Implementing barbershop-based health-promotion interventions for Black men: A systematic scoping review.

OBJECTIVE: Health-promotion efforts among Black men in the United States have been limited in their ability to recruit, retain, and produce meaningful health-related changes. These difficulties have led to Black men being referred to as a "hard-to-reach" population-a designation that places undue blame on these men as opposed to the dissemination and implementation strategies being used by health-promotion specialists. Gender- and race-based strategies that align with the lived experiences of these men are likely to circumvent these challenges. Barbershops are cultural institutions that are uniquely positioned to promote health among Black men. There is little guidance on how to develop, implement, and evaluate barbershop-based efforts. This scoping review seeks to provide this guidance by applying the RE-AIM framework to analyze existing interventions. METHOD: Information was identified by searching the following bibliographic databases: PubMed, EMBASE PsycINFO, CINAHL, and Web of Science. A grey literature search was conducted using Web of Science and ClinicalTrials.gov. Results were uploaded to Rayyan. Each article was independently and blindly assessed by two reviewers. A third reviewer blindly resolved any discrepancies. Data were then independently extracted by the two reviewers. Discrepancies were flagged and resolved collaboratively. RESULTS: Results indicate that barbershop-based health-promotion efforts that prioritize community engagement and intentional alignment to the gender- and race-based lived experiences of Black men are likely to result in satisfactory recruitment, retention, and health-related changes among these men. CONCLUSIONS: More intervention efforts are needed that target young Black adults, rural Black men, mental health outcomes, and which implement peer-to-peer models. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Formative Exploration of the Feasibility of Embedding Community Assets Into Primary Health Care: Barbershop and Place of Worship Readiness in Guyana.

INTRODUCTION: Community engagement is key to improving the quality of primary health care (PHC), with asset-based interventions shown to have a positive impact on equity and health outcomes. However, there tends to be a disconnect between community-based interventions and PHC, with a lack of evidence on how to develop sustainable community-primary care partnerships. This paper reports on the formative phases of 2 studies exploring the feasibility of embedding community assets, namely places of worship and barbershops, into the PHC pathway for the prevention and control of NCDs in deprived settings. It describes the participatory approach used to map and gather contextual readiness information, including the enablers and constrainers for collaborative partnerships with PHC. METHODS: Grounded in community-based participatory research, we used elements of ground-truthing and participatory mapping to locate and gather contextual information on places of worship and barbershops in urban and rural communities. Local knowledge, gathered from community dialogs, led to the creation of sampling frames of these community assets. Selected places of worship were administered a 66-item readiness questionnaire, which included domains on governance and financing, congregation profile, and existing health programs and collaborations. Participating barbershops were administered a 40-item readiness questionnaire, which covered barbers' demographic information, previous training in health promotion, and barbers' willingness to deliver health promotion activities. RESULTS: Fourteen barbershops were identified, of which 10 participated in the readiness survey, while 240 places of worship were identified, of which 14 were selected and assessed for readiness. Contextual differences were found within and between these assets regarding governance, accessibility, and reach. Key enablers for both include training in health promotion, an overwhelming enthusiasm for participation and recognition of the potential benefits of a community-primary care partnership. Lack of previous collaborations with the formal health system was common to both. CONCLUSION: The participatory approach extended reach within underserved communities, while the readiness data informed intervention design and identified opportunities for partnership development. Contextual differences between community assets require comprehensive readiness investigations to develop suitably tailored interventions that promote reach, acceptance, and sustainability.

Cost-Effectiveness of Hypertension Treatment by Pharmacists in Black Barbershops.

