Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required. Purpose: To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients. Methods: Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey). Results: Significant intervention effects were observed for health-related quality of life on the mental component summary score (p = 0.02), and the social functioning (p = 0.04) and role-emotional (p = 0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p = 0.02), body mass index (p = 0.05), vegetable intake (p = 0.04) and alcohol consumption (p = 0.05). Conclusions: Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients. ? 2012 International Society of Behavioral Medicine.