Table 1 Project ReD CHiP’s specific aims, hypotheses and main outcome measures

To perform a multi-method, staged quality improvement intervention (better blood pressure measurement, patient care management and provider education) to increase guideline concordant hypertension care and to reduce racial disparities in blood pressure control.

• Better blood pressure measurement and better blood pressure data will lead to less clinical inertia and, ultimately, better blood pressure control and less racial disparities.

• % of patients with controlled BP and % of patients with uncontrolled BP with medication titration in the last 3 months

• Each intervention will have an additive effect and the use of all three interventions will result in a higher percentage of patients receiving guideline-concordant hypertension care and a greater reduction in racial disparities than any single combination or any combination of two interventions.

• % of patients with controlled BP and racial disparity in controlled BP

• The care management intervention will have greater net improvement in blood pressure control at the clinic level than the provider education intervention. The provider education will have an additive and greater effect when implemented after the care management intervention than when employed without the care management intervention.

• % of patients with controlled BP and racial disparity in controlled BP

To determine the association of organizational functioning and organizational cultural competence with guideline concordant hypertension care and racial disparities in blood pressure control.

• Clinics will reflect their local surroundings and clinics with a higher percentage of minority persons will have lower organizational functioning.

• % of patients with BP control, stratified by race, compared across clinics

• Clinics with greater organizational cultural competence will have greater guideline concordant hypertension care and less racial disparities in blood pressure control.

• Degree of racial disparity

To determine the association between organizational functioning and organizational cultural competence at the clinic and system level with the implementation and success of the quality improvement interventions.

• Clinics with higher organizational functioning will have a higher rate of implementation and more blood pressure control and reduction in racial disparities than clinics with lower organizational functioning.

• Degree of implementation for each of the interventions

• Clinics with greater organizational cultural competence will have a higher rate of implementation and more blood pressure control and reduction in racial disparities than clinics with less cultural competence.

• Degree of implementation for each of the interventions