BACKGROUND: In LABBPS (Los Angeles Barbershop Blood Pressure Study), pharmacist-led hypertension care in Los Angeles County Black-owned barbershops significantly improved blood pressure control in non-Hispanic Black men with uncontrolled hypertension at baseline. In this analysis, 10-year health outcomes and health care costs of 1 year of the LABBPS intervention versus control are projected. METHODS: A discrete event simulation of hypertension care processes projected blood pressure, medication-related adverse events, fatal and nonfatal cardiovascular disease events, and noncardiovascular disease death in LABBPS participants. Program costs, total direct health care costs (2019 US dollars), and quality-adjusted life-years (QALYs) were estimated for the LABBPS intervention and control arms from a health care sector perspective over a 10-year horizon. Future costs and QALYs were discounted 3% annually. High and intermediate cost-effectiveness thresholds were defined as <$50 000 and <$150 000 per QALY gained, respectively. RESULTS: At 10 years, the intervention was projected to cost an average of $2356 (95% uncertainty interval, -$264 to $4611) more per participant than the control arm and gain 0.06 (95% uncertainty interval, 0.01-0.10) QALYs. The LABBPS intervention was highly cost-effective, with a mean cost of $42 717 per QALY gained (58% probability of being highly and 96% of being at least intermediately cost-effective). Exclusive use of generic drugs improved the cost-effectiveness to $17 162 per QALY gained. The LABBPS intervention would be only intermediately cost-effective if pharmacists were less likely to intensify antihypertensive medications when systolic blood pressure was ≥150 mm Hg or if pharmacist weekly time driving to barbershops increased. CONCLUSIONS: Hypertension care delivered by clinical pharmacists in Black barbershops is a highly cost-effective way to improve blood pressure control in Black men.

Protocol for a systematic review of health promotion interventions for African Americans delivered in US barbershops and hair salons.

INTRODUCTION: African American adults are disproportionately burdened by chronic diseases, particularly at younger ages. Developing culturally appropriate interventions is paramount to closing the gap in these health inequities. The purpose of this systematic review is to critically evaluate health promotion interventions for African Americans delivered in two environments that are frequented by this population: barbershops and hair salons. Characteristics of effective interventions will be identified and evidence for the effectiveness of these interventions will be provided. Results of this review will inform future health promotion efforts for African Americans particularly focused on the leading health inequities in obesity-related chronic diseases: cardiovascular disease, cancer and type 2 diabetes. METHODS AND ANALYSIS: Subject headings and keywords will be used to search for synonyms of 'barbershops,' 'hair salons' and 'African Americans' to identify all relevant articles (from inception onwards) in the following databases: Academic Search Ultimate, Cumulative Index of Nursing and Allied Health Literature, Embase, PsycINFO, PubMed, Web of Science (Science Citation Index and Social Sciences Citation Index) and ProQuest Dissertations. Experimental and quasi-experimental studies for adult (>18 years) African Americans delivered in barbershops and hair salons will be included. Eligible interventions will include risk reduction/management of obesity-related chronic disease: cardiovascular disease, cancer and type 2 diabetes. Two reviewers will independently screen, select and extract data and a third will mediate disagreements. The methodological quality (or risk of bias) of individual studies will be appraised using the Effective Public Health Practice Project Quality Assessment Tool. Quality and content of the evidence will be narratively synthesised. ETHICS AND DISSEMINATION: Since this is a protocol for a systematic review, ethical approval is not required. Findings from the review will be widely disseminated through conference presentations, peer-reviewed publications and traditional and social media outlets.

Health Promotion Awareness in Barbershops and Salons: An International Cross-Sectional Survey in Japan and Thailand.

Aging societies are a worldwide concern, as people are living longer than ever before. The success of the "barbershop project" in improving community health in the USA suggests that the aging issue can be tackled using this method even in Asia. Nevertheless, the health promotion awareness of barbers/stylists has barely been reported in Asia. This study aimed to identify the health promotion awareness of barbers and stylists in Japan and Thailand. An international cross-sectional survey was conducted between March and December 2017. Questionnaire contents included the "current status of existing health-promotion-related services," "awareness of contribution to maintaining people's health," and "awareness of collaboration with health care professionals." Participants were 99 Japanese and 101 Thai shop owners. In Japan, more health-promotion-related services were already provided through shops, and health care awareness was higher than in Thailand. In both countries, some shops were willing to collaborate with health care professionals. In Japan, "barbers/stylists have consultation opportunities with health care professionals," "health-related leaflets are provided," "development of therapy/care," and "barbershops/salons become a bridge between communities and hospitals" were mentioned as ideas for collaboration. In conclusion, barbers/stylists are highly interested in health due to the direct connection between beauty and health. Collaboration between barbershops/salons and health care professionals is possible, especially in Japan due to its super-aging society. Further development of the barbershop/salon project is needed.

