Jorge Yarzebski, M.D., M.P.H. is a Research Assistant Professor in the Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Medical School (UMMS). He is a Hispanic physician from Guatemala who has served as the project director of the NHLBI funded Worcester Heart Attack Study for the past several years. His research mentor for this scientific career development award is Robert Goldberg, Ph.D., Professor of Medicine and Epidemiology in the UMMS Department of Medicine. Dr. Goldberg is the Principal investigator of two NHLBI funded studies: the Worcester Heart Attack Study and the Rapid Early Action for Coronary Treatment trial (REACT). Over the proposed five year period of this award, Dr. Yarzebski will utilize data from the longitudinal Worcester Heart Attack Study from 1999 to examine physicians' attitudes and practices, and patients' knowledge, attitudes and beliefs in the management of high total cholesterol following acute myocardial infarction (AMI) in twelve hospitals from a population based perspective. Standardized telephone surveys will be administered to patients at 10- 12 weeks and at 12 months following hospital discharge by trained survey staff from the UMMS to ascertain patient's knowledge, attitudes, and adherence to lipid lowering medications. Questionnaires will be mailed to the physicians of these patients within the first 3 months of the study to ascertain their reasons for prescribing or not prescribing lipid lowering medications. This will be accomplished in conjunction with the review and validation of the medical records of residents of the Worcester, MA, metropolitan area hospitalized with AMI at all greater Worcester hospitals during 1999. Further details and Dr. Yarzebski's role in the proposed project are provided in the application. Dr. Yarzebski will explore the availability of other large clinical/epidemiological databases to pursue additional research projects and collaborative research proposals. An advisory committee of active and experienced clinical and public health researchers will guide his career development. At the completion of this research training experience, Dr. Yarzebski will be provided with significant educational and research training and experiences to become a successful independent investigator.