Setting South Carolina is an ideal setting within which to test the proposed intervention, TG by teleconference. AA represent about 31 % of the population. Unlike other parts of the US, SC is mostly rural (and 46 % of its AA are rural) and the AA population has experienced very little in-migration over the past several centuries.137 Furthermore, religious affiliation is largely fundamentalist Christian (African Methodist Episcopal, Baptist and Pentecostal Churches),138 and a spiritual focus permeates the community, which is known as the "Buckle" of the Bible Belt.