Assessment of the autoxidation mechanism of p-toluenediamine by air and hydrogen peroxide and determination of mutagenic environmental contaminant in beauty salon effluent.

The present work investigated the autoxidation reaction of p-toluenediamine (PTD) - a precursor - widely used in permanent hair dyeing formulation, under experimental conditions close to the hair dyeing process (oxygen and/or peroxide in ammoniacal medium), by chromatographic and spectroscopic techniques. In additional, evaluated the mutagenicity of the PTD oxidation products and the presence of PTD and this products in wastewater from beauty salon, as well as in surface water and drinking water using HPLC coupled to a diode array detector and linear scan voltammetry. Through this study, it was possible the identification of semi-quinonediimine, quinonediimine, dimers (derived from toluenediamine), and trimer radical identified as Bandrowski's Base derivative (BBD) formed during autoxidation of PTD. Salmonella Typhimurium YG1041 assay with and without metabolic activation induced rat-liver (S9) indicated mutagenic activity for BBD. Levels of PTD were determined by the standard addition method in samples collected from the wastewater of a beauty salon, as well as from the water before and after treatment in a drinking water treatment plant (DWTP) reached concentrations of 2.08 ±â€¯0.21, 2.36 ±â€¯0.10 × 10-3, and 1.77 ±â€¯0.13 × 10-3 mg L-1, respectively. In addition, linear sweep voltammetry was used to monitor the BBD found at the concentration of 1.59 ±â€¯0.35 mg L-1 in wastewater collected from the beauty salon.

Barbershop Talk: African-American Men's Perceptions of Nursing as a Career.

African-American men are significantly underrepresented in nursing. An increase in African-American nurses would more accurately represent the patient demographic and has the potential of mitigating health disparities in this population. This study used a qualitative approach with interviews from 7 participants recruited from barbershops in Northern California. As a result, 3 major themes emerged from the data: (a) minimal understanding of how to become a nurse, (b) the stigma of a feminized profession, and (c) a need for African-American men in nursing. Furthermore, this study found that barbershops are a viable setting for obtaining the perspectives of African-American men. This data provides important information about where schools of nursing can focus resources when trying to recruit African-American men. Providing detailed information about what nurses do and by depicting how nursing has changed over the decades to include men might be a mechanism for African-American men to consider nursing as a career option.

Outreach Strategies to Recruit Low-Income African American Men to Participate in Health Promotion Programs and Research: Lessons From the Men of Color Health Awareness (MOCHA) Project.

African American men continue to bear a disproportionate share of the burden of disease. Engaging these men in health research and health promotion programs-especially lower-income, African American men who are vulnerable to chronic disease conditions such as obesity and heart disease-has historically proven quite difficult for researchers and public health practitioners. The few effective outreach strategies identified in the literature to date are largely limited to recruiting through hospital clinics, churches, and barbershops. The Men of Color Health Awareness (MOCHA) project is a grassroots, community-driven initiative that has developed a number of innovative outreach strategies. After describing these strategies, we present data on the demographic and health characteristics of the population reached using these methods, which indicate that MOCHA has been highly effective in reaching this population of men.

UK trends of allergic occupational skin disease attributed to fragrances 1996-2015.

