DESCRIPTION (TAKEN FROM APPLICANT): The long-term objective of the proposed research is to identify and evaluate easily replicated, cost effective, and time efficient intervention and assessment instruments for improving the cultural sensitivity of primary care clinic physicians, clinical staff, and medical students. This research involves evaluating the effects of a theorygrounded and research-based Patient-Centered Culturally Sensitive Health Care (PC-CSC) Intervention Model when it is implemented in a community-based primary care clinic with low-income, ethnically diverse patients (i.e. Black American, Hispanic American, and White American patients) who have hypertension alone or with one or more other chronic illness. The PC-CSC Model consists of three sequential component modules: (a) altering the physical environment of the health care clinic to make it more culturally sensitive, (b) training health care providers and clinic staff to provide patient-defined culturally sensitive health care, and (c) training patients to obtain and inspire culturally sensitive health care. These component modules will be implemented sequentially in order to test the effects of each module on (a) patient-perceived health care quality (such as perceived cultural sensitivity in health received and patient satisfaction), (b) patient outcomes (such as medication adherence and health promoting behaviors), and (c) the levels at which health care providers and clinic staff perceive showing cultural sensitivity in the health care delivery process. To assess these effects the PC-CSC Model will be implemented at an Intervention Clinic but not at a similar, carefully selected Control Clinic; furthermore, a time series research design will be used wherein each patient and staff member will serve as /her/his own control. A secondary, but important objective of this research is to determine the psychometric properties of recently developed instruments designed to evaluate perceived cultural sensitivity in health care provided and health care received. Findings from this proposed research will be nationally disseminated to promote culturally sensitive health care and, ultimately, to reduce the health status disparities that exist between majority and minority Americans.