Faith community nursing programs have grown out of churches as a response to the inequity of healthcare delivery to uninsured and underinsured communities. These programs provide outreach to community members and extend their services beyond just the parishioners of the churches, reaching more uninsured people than traditional medical services. Although faith community nursing programs have been established throughout the United States, no evaluation of these programs has been done. QueensCare is taking the lead in measuring the effect of parish nurses on health outcomes. In this project we have one specific aim: to measure the effect of parish nurse visits on blood pressure control on community-dwelling hypertensive patients. Our study will involve recruiting hypertensive patients from parish nurse led health fairs and interviewing subjects at the time of recruitment. Patients will either be randomized to parish nurse visits or primary care physician appointments. We will have a 4-month follow-up period with a re-check of blood pressures and an exit interview of the patient. From this study, we hope to better understand if parish nurse visits improve blood pressure and medication compliance among hypertensive patients.

Inclusion Criteria:

• We will be including adults who are 18 years and older who have attended a health fair or screening event at one of QueensCare Health and Faith Partnership parish nurse sponsored church events in Los Angeles.
• Patients must be either English or Spanish speaking.
• Patients will be enrolled by blood pressure readings at the screening event. We will be using the JNC 71 criteria for diagnosing hypertension.
• Patients with blood pressures above 140/90 will be defined as hypertensive.
• Diagnosed and previously undiagnosed hypertensive patients will be included in the study.
• The patient must also be able to come to the follow-up appointment in 4 months.

Exclusion Criteria:

• Pregnant women will not be included in the study.
• Patients who do not speak English or Spanish will be excluded from the study since we do not have the capacity to translate all our materials into multiple languages.
• Those deemed by the research assistant to be incapable to give informed consent (due to intoxication, dementia, or other causes) will also be excluded from the study.
• Patients younger than 18 years old will be excluded from the study.
• Patients who have seen a parish nurse in her office hours in the past 6 months will be excluded from the study. We do not want patients who have an already established relationship with a parish nurse to be enrolled in the study with the chance of being randomized to the physician-only arm, which would interrupt the continuity of care the patient is receiving from the parish nurse.