This collaboration between Weill Cornell Medicine, the University of Alabama at Birmingham, the University of North Carolina at Chapel Hill, and Eastern Carolina University will enroll 2000 African Americans cared for at 80 rural practices in Alabama and North Carolina. Practices will be randomized to one of four study arms: peer coaching to improve blood pressure self-management, practice facilitation to help practice implement best practices for hypertension control including elements of patient centered medical homes, both peer coaching and practice facilitation, and enhanced usual care. Numerous opportunities exist to write papers using the study’s data, learn about the conduct of pragmatic trials, and become integrated into a multi-site large trial.