IMPLEMENTING AND SCALING UP A TEAM-BASED CARE STRATEGY FOR HYPERTENSION CONTROL IN COLOMBIA AND JAMAICA - PROJECT SUMMARY/ABSTRACT HYPERTENSION DISPROPORTIONALLY AFFECTS POPULATIONS IN LOW- AND MIDDLE-INCOME COUNTRIES (LMICS), ESPECIALLY IN LATIN AMERICA AND THE CARIBBEAN (LAC), WITH A HIGH PREVALENCE AND LOW CONTROL RATE, RESULTING IN AN EXCESS BURDEN OF CARDIOVASCULAR DISEASE (CVD). DESPITE WIDELY AVAILABLE EVIDENCE-BASED INTERVENTIONS, ONLY 7.7% OF PATIENTS IN LMICS HAD THEIR BLOOD PRESSURE (BP) CONTROLLED IN 2010. TO CLOSE THE KNOWLEDGE-PRACTICE GAP FOR HYPERTENSION CONTROL IN LAC, A MULTIDISCIPLINARY TEAM OF INVESTIGATORS FROM COLOMBIA, JAMAICA, AND THE US WILL WORK WITH NATIONAL AND LOCAL GOVERNMENT AGENCIES AND HEALTH SYSTEMS TO TEST THE IMPLEMENTATION AND EFFECTIVENESS OUTCOMES OF IMPLEMENTING AND SCALING UP A TEAM-BASED CARE STRATEGY FOR BP CONTROL IN COLOMBIA AND JAMAICA. THE RE-AIM (REACH EFFECTIVENESS ADOPTION IMPLEMENTATION MAINTENANCE) FRAMEWORK IS BEING USED TO GUIDE THE DEVELOPMENT AND EVALUATION OF THE IMPLEMENTATION STRATEGIES. PHYSICIAN-NURSE (OR PHARMACIST)-COMMUNITY HEALTH WORKER (CHW) TEAMS WILL WORK COLLABORATIVELY WITH PATIENTS TO ACHIEVE SHARED TREATMENT GOALS. NURSES OR PHARMACISTS WILL TITRATE MEDICATIONS USING A SIMPLE PROTOCOL UNDER PHYSICIAN SUPERVISION, CHWS WILL CONDUCT HEALTH COACHING ON LIFESTYLE CHANGE AND MEDICATION ADHERENCE, AND PATIENTS WILL ACTIVELY ENGAGE IN SELF-MANAGEMENT (INCLUDING HOME BP MONITORING). SPECIFIC AIM 1 WILL TEST THE REACH, EFFECTIVENESS, ADOPTION, IMPLEMENTATION (FIDELITY), AND MAINTENANCE (SUSTAINABILITY) OF IMPLEMENTING A TEAM- BASED CARE STRATEGY IN A CLUSTER RANDOMIZED TRIAL. A TOTAL OF 40 PRIMARY CARE CLINICS (20 FROM COLOMBIA AND 20 FROM JAMAICA; 32 PATIENTS PER CLINIC AND 1,280 IN TOTAL) WILL BE RANDOMLY ASSIGNED TO A TEAM-BASED CARE STRATEGY OR ENHANCED USUAL CARE FOR 12 MONTHS TO TEST IMPLEMENTATION AND EFFECTIVENESS OUTCOMES. A 6-MONTH POST-TRIAL FOLLOW-UP STUDY WILL BE CONDUCTED TO ASSESS SUSTAINABILITY. THIS TRIAL HAS 90% STATISTICAL POWER TO DETECT AN ABSOLUTE DIFFERENCE OF 15% IN HYPERTENSION CONTROL (BP