Objective — to enhance the effectiveness of preventive counseling (PC) in the rural population of the Krasnodar Territory. Design: an open-label randomized epidemiological study. Subject and methods. A population-based sample of 2189 adults (54% were female and 46% were male) from the rural areas of the Krasnodar Territory was examined and formed randomly by the territorial principle on the basis of therapeutic and prophylactic institutions by the method developed by L. Kish. Cardiovascular (CV) risk factors were assessed by a survey method using a unified questionnaire included in the basic follow-up and prevention examination questionnaire. Persons (n=1006; 43.2% were male and 56.8% were female) with a high or very high total CV risk underwent in-depth PC: individual PC (IPC) and group PC (GPC) at the Department of Medical Prevention; re-examination was performed after 3 years (an 80.1% response rate). Results. At 3-year follow-up, the effectiveness of in-depth PC among men was significantly higher in the use of IPC + GPC than that of IPC only. Thus, in persons with a diastolic blood pressure of at least 90 mm Hg, the effectiveness of IPC (a reduction in the prevalence of a risk factor) amounted to 8.7% and that of IPC in conjunction with GPC was 36.3%, which is 27.6% more than that of IPC. There was also a statistically significant difference in the effectiveness of IPC in combination with GPC versus IPC: it was 7.8% higher in people with abdominal obesity (AO) than that of IPC only, 16.7% higher than in those with hypercholesterolemia (HC), 23.2% higher than in those with low physical activity (LPA), and 19.2% higher than in those with excessive alcohol consumption. On the contrary, among smokers and people with poor nutrition (PN), the effectiveness of in-depth IPC was statistically significantly higher than IPC in conjunction with GPC (11.8 and 12.7% higher, respectively). Among women, the greatest differences in the effectiveness between IPC and the latter together with GPC were found among persons with HC and among smokers. In the women with HC, the effectiveness of IPC amounted to 9.9% and that of IPC in combination with GPC was 31.8%; in the smokers the effectiveness of IPC was 26.3%, while that of IPC in conjunction with GPC was 40%. IPC proved to be more effective in women with PN. People with higher and secondary education showed the most significant results after IPC in conjunction with GPC. Both types of PC had comparable efficiency in persons with secondary specialized education. Conclusion. IPC in combination with GPC displayed the highest efficiency of modification of CV risk factors at 3-year follow-up. IPC is most effective in correcting smoking in men, PN in persons of both sexes; a combination of IPC and GPC is most effective in correcting hypertension, AO, HC, excessive alcohol consumption in people of both sexes, smoking, obesity in women, and LPA in men.