Metropolitan Family Health Network, Inc., a Federally Qualified Health Center will develop, implement and evaluate the efficacy of training designed to affect an innovative, sustainable paradigm shift in the career path of certified Medical Assistants (MA). The Project will develop curricula and train MAs to conduct evidence-based patient risk assessments prior to patient appointments with their doctor. MA2 is designed to make more effective use of a talented, but underutilized segment of the medical workforce, creating a career step between MA and nurse. MA2 training will utilize the Breakthrough Series training model and leverage the cultural congruence and credibility of MAs with FQHC patients. MA2 training will include didactic and experiential instruction in cultural congruence, health literacy, communication skills and administration of a minimum of five evidence-based risk screening protocols (i.e., depression, substance abuse, tobacco use, etc.; previously performed by practitioners). The goals of the Project are to 1) improve compliance with quality assurance protocols for using risk-based screening assessments; 2) improve patient and practitioner satisfaction; 3) improve MA2 job satisfaction and retention by creating a career path; 4) reduce health disparities by improving patient/provider communication/information; and 5) improve health outcomes by mitigating risk through early intervention.