BACKGROUND: Fragrances are well known to cause allergic contact dermatitis (ACD). Occupationally related cases occur, with certain groups being at higher risk. OBJECTIVE: To investigate the incidence of occupationally related cases of cutaneous fragrance allergy and to evaluate trends. METHOD: Data on incident cases of occupational ACD caused by fragrances between 1996 and 2015 (inclusive) reported to the EPIDERM surveillance scheme were analysed. RESULTS: Of the cases reported to EPIDERM during the study period, 5.2% had ACD attributed to fragrances. The highest annual incidence rates were observed in women. Hairdressers, beauticians and people working in related occupations had a 47-fold higher incidence rate ratio than the reference category (the average of all other occupations combined). Trends analysis suggested a non-significant increase in fragrance allergy over the study period among all occupations, and beauty and food workers, and a slight decrease in healthcare workers. CONCLUSIONS: Fragrance allergy is a significant problem in an occupational setting. Although there was no significant change in the incidence of fragrance-related allergic occupational contact dermatitis (OCD) during the 20-year study period, this does not mirror the trend in OCD, which is falling. Fragrance allergy continues to be a major contributor to OCD, and contributes to a greater proportion of cases.

Organizational-Level Recruitment of Barbershops as Health Promotion Intervention Study Sites: Addressing Health Disparities Among Black Men.

This article describes the process and results associated with the organizational-level recruitment of Black barbershops into Fitness in the Shop (FITShop), a 6-month barbershop-based intervention study designed to promote physical activity among Black men. Organizational-level recruitment activities included (1) a telephone call to prospective barbershop owners to assess their interest and eligibility for participation, (2) an organizational eligibility letter sent to all interested and eligible barbershops, (3) a visit to interested and eligible barbershops, where a culturally sensitive informational video was shown to barbershop owners to describe the study activities and share testimonies from trusted community stakeholders, and (4) a signed agreement with barbershop owners and barbers, which formalized the organizational partnership. Structured interviews were conducted with owners of a total of 14 enrolled barbershops, representing 30% of those determined to be eligible and interested. Most enrolled shops were located in urban settings and strip malls. Barbershop owners were motivated to enroll in the study based on commitment to their community, perceived client benefits, personal interest in physical activity, and a perception that the study had potential to make a positive impact on the barbershop and on reducing health disparities. Results offer important insights about recruiting barbershops into intervention trials.

Feasibility of Assessing Falls Risk and Promoting Falls Prevention in Beauty Salons.

Falls are a major public health risk and a leading cause of emergency room visits for people of all ages. Finding ways to increase access to information and evidence-based falls prevention strategies is critically important across the lifespan. We tested the feasibility of conducting a falls risk assessment and awareness program among customers who attend beauty salons. We enrolled 78 customers from 2 beauty salons who completed a written questionnaire as well as several biometric and functional balance tests designed to assess falls risk. On average, enrolled participants were 56 years of age (range: 19-90), female (n = 70, 91%), and Black (n = 47, 62%). Eleven percent of enrolled customers were classified as at high risk of falls because they had reported two or more falls in the last 6 months. We found that younger age, higher education, employment, moderate physical activity, and decreased frequency of salon visits were associated with fewer falls. Results demonstrated initial interest in, and the feasibility of recruiting and enrolling customers into a beauty salon-based falls risk assessment and awareness program. Beauty salons, which are in all communities, represent an innovative setting for reaching people of all ages with life-saving falls prevention information and services.

Rural Shop-Based Health Program Planning: a Formative Research Approach Among Owners.

African American barbershops and beauty salons are settings that have been identified as a significant and culturally relevant venue to reach minority populations for health promotion activities. By being located in almost every town in the USA, this setting is a viable means to promote healthy lifestyles among African Americans. The purpose of this formative research project was to assess African American barbershop and beauty salon owners' perceptions of providing health promotion programming in their shops, as well as to obtain information on health topics of interest and strategies for implementation. Interviewees were recruited using snowballing among clientele and owner referrals, between November 2014 and August 2015. A total of 20 barbershop and salon owners, across 11 counties in eastern North Carolina, completed face-to-face interviews. Responses were stratified by barbershops and beauty salons. Across both groups, all owners stated it would be a good idea to have health programs/interventions within the shop setting. Most noted topics of interest included diet and nutrition, hypertension, and (wo)men's reproductive health. When asked further about these desired topics, both benefits and relevance to customers and the African American community were the reasons for their selections. In addition, across barbershops and salons, 90 % of owners stated interest in having a program implemented in their shop. This information will be used to guide the development of shop-based interventions, with the aid of a community advisory board composed of shop owners, individual barbers and stylists and customers.

Alternative Locales for the Health Promotion of African American Men: A Survey of African American Men in Chicago Barbershops.

African American men (AA) carry unequal burdens of several conditions including cancer, diabetes, hypertension, and HIV. Engagement of diverse populations including AA men in research and health promotion practice is vital to examining the health disparities that continue to plague many racially and ethnically diverse communities. To date, there is little research on best practices that indicate locations, community areas and settings to engage AA men in research and health promotion. Traditionally, the AA church has been a key area to engage AA men and women. However, changing tides in attendance of AA parishioners require additional information to identify areas where AAs, particularly, AA men congregate. The AA barbershop has been identified as a place of social cohesion, cultural immersion and solidarity for AA men but specific sub-populations of AA men may be underrepresented. To further investigate additional locales where AA men congregate, this study engaged AA barbers and clients in several urban community barbershops in Chicago, Illinois. 127 AA men over age 18y/o receiving grooming services in 25 Chicago area barbershops across 14 predominantly AA communities were consented and recruited for a quantitative survey study. The self-administered surveys were completed in ~15 min and $10 compensation was provided to men. Descriptive statistics were reported for demographic variables and for frequency of responses for locations to find AA men of specific age ranges for health promotion and screening activities. Outside of the traditionally used churches or barbershops, the top recommended recruitment sites by age were: 18-29y/o- city park or a recreational center; 30-39y/o- gym, bars or the street; 40-49y/o- various stores, especially home improvement stores, and the mall; and 50y/o+- fast food restaurants in the mornings, such as McDonalds, and individual's homes. The study participants also reported that locations where AA men congregate vary by age. Findings from this study illustrate that AA barbers and barbershops remain a key stakeholder in health promotion among AA men. The findings also demonstrate the need for additional research to examine best practices for identifying locations where diverse groups of AA men that vary by age and sexual orientation may congregate in order to support increased health promotion among AA men.

A Survey of African American Men in Chicago Barbershops: Implications for the Effectiveness of the Barbershop Model in the Health Promotion of African American Men.

The barbershop has been used to target African American (AA) men across age groups for health screenings, health interventions, and for research. However, few studies explore the sociodemographic characteristics of barbers and their clients. Additionally, few have evaluated the client's relative comfort with receiving health information and screenings in barbershops and other non-clinical settings. Lastly, it is unknown whether barbers feel capable of influencing health-decision making of AA men. AA male clients and barbers completed a self-administered survey in barbershops in predominantly AA neighborhoods throughout Chicago, Illinois. We assessed sociodemographic characteristics and attitudes towards receiving physical and mental health education and screenings in barbershops and other settings. Barbers were also surveyed regarding their most and least common clients by age group and their perceived ability to influence the decision-making of AA males by age group. AAs surveyed in barbershops have similar rates of high school completion, poverty and unemployment as the AA residents of their neighborhood. AA males prefer to receive health education and screening in clinician offices followed by barbershops and churches. Barbers reported serving males age 18-39 years of age most frequently while men 50 years and older were the least served group. Overall, barbers did not believe they could influence the decision-making of AA men and in the best case scenario, only 33 % felt they could influence young men 18-29 years old. Barbershops reach AA men that are representative of the demographics of the neighborhood where the barbershop is located. Barbers reach a small population of men over age 49 and feel incapable of influencing the decisions of AAs over age 39. Further studies are needed to assess other locales for accessing older AA men and to evaluate the feasibility of mental health interventions and screenings within the barbershop.

The Role of the Skin Barrier in Occupational Skin Diseases.

Occupational skin diseases (OSDs) are the second most common occupational diseases worldwide. Occupational contact dermatitis (OCD) is the most frequent OSD, and comprises irritant contact dermatitis (ICD), allergic contact dermatitis (ACD), contact urticaria and protein contact dermatitis. There are many endogenous and exogenous factors which affect the development of OCD, including age, sex, ethnicity, atopic skin diathesis, certain occupations and environmental factors. One of the most important contributing causes is skin barrier dysfunction. The skin provides a first-line defense from environmental assaults and incorporates physical, chemical and biological protection. Skin barrier disturbance plays a crucial role in various skin diseases such as atopic dermatitis (AD), ichthyosis, ICD and ACD. Genetic factors, such as filaggrin gene (FLG) mutations, and external factors, such as skin irritants interfering with stratum corneum structure and composition, may lead to abnormalities in skin barrier function and increased vulnerability to skin diseases. FLG encodes the cornified envelope protein, filaggrin, which is involved in skin barrier function. FLG mutation is associated with the development of OCD. High-risk occupations for OCD include health care workers, hairdressers and construction workers. There are often multiple contributing causes to OCD, as workers are exposed to both irritants and allergens. AD is also associated with skin barrier disruption and plays an important role in OCD. ICD often precedes and facilitates the development of ACD, with impairment of the skin barrier contributing to the concurrence of ICD and ACD in many workers with OCD.

Screening at hair salons: The feasibility of using community resources to screen for intimate partner violence.

BACKGROUND: Intimate partner violence (IPV) is a source of severe health consequences, and therefore, health care organizations have recommended routine IPV screening. Implementing health-related screenings outside of health care facilities is common public health practice, but to date, IPV screening in hair salons has not been reported. The objective of this study was to determine the prevalence of IPV among women at hair salons. We hypothesized that women would disclose IPV in this setting and that rates of abuse would reflect national averages. METHODS: We recruited a convenience sample of hair salons in Connecticut in 2014. Hair stylists were trained on how to recognize and refer IPV victims. Self-reported IPV of salon clients was measured by a tablet-based validated screening tool, the Patient Satisfaction and Safety Survey. RESULTS: Overall, reported past-year prevalence of physical abuse was 3.6%, past-year prevalence of sexual abuse was 2.7%, lifetime prevalence of emotional or physical abuse was 34.2%, and 5.3% of the sample reported that they had been hurt that day by their current or former partner. Past-year physical abuse was more common among women 30 years to 39 years old (9.1%), black (9%), and single women (7.5%). Past-year sexual abuse was more common among women 20 years to 29 years old (13.8%), other races (6.7%), and single women (5.4%). Lifetime abuse was more common among women 50 years to 59 years old (13.8%), black (36.1%), and divorced women (69.7%). Hurt-today abuse was more common among women younger than 20 years (12.5%), other races (13.3%), and women in common law relationships (25%). CONCLUSION: Women in our study reported IPV prevalence rates consistent with national data. Documentation of IPV prevalence in hair salons will provide much-needed support for novel interventions such as CUT IT OUT, a national program designed to train hair stylists on how to recognize and refer IPV victims.

Occupational skin disease in Victoria, Australia.

OBJECTIVES: To describe the characteristics of patients with occupational skin disease (OSD) in a tertiary referral clinic in Victoria, Australia. METHODS: A retrospective review was conducted of records from patients seen at the Occupational Dermatology Clinic in Melbourne, Australia between 1 January 1993 and 31 December 2010. RESULTS: Of the 2894 people assessed in the clinic during the 18-year period, 44% were women and 56% were men. In all, 2177 (75%) were diagnosed with occupational skin disease (OSD). Of the patients with a work-related skin condition, 45% (n = 979) were considered to be atopic. The most common diagnosis in those with OSD was irritant contact dermatitis (ICD) (44%), followed by allergic contact dermatitis (33%) and endogenous eczema (11%). Women were significantly more likely to have soaps and detergents (P < 0.001) and water/wet work (P < 0.001) as causes of their ICD than men. Men were significantly more likely to have oils and coolants (P < 0.001) and solvent exposures (P < 0.001) as causes of their ICD. Occupational groups with the highest incidence of OSD were the hair and beauty professions (70 per 100 000), followed by machine and plant operators (38 per 100 000) and health-care workers (21 per 100 000). CONCLUSION: We confirm the importance of occupational contact dermatitis as the most common cause of OSD, with ICD being the most common diagnosis. There are differences in the causes of ICD between our group of male and female workers. For the first time in Australia, rates of OSD in certain industries have been calculated.