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The health literacy levels of citizens in Wuhan are insufficient and need to improve. The health literacy levels of citizens in Wuhan are insufficient and need to improve. Cardiovascular diseases (CVDs) and diabetes mellitus (DM) are among the leading cause of morbidity and mortality in low-and-middle-income countries (LMICs) but evidence in these contexts regarding the effectiveness of primary prevention interventions taking into account patient adherence is scarce. We aimed to evaluate the effectiveness of a cardiovascular risk management program (De Todo