A Public Health Action Plan to Prevent Heart Disease and Stroke charts a course for the Centers for Disease Control and Prevention (CDC) and collaborating public health agencies, with all interested partners and the public at large, to help in promoting achievement of national goals for preventing heart disease and stroke over the next 2 decades--through 2020 and beyond. The Action Plan was released in April 2003 and includes 24 recommendations and 69 proposed action steps to be implemented now and in the years ahead. To set priorities for action and to define a limited set of concrete tasks for immediate implementation, a process was undertaken that included CDC and lead partners, the American Heart Association/American Stroke Association and Association of State and Territorial Health Officials, as well as the Action Plan Working Group and other members of the National Forum for Heart Disease and Stroke Prevention. This report presents details of the methods used and discussion of this process and its outcome. The process was facilitated by Concept Systems, Inc. and began with refinement of proposed action steps to yield a final list of 75 items. Next, the Action Plan Working Group and the full National Forum membership were invited to rate each proposed action step as to its relation to the mission and capacity of the organization represented by each respondent. This process, with review and discussion of results by the Working Group in January 2004, identified a subset of 22 priority action steps. The National Forum then met in April 2004 to discuss these priorities and ultimately adopted eight concrete tasks for immediate implementation.