Physical inactivity and obesity, both of which are modifiable cardiovascular disease (CVD) risk factors, increase substantially during the transition from adolescence to young adulthood. CVD is the 5th leading cause of death in people ages 18 to 29. This disease has enormous social and financial repercussions; however, many college age students do not see chronic disease as a personal threat. Few researchers have examined chronic disease risk in young adults or used a consistent, objective measurement of physical activity. A pre-post, quasi-experimental study was conducted to evaluate the association between a health and fitness class, physical education 215 (PHED 215) and chronic disease risk, cardiorespiratory fitness (CRF) level, body fat percentage, self-motivation, exercise self-efficacy, and transtheoretical model (TTM) physical activity stage of change progression among male and female college students (n = 64). The TTM was utilized as the theoretical framework for this study. Secondary data were analyzed via descriptive statistics, paired t test (or Wilcoxon signed-rank test if data were not normal), and Bowker's test of symmetry. Results showed a statistically significant association between PHED 215 and 2 dependent variables: cardiorespiratory fitness level (p = 0.0001) and progressive movement through the TTM stages of change (p = 0.0061). Because college age students are shaping their adult behaviors, positive health change adopted during this critical time could increase CRF, establish lifelong exercise habits, improve quality of life, and delay and decrease obesity risk and chronic disease and related costs. While further study in different settings is warranted, PHED 215 could be used as a blueprint for other interventions in the education, community, and healthcare settings.