Racial and ethnic minority groups suffer a disproportionately larger burden from hypertension and diabetes than whites. African-Americans and Hispanics are at a higher risk of having hypertension or diabetes, are less likely to be aware that they are hypertensive, are more likely to have target organ damage, and have significantly higher age-adjusted diabetes and hypertension-related mortality than whites. As part of our community-based participatory research program, we have developed a partnership among health services researchers from the Harvard Medical School, a community-based health advocacy organization, and seven community health centers located in four Boston neighborhoods with a large representation of non-Hispanic black and Hispanic residents (Dorchester, Jamaica Plain, Mattapan, and Roxbury). As collaborators for this study, investigators from the Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) academic research team are working with the Center for Community Health Education, Research, and Service (CCHERS) and a community advisory committee comprised of medical directors from neighborhood community health centers and community residents in leadership positions in community-based advocacy organizations.

The goals of this project are to:

• assess the needs of non-Hispanic blacks and Hispanics with hypertension or diabetes within the four Boston neighborhoods;

• examine the barriers and plausible approaches to improving care provided to these residents

During this two-year study, we will conduct focus groups of non-Hispanic black and Hispanic patients who receive care for diabetes or hypertension in our participating community health centers. We will interview health center staff and directors about the relationship of health centers’ organizational structure with disparities in cardiovascular risks among minority patients with diabetes and hypertension. After conducting these information-gathering activities, we will develop both a patient-focused and a health-center-focused intervention to pilot test in a randomized trial within four neighborhood community health centers. By sharing the information gained through this collaborative effort, researchers and community-based organizations will have access to the information necessary to design practical and generalizable interventions to reduce racial and ethnic disparities in hypertension and diabetes outcomes.