have had a CVD procedure such as installation of a stent or angioplasty
• Gave peripheral vascular disease, intermittent claudication or peripheral arterial disease
• Lack of capacity to consent

Immediately after subjects complete the baseline surveys they will be randomized. The research coordinator will open a sealed envelope that specifies which group the subject is in. Neither the subject nor the research coordinator can choose the randomization group. The randomizations envelopes will be prepared