The proposed community based participatory research (CBPR) project will promote the involvement and input of community members to improve an established multicultural network/system of care. Specifically, this project will focus on improving outreach and access to care in the area of cardiovascular risk factors, using culturally-appropriate approaches suggested by the community via the CBPR process. This project supports the missions of both the NIH and the NHLBI by working to develop an innovative, community-based model for enhancing access to medical care for low-income, uninsured, minority populations. This project will serve as a pilot to embed CBPR into the developing care network of a large multicultural community, integrating baseline and post-process implementation evaluation components to permit continuous enhancement to the developed strategies for outreach and increased access to care. The multicultural network/system of care, provided by a collaboration of nonprofit organizations coordinated by Primary Care Coalition (PCC) of Montgomery County, MD, currently offers multiple care sites, has successfully implemented shared electronic medical records, and includes minority health initiatives for African American, Asian American, and Latino populations. This project will build on these initiatives, as well as the county-supported Montgomery Cares program, and will incorporate participation from different levels of the community to determine the most appropriate outreach and access to care strategies for each of the represented cultures. Implementation of the project will be guided by the PRECEDE-PROCEED model, with community members making key decisions. Anticipated interventions for participants who exhibit risk factors for cardiovascular disease include: providing an appointment for further evaluation at the network clinics, offering translation services, counseling participants about preventive approaches to health preservation and costs/eligibility for health care services, and supplying information about community support groups. Anticipated additional efforts for the community-at-large will include education and outreach campaigns to inform community members of opportunities for screening. Further, this project anticipates establishing a baseline and surveillance database to support program evaluation and future expansion of the project. This project is relevant to public health because CBPR has the potential to address challenging gaps in the health care system related to social and cultural issues pertinent to each racial/ethnic group represented, and, that if addressed, can facilitate outreach, health awareness, screening participation of those most at risk, and ultimately access to care. With community buy-in and support from community partners and local health clinics, the project team plans to reduce disparities and improve health in a multicultural community. ? ? ?