Collecting Hair Samples for Hair Cortisol Analysis in African Americans

Abstract

The hormone cortisol is typically assessed in saliva, serum, or urine samples. More recently, cortisol has been successfully extracted from hair, including humans. The advantage of hair cortisol concentration is that it reflects a retrospective representation of hypothalamic-pituitary-adrenal (HPA) axis function over time, much like hemoglobin A1C represents glycemic control. However, obtaining hair samples can be challenging, due to the cultural beliefs and hair care practices of minority participants. For example, African Americans may be reluctant to provide samples. Additionally, few researchers are trained to collect hair samples from African Americans. The purpose of this paper is to present a culturally informed protocol to help researchers obtain hair samples from African Americans. To illustrate the representative results of this protocol implementation, de-identified data from African Americans that participated in a community-based study on chronic stress are provided. Hair practice preferences are assessed. The participants are made comfortable by showing pictures of hair samples prior to cutting their hair. The single strain twist and gently pull method is used to collect approximately 30 - 50 strands of hair from the posterior vertex region of the scalp. This protocol will significantly improve collection of hair samples from African Americans.

A randomized control trial to test a peer support group approach for reducing social isolation and depression among female Mexican immigrants

“…This line of inquiry is an major advance in revealing the often subtle ways that dysregulation of cortisol levels is implicated in the risk of disease and negative health outcomes [113]. We will gather hair samples from all participants at baseline and 12 months to measure average levels of circulating cortisol as a biological marker for chronic stress [81][82][83][84][85][86]117]. The data collectors will use scissors to obtain a pencil-width (at least 3 cm long) of hair from the crown of the participant's head as described [85,118].…”

Development of a culturally informed protocol for hair cortisol sampling in Black women

“…Acceptability of hair sampling for cortisol is improved when researchers appreciate the unique concerns of Black women about their hair and work to facilitate trust in the research and hair sampling process. Researchers who do not understand the substantial range of the significance of hair to Black women may inadvertently devalue the importance of hair, reducing participation (Wright et al, ). Barriers to hair collection may be reduced through careful consideration of sampling protocols and processes.…”

“…However, hair collection may involve differing degrees of burden for specific populations. Black women, in particular, may find hair collection challenging, limiting their participation in studies (Wright et al, ). Geronimus, Hicken, Keene, and Bound () proposed a weathering hypothesis, in which chronic and excessive stress experienced by Black women early in the life span causes premature biological aging leading to poorer perinatal and other health outcomes.…”

“…Hair styling practices may not only increase the likelihood of hair breakage but may also limit accessibility of the hair for sampling. The sampling site may be difficult to access due to styles including braids, extensions, or dreadlocks (Wright et al, ). Women whose hair has been professionally braided may be reluctant to have braids untwisted, both because of the cosmetic effect and the financial investment in braiding, which can exceed $100 (Wright et al, ).…”

“…The sampling site may be difficult to access due to styles including braids, extensions, or dreadlocks (Wright et al, ). Women whose hair has been professionally braided may be reluctant to have braids untwisted, both because of the cosmetic effect and the financial investment in braiding, which can exceed $100 (Wright et al, ). Larger extensions, or weaves, may or may not allow sampling in the target area depending on how the extensions are attached.…”