Flor Alvarado, Diversity Supplement Project Summary The “Community Health Worker-Led Church-Based Intervention for Eliminating Cardiovascular Health Disparities in African Americans (CHERISH)” study is a cluster randomized trial that will test whether a community health worker (CHW)-led and church-based multifaceted strategy for implementing 2019 ACC/AHA Guidelines on the Primary Prevention of cardiovascular disease (CVD) can reduce cardiovascular health disparities among African Americans residing in New Orleans, Louisiana. Extensive research highlights the impact of social determinants of health (SDH) on cardiovascular health, and particularly suggest that individual-level determinants may not fully account for variation in CVD-related outcomes. Areas with socioeconomic deprivation have been linked to greater mortality and CVD related outcomes, whereas neighborhood physical and social environments have also been tied to CVD risk, independent of individual level factors. However, there has been limited research evaluating the associations between neighborhood SDH and earlier outcomes that may influence cardiovascular health including: regular use of routine preventative care or prescribed medications, confidence in actively engaging in medical care, or perceptions related to acceptability, appropriateness, and perceived feasibility of participating in lifestyle and pharmaceutical interventions. Understanding how these outcomes are influenced by neighborhood factors is critical. To this end, the objective of this ancillary study, is to use a mixed-methods approach to evaluate the relationships between neighborhood-level SDH to these upstream health-related beliefs and behaviors among African Americans at risk for CVD residing in in New Orleans, LA. These critical assessments of neighborhood-level SDH in the target population will help inform the intervention and provide further context for the interpretation of outcomes in the parent study.