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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 (nϭ36) or a contemporaneous comparison group (nϭ27). Groups were similar at baseline. BP fell by 16Ϯ3/9Ϯ2 mm Hg in the enhanced intervention group but was unchanged in the comparison group (PϽ0.0001, adjusted for age and body mass index). HTN treatment and control increased from 47% to 92% (PϽ0.001) and 19% to 58% (PϽ0.001), 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 (nϭ321) 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 (PϽ0.01). 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. Key Words: population science Ⅲ special populations Ⅲ blood pressure measurement/monitoring Ⅲ blacks Ⅲ hypertension H ypertension (HTN) is more prevalent, more severe, and causes disproportionate numbers of premature disabilities and deaths from heart attack, stroke, and end-stage renal disease in blacks than in all other racial/ethnic groups in the United States. [1][2][3] HTN is present in 40% of blacks, with blood pressure (BP) being controlled with medication to a recommended value of Ͻ140/90 mm Hg in less than one-third of these affected high-risk individuals. 2,4 In the other two-thirds, HTN either is untreated or undertreated.Among black women, HTN treatment rates are high, and most of the uncontrolled HTN occurs under the watchful eye of the healthcare system. 2,5 Black men have less frequent contact with the healthcare system and considerably lower rates of HTN detection and treatment. 2,[5][6][7][8] The black church has been a conventional site for medical outreach and HTN screening programs. 9,10 However, regular church attendance is much less common among black men than women. 6,11 To reach a larger fraction of the at-risk male population, we approached the black-owned barbershop, a cultural institution that regularly attracts large numbers of black men and provides an open forum for dis...

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Background: Hypertension (HTN) control rates in the United States remain lower in black than white persons, particularly before 65 years of age. Potential sociocultural factors have not been sufficiently addressed.Methods: We analyzed data from structured interviews and blood pressure measurements in a population-based sample of 1514 hypertensive (1194 non-Hispanic black and 320 non-Hispanic white) subjects aged 18 to 64 years in Dallas County, Texas, from 2000 to 2002 to identify sociocultural factors associated with low rates of HTN control. We calculated adjusted odds ratios (aORs) and 95% confidence intervals (CIs) using multivariate logistic regression.Results: Awareness, treatment, and control of HTN were negatively associated with a common perception of good health, with aORs (95% CIs) of 0.37 (0.27-0.50) for awareness, 0.47 (0.36-0.62) for treatment, and 0.66 (0.51-0.86) for control. They were positively associated with having a regular physician, with aORs (95% CIs) of 3.81 (2.86-5.07) forawareness,8.36(5.95-11.74)fortreatment,and5.23(3.30-8.29) for control. Among untreated hypertensive subjects, lack of perceived need for a regular physician was associated with perceived good health (aOR [95% CI], 2.2 [1.2-4.0]), male gender (aOR [95% CI], 2.4 [1.4-4.1]), and black race/ethnicity (aOR [95% CI], 2.1 [1.0-4.4]). The HTN outcomes were unrelated to perceived racism or lay beliefs about the causes, consequences, and treatment of HTN.Conclusions: Among young to middle-aged hypertensive subjects, a perception of good health and the lack of perceived need for a regular physician remain major factors associated with untreated and uncontrolled HTN at the community level-particularly among black men. These factors merit greater emphasis in professional education and public health programs on HTN.

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