Inclusion Criteria:  African immigrants who are aged 25-75 years Participants who report being uninsured or have no access to a healthcare provider Have at least two of the following chronic conditions: Body-mass index ≥ 25 kg/m2 Self-reported fasting plasma glucose of 95 to 125 mg/d or HbA1c of 5.7-6.5% in the past 6 months Systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥ 90 mmHg  Exclusion Criteria:  Participants who cannot communicate in English Participants who have cognitive challenges that would restrict them from participation Participants who have any serious illness that would interfere with participation Participants who are not members of the churches that are involved in this study