Prevention of ischaemic heart disease is a priority for public health. Revised Mandatory Guidelines have resulted in substantial investment in individual healthy lifestyles programs and local health units have been encouraged to develop comprehensive heart health promotion programs. Initiatives to support this direction include the Heart Health Action Program, the Canadian Heart Health Initiative, the Ontario Heart Health Network, the Report of the Chief Medical Officer of Health and the Teaching Health Unit program. In spite of this, local health units have been slow to adopt comprehensive heart health approaches. The Canadian Heart Health Initiative-Ontario Project (CHHIOP) is studying the dissemination of community heart health programming, particularly factors influencing adoption by local public health departments. CHHIOP's observational component uses province-wide health unit and community "scans" and in-depth studies using qualitative methodology. CHHIOP's interventional component is developing a provincial linkage system.