Understanding the factors that motivate behavioral change is central to health promotion efforts. We used qualitative descriptive methods in an effort to understand the role of self-knowledge in the process of risk factor modification. The sample consisted of 17 men and 7 women with diagnosed coronary heart disease, who were attempting to initiate and sustain programs of cardiovascular risk modification. Participants described selfknowledge in terms of three contextually situated patterns: representational, evaluative, and behavioral action. Results reinforce the motivational role of the self and highlight the importance of understanding dimensions of selfknowledge relevant to cardiovascular risk reduction. ß 2007 Wiley Periodicals, Inc.