Primary Care Provider Understanding of Hair Care Maintenance as a Barrier to Physical Activity in African American Women

Abstract

Introduction: African American (AA) women have reported hair maintenance as a barrier to regular exercise; however, to our knowledge, this study is the first to identify primary care provider thoughts, attitudes, beliefs, and knowledge regarding hair as a barrier to increased physical activity among AA females. Methods: A 13-question electronic survey was sent via email to 151 clinicians working within a department of family medicine's 8 ambulatory clinics within a large urban academic medical center. Results: A total of 62 primary care clinicians completed the survey, which is a response rate of 41%. The vast majority of respondents (95%) sometimes/often engage in discussions with AA female patients regarding physical activity. However, 76% of respondents have never included a hairstyling or maintenance assessment in that discussion and only 34% noted being comfortable discussing this topic. Among a list of potential barriers to exercise, hair maintenance/scalp perspiration was rarely endorsed as important by clinicians. Discussion: This study highlights a need for increased education among primary care providers regarding AA hair care and maintenance practices as a barrier to increased physical activity in AA women. If specific barriers to increasing healthy habits among AA women are to be addressed, there must be a baseline knowledge of hair care and maintenance barriers, an understanding of the strong influence of cultural norms and practices as it relates to physical activity and exercise, and an increased comfortability when engaging in difficult cross-cultural conversations to ultimately improve health outcomes in AA females. (J Am Board Fam Med 2019;32:944-947.)

Physical Activity, Coronary Artery Calcium, and Cardiovascular Outcomes in the Multi-Ethnic Study of Atherosclerosis (MESA)

“…Healthcare providers need to encourage PA among their patients at risk, although sex-and racial/ethnic-specific barriers to PA should be considered in order to increase engagement. For example, a small body of research has identified hair care as a significant obstacle among Black women, with responders reporting "sweating out my hairstyle" as a barrier to PA (32)(33)(34). Other literature among a group of Latina women reported that caregiving, family obligations, child care, and lack of relatives to help with child care were barriers to exercise (35)(36)(37).…”

Narrative review – Barriers and facilitators to promotion of physical activity in primary care

“…These studies highlighted some socio‐cultural issues influencing PA for health, with reference to cultural norms for females within Arabic cultures 78,94 . In African American populations, Tolliver et al 97 . highlighted that hair care in female populations was a barrier to PA.…”

“…30,78,94,95 These studies highlighted some socio-cultural issues influencing PA for health, with reference to cultural norms for females within Arabic cultures. 78,94 In African American populations, Tolliver et al 97 highlighted that hair care in female populations was a barrier to PA. Given the increasing globalisation of the world, with increasing socio-cultural diversity, further research exploring culture-specific barriers to PA for health is required.…”

African american hair care

“…El hábito de alisar el cabello crespo probablemente comenzó durante el período de la esclavitud, cuando las mujeres negras usaban materiales grasos y, a veces, resinas vegetales para alisar su cabello. A mediados de 1900, Sarah Breedlove (más tarde conocida como Madame C. J. Walker), una mujer afroamericana, creó un ungüento compuesto por varios aceites y revolucionó el peinado del cabello crespo (52,53) .…”

“…Lora, L; Gómez, MB; Da Cruz, K las afroamericanas en comparación con las mujeres blancas. Entre esta población, el uso de tintes para el cabello de tonos oscuros se asoció con un mayor riesgo de cáncer de mama (52,57) . Recientemente la industria cosmética ha invertido esfuerzos en el estudio de este tipo de cabellos en busca de entender mejor y adaptar cosméticos en el mismo sentido (58) .…”