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2025 Impact Report

Where Communities Lead Heart Health

"I Am Because We Are" Ubuntu Philosophy in Practice

By the numbers

Three-year longitudinal analysis and proven model (2023–2025). In 2025 we proved what's possible when communities lead their own health.

1,302
Screenings conductedAcross 19 locations
879
Unique participants10 neighborhoods
22
People connected to careSevere hypertension identified and referred
25.5%
Retention rateParticipants who returned for care
Letter from the founder

In 2012, at age 26, I received a diagnosis that would change my life forever: left ventricular non-compaction cardiomyopathy, a rare congenital heart defect. What followed was a ten-year journey through advanced heart failure, six years with an LVAD keeping me alive while I waited for a donor heart.

In 2025, we proved what's possible when communities lead their own health. We conducted 1,302 cardiovascular screenings across 19 locations, served 879 unique individuals. We identified 22 people in hypertensive crisis and referred each person to care. We did this on FY2025 expenses of $144,540.

Most importantly, we built a model that works. A four-phase framework any community can replicate. As we enter 2026, we are transitioning from a proven community model to a sustainable infrastructure.

Somaneh “Bouba” Diemé, Founder & Chief Inspiration Officer

Three-year growth trajectory

  • Total screenings: 322 → 740 → 1,302 (+304%)
  • Unique participants: 62 → 650 → 879 (+1,318%)
  • Screening locations: 7 → 14 → 19 (+171%)
  • Neighborhoods served: 1 → 7 → 10 (10×)
  • Operating budget: $89K → $103K → $144,540 (+62%)
  • People connected to care (crises identified and referred): 7 → 18 → 22 (+214%)

The replicable four-phase care model

  • Phase 1. Identification (visits 1–2): free screening, crisis referral, warm handoffs. 26.6% improve.
  • Phase 2. Active Monitoring (visits 3–6): bi-weekly follow-up, cultural navigation. 68% improve.
  • Phase 3. Behavior Change (visits 7–9): lifestyle coaching, peer support. 74% improve.
  • Phase 4. Maintenance (visits 10+): monthly check-ins, community integration. 66.7% maintain gains.

Clinical outcomes by engagement level

A clear dose-response relationship: more visits, better outcomes. Participants with 6+ visits saw average BP drops of −12.4 / −6.1 mmHg with a 74% improvement rate. Optimal engagement: 4–6 week screening intervals maintained over 6+ months.

The retention breakthrough

  • HGF patient-led model: 25.5%
  • HGF, East Boston Senior Center: 41%

Cost context

  • Nationally, one hospital stay for a hypertensive crisis has a median cost of care of about $49,000 (Nahle T. et al., J Clin Hypertens 2026;28:e70207).
  • In 2025, our community health workers identified 22 cases of severe high blood pressure and referred each person to care, on FY2025 expenses of $144,540.

FY2025 financials

  • Revenue $151,189: 61% grants, 23% individual/corporate, 6% earned, 4% in-kind, 4% board, 2% employee giving.
  • Expenses $144,540: 54% program delivery, 13% occupancy, 11% technology, 9% marketing, 8% G&A, 5% professional services.
  • Net operating result: +$6,649 (+4.4%)
  • 2026–2028 strategy: shift grant dependency from 61% → 30% while building earned revenue to 70% of the mix.

Cumulative impact since founding (2018–2025)

  • 7,800+ community members served
  • $525K+ resources mobilized
  • 2,340+ total screenings conducted
  • 47+ hypertensive crises identified
  • 10 neighborhoods reached over 5 continuous years

Looking ahead, 2026 strategy

Become the trusted bridge between communities at high risk of heart disease and the care system, and prove it works. 2026 targets include 1,000 unique individuals, ≥25.5% retention, ≥74% BP improvement at 6+ visits, the first paying provider contract, and a three-year-outcomes white paper.

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Get the full 2025 report.

The question is no longer whether this model works. The question is how to scale it beyond Boston.