Aim 2: Evaluate the effectiveness of group medical visits and microfinance for CVD risk reduction. The effectiveness of group medical visits and microfinance groups for CVD risk reduction will be evaluated among individuals with diabetes or at increased risk for diabetes, by conducting a four-arm cluster randomized trial . The primary outcome measure will be one-year change in SBP, and a key secondary outcome measure will be change in CVD risk score. Randomization will occur at the level of the CU (cluster), and will be stratified by Division. Each of the 32 CUs will be randomly allocated (eight CUs per arm).