“…The first component is an evaluation of a statewide cooperative to support the in-clinic implementation of the HH4M model. This has been described elsewhere [ 20 ]. This paper focuses on the second component, evaluating the ability of rural and medically underserved practices to implement the elements of the HH4M model by identifying drivers of and barriers to sustainable implementation, and testing whether the model improves (a) blood pressure control and (b) tobacco use screening and cessation.…”