PROJECT SUMMARY/ABSTRACT Hypertension is the most common risk factor for cardiovascular disease affecting nearly one-half of the U.S. population and causing a large number of deaths every year. High blood pressure rates and stroke risk are particularly high in African American patients and vulnerable populations who receive care at safety-net clinics. The main barriers to achieving blood pressure control are both provider-related and patient-related, and include suboptimal frequency of follow up, clinicians’ failure to intensify treatment and poor medication adherence. Many barriers to BP control may be surmountable with emerging digital technology. The use of Clinical Decision Support tools can help accomplish these goals by nudging clinicians toward more frequent treatment intensification and empowering patients to participate, communicate and monitor their blood pressure. We have developed a CDS technology platform embedded in the electronic health record (EHR), called Engage-Rx, to enable a team-based care with patient engagement targeted to improve hypertension management in safety-net clinics and other low-resource clinical settings. We propose to test the usability of Engage-Rx among racially and economically diverse patients and its preliminary efficacy at improving hypertension management. Our goals will be achieved though the following Specific Aims: (1) to assess and improve the usability of the Engage-Rx patient engagement platform from the perspective of racially and economically diverse patients; (2) to conduct a pilot study to assess the feasibility and preliminary efficacy of the Engage-Rx patient engagement platform within usual primary care workflow. Should this exploratory study reveal that the use of Engage-Rx leads to improved quality of care and higher treatment intensification, the proposed work would provide an important tool to improve hypertension management. This study will provide the foundation for a functional and usable product that will be expanded to more chronic diseases and tested in a SBIR Phase II RCT.