Acceptability of a Salon-Based Intervention to Promote Colonoscopy Screening Among African American Women

PrEP-aring stylists: Development of a stylist educational workshop to increase PrEP awareness and knowledge among Black women in the US south

BACKGROUND

Black cis-gender women are disparately affected by HIV and require prioritization in prevention efforts, including pre-exposure prophylaxis (PrEP). Preparing trusted community leaders such as salon stylists as health-based opinion leaders may be promising to increasing awareness, knowledge, and uptake of PrEP among Black women. We sought to develop training and better understand stylists who may participate in a salon-based PrEP intervention for Black women.

METHODS

A community-research partnership designed a stylist training workshop for stylists with a majority Black women clientele. A two-session workshop focused on HIV knowledge, HIV prevention including PrEP, and the role of an opinion leader to influence community social and health norms. An exploratory research design and analysis was conducted to examine stylists and provide training feedback.

CONCLUSIONS

Stylists showed a high level of knowledge and willingness to serve as an opinion leader in their salons and with their communities. Stylists also verified medical mistrust in the healthcare system that makes community-based interventions attractive. This article discusses how the training was piloted and accepted by stylists.

Decision-making on colorectal cancer screening in Curaçao - interviews with the target population

BACKGROUND

During the first year of the population based colorectal cancer (CRC) screening program on Curaçao, about 20% of invitees participated. This study explored the target population's perceptions and awareness on CRC (screening), beliefs on the program provision, their preferences and information needs for informed decision-making.

METHODS

Semi-structured interviews with 23 individuals, who were not yet invited for CRC screening, were recorded, transcribed, coded and analyzed.

RESULTS

CRC (screening) was discussed in the context of personal health, where own responsibility and food were important. Cancer was perceived as an unpredictable disease that causes suffering and leads to death and was also associated with fear. Despite being aware of the program, most respondents were not familiar with the screening procedure. Provision of the screening program was regarded positively and as an opportunity to contribute to health improvement. This seemed related to the expressed trust in the Caribbean Prevention Center (program organizer). Respondents preferred to make independent decisions about CRC screening participation. A personal approach, visual aids and media were the preferred sources of information.

CONCLUSION

The results of our interviews suggest that it may be beneficial to provide information on CRC screening in Curaçao within the context of personal health. While including sensitivity to fears and respect for the autonomy of the target population. Finally, electronic media maybe useful in supporting informed decision-making.

The association between socioeconomic status and use of potentially inappropriate medications in older adults

BACKGROUND

Potentially inappropriate medication (PIM) use is an important public health problem, particularly among older adults who may need multiple pharmacologic therapies for various chronic conditions. As socioeconomic status (SES) affects the quality of healthcare that individuals receive, SES may be associated with the use of PIM in older adults. This study aimed to determine whether low SES is associated with increased use of PIM.

METHODS

We studied 4927 participants (aged 66-90 years) who were on at least one medication at visit five (2011-2013) of the Atherosclerosis Risk in Communities Study. We created a cumulative SES score categorized as high (7-9), middle (3-6), and low (0-2) based on education, income, and area deprivation index. We use multivariable logistic regression to examine the associations between SES and use of two or more PIM for older adults, defined by the 2019 Beers Criteria.

RESULTS

A total of 31.0% and 6.9% of the participants used one or more PIM and two or more PIM, respectively. After adjusting for demographic characteristics and insurance type, low cumulative SES score was associated with significantly greater use of two or more PIM (odds ratio [OR] = 1.83 [95% confidence interval (CI) 1.18-2.86]), as was middle cumulative SES score (OR = 1.40 [95% CI 1.06-1.83]), compared to high cumulative SES score. The results remained significant after further adjusting for comorbidities and medication burden for low cumulative SES score (OR = 1.66 [95%CI 1.02-2.71]).

CONCLUSIONS

We found that lower SES was associated with greater use of PIM among older adults independent of their medication burden and comorbidities, suggesting socioeconomic disparities in quality of medication management. Focused efforts targeting older adults with low SES to reduce PIM use may be needed to prevent adverse drug events.

Using PrEP and Doing it for Ourselves (UPDOs Protective Styles), a Web-Based Salon Intervention to Improve Uptake of Pre-exposure Prophylaxis Among Black Women: Protocol for a Pilot Feasibility Study

BACKGROUND

Multilevel interventions are necessary to address the complex social contributors to health that limit pre-exposure prophylaxis use among Black women, including medical distrust, pre-exposure prophylaxis stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of pre-exposure prophylaxis among Black women will be more successful if information-sharing and implementation take place within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision-making about pre-exposure prophylaxis for themselves and members of their social networks who are eligible for pre-exposure prophylaxis.

OBJECTIVE

The goal of this project is to improve knowledge, awareness, uptake, and trust of pre-exposure prophylaxis, as well as reduce pre-exposure prophylaxis stigma, among Black women living in the US South.

METHODS

This multilevel, mixed methods study uses a community-engagement approach to develop and pilot test a salon-based intervention. There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of a pre-exposure prophylaxis navigator. First, stylist training will be provided through two 2-hour training sessions delivered over 2 consecutive weeks. We will use a pre- and posttest design to examine knowledge and awareness improvement of pre-exposure prophylaxis among the stylists. Upon full completion of training, the stylists will receive a certificate of completion and "Ask Me about PrEP" signage for their beauty salons. Second, together with the community, we have codeveloped a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (1) HIV, (2) pre-exposure prophylaxis, and (3) Black women's social contributors to health. Quantitative and qualitative measures will be used in a pre- and posttest design to examine pre-exposure prophylaxis knowledge, awareness, risk, stigma, trust, intentions, and women's perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog will be provided after each video. Third, participants will have access through an email or text message link to a pre-exposure prophylaxis navigator, who will respond to them privately to answer questions or make referrals for pre-exposure prophylaxis as requested.

RESULTS

This project was funded in October 2020 by Gilead Sciences and was approved by the Duke University School of Nursing institutional review board in April