This study will include a total of 2,000 African American participants. Participant recruitment will take place in participating practices, and 25 patients with uncontrolled hypertension per practice will be recruited. Our goal is to recruit from 80 practices. 50 from UAB, 10 from UNC and 20 from ECU.


Patient Criteria

Inclusion Criteria

  • African American adults aged 19-85 years
  • Uncontrolled HTN*
  • Black Belt resident
  • English speaking
  • Willing to work with a peer coach
  • Willing to sign informed consent
  • Has access to a telephone

Exclusion Criteria

  • Plans to move out of the area within two years
  • Advanced illness with limited life expectancy
  • Pregnant or plans to get pregnant in the next year
  • Advanced chronic kidney disease (estimated glomerular filtration rate <45 ml/min/1.73 m2)
  • Unwillingness to work with a peer coach or to sign informed consent
  • Lack of phone access  

Practice Criteria

Inclusion Criteria


  • Location in the Black Belt
  • Serve a predominately rural population
  • High proportion of indigent patients
  • High proportion of African American patients
  • Internet access at the practice
  • Willingness to sign a Letter of Agreement to participate
  • Willingness to identify a Practice Champion
  • Willingness to modify structure and processes of care with the help of a practice facilitator
  • Willingness to work with peer coaches