Health promotion interventions for African Americans delivered in U.S. barbershops and hair salons- a systematic review

Abstract

Background African American adults suffer disproportionately from obesity-related chronic diseases, particularly at younger ages. In order to close the gap in these health disparities, efforts to develop and test culturally appropriate interventions are critical. Methods A PRISMA-guided systematic review was conducted to identify and critically evaluate health promotion interventions for African Americans delivered in barbershops and hair salons. Subject headings and keywords used to search for synonyms of ‘barbershops,’ ‘hair salons,’ and ‘African Americans’ identified all relevant articles (from inception onwards) from six databases: Academic Search Ultimate, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, PubMed, Web of Science (Science Citation Index and Social Sciences Citation Index). Experimental and quasi-experimental studies for adult (> 18 years) African Americans delivered in barbershops and hair salons that evaluated interventions focused on risk reduction/management of obesity-related chronic disease: cardiovascular disease, cancer, and type 2 diabetes were included. Analyses were conducted in 2020. Results Fourteen studies met criteria for inclusion. Ten studies hosted interventions in a barbershop setting while four took place in hair salons. There was substantial variability among interventions and outcomes with cancer the most commonly studied disease state (n = 7; 50%), followed by hypertension (n = 5; 35.7%). Most reported outcomes were focused on behavior change (n = 10) with only four studies reporting clinical outcomes. Conclusions Health promotion interventions delivered in barbershops/hair salons show promise for meeting cancer screening recommendations and managing hypertension in African Americans. More studies are needed that focus on diabetes and obesity and utilize the hair salon as a site for intervention delivery. Trial registration PROSPERO CRD42020159050.

Hair Stylists as Lay Health Workers: Perspectives of Black Women on Salon-Based Health Promotion

“…In a systematic review, interventions that were led or supported by a barber or hair stylist had a positive impact on both intervention effectiveness and feasibility. 13 When barbers and stylists were trained on intervention content and delivery, there were high levels of implementation, satisfaction with the intervention by clients, and intention to continue with the intervention beyond the study. 13 Studies that linked intervention delivery to a clinical partner reported significant positive results.…”

“… 13 When barbers and stylists were trained on intervention content and delivery, there were high levels of implementation, satisfaction with the intervention by clients, and intention to continue with the intervention beyond the study. 13 Studies that linked intervention delivery to a clinical partner reported significant positive results. 13 In another study, barbers who went through training to deliver information on prostate cancer screening to their clients, had significantly higher levels of prostate cancer knowledge post-training.…”

“… 13 Studies that linked intervention delivery to a clinical partner reported significant positive results. 13 In another study, barbers who went through training to deliver information on prostate cancer screening to their clients, had significantly higher levels of prostate cancer knowledge post-training. 33 Providing trainings for stylists (with documentation/certification), supporting materials from professional health organizations, partnering with health professionals, and capitalizing on stylists’ professional expertise by linking hair/skin/scalp health to other health issues can possibly enhance clients’ receptivity to stylists as lay health workers and warrants further investigation.…”

Structural Barriers Associated with the Intersection of Traumatic Stress and Gun Violence: A Case Example of New Orleans

“…Other health promotion campaigns are using barbershops and hair salons as potential opportunities for intervention. While some evaluation studies for education on hypertension and diabetes show promising results, more research is needed to evaluate the effectiveness of utilizing these locations for community-level interventions [ 47 ]. Specific interventions and studies are needed to address community-level education on trauma and anxiety-related symptoms to improve recognition and referrals for care in Black communities.…”

Barbershops as a setting for supporting men's mental health during the COVID-19 pandemic: a qualitative study from the UK

“…Various initiatives have been influenced by the ‘barbershop model’ of health promotion that emerged in the 1980s to address health problems in African-American communities, for whom barbershops have historically provided a safe gathering place with important social and cultural functions. 14 Key components of the barbershop model have included training barbers to improve health literacy and offering guidance on how to initiate client referrals to professional healthcare providers. However, mental health outcome data have been scarcely reported and the applicability to other populations and contexts is uncertain, despite international interest and examples of public funding.…”