title: Barbershops as hypertension detection, referral, and follow-up centers for black men.
abstract: Barbershops constitute potential sites for community health promotion programs targeting hypertension (HTN) in black men, but such programs have not been evaluated previously. Here we conducted 2 nonrandomized feasibility studies to determine whether an enhanced intervention program of continuous blood pressure (BP) monitoring and peer-based health messaging in a barbershop lowers BP more than standard screening and health education (study 1) and can be implemented by barbers rather than research personnel (study 2). In study 1, we measured changes in HTN treatment and BP in regular barbershop customers with poorly controlled HTN assigned for 8 months to either an enhanced intervention group (n=36) or a contemporaneous comparison group (n=27). Groups were similar at baseline. BP fell by 16+/-3/9+/-2 mm Hg in the enhanced intervention group but was unchanged in the comparison group (P<0.0001, adjusted for age and body mass index). HTN treatment and control increased from 47% to 92% (P<0.001) and 19% to 58% (P<0.001), respectively, in the enhanced intervention group, whereas both remained unchanged in the comparison group. In study 2, barbers were trained to administer the enhanced intervention continuously for 14 months to the entire adult black male clientele (n=321) in 1 shop. Six barbers recorded 8953 BP checks during 11 066 haircuts, thus demonstrating a high degree of intervention fidelity. Furthermore, among 107 regular customers with HTN, treatment and control increased progressively with increasing intervention exposure (P<0.01). Taken together, these data suggest that black-owned barbershops can be transformed into effective HTN detection, referral, and follow-up centers. Further research is warranted.
authors.affiliation: Division of Hypertension, Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX 75390-8586, USA.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Hess
authors.forename: Jason S
authors.initials: JS
authors.lastname: Reingold
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jones
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Fellman
authors.forename: Premere
authors.initials: P
authors.lastname: Knowles
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Ravenell
authors.forename: Stacey
authors.initials: S
authors.lastname: Kim
authors.forename: Jamie
authors.initials: J
authors.lastname: Raju
authors.forename: Erica
authors.initials: E
authors.lastname: Ruger
authors.forename: Sharonda
authors.initials: S
authors.lastname: Clark
authors.forename: Chibuike
authors.initials: C
authors.lastname: Okoro
authors.forename: Ore
authors.initials: O
authors.lastname: Ogunji
authors.forename: Patricia
authors.initials: P
authors.lastname: Knowles
authors.forename: David
authors.initials: D
authors.lastname: Leonard
authors.forename: Ruth P
authors.initials: RP
authors.lastname: Wilson
authors.forename: Robert W
authors.initials: RW
authors.lastname: Haley
authors.forename: Keith C
authors.initials: KC
authors.lastname: Ferdinand
authors.forename: Anne
authors.initials: A
authors.lastname: Freeman
authors.forename: Ronald G
authors.initials: RG
authors.lastname: Victor
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001461:Barbering; D044383:Black People; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination; D015331:Cohort Studies; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006266:Health Education / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010379:Peer Group; D012017:Referral and Consultation
chemical_list: D000959:Antihypertensive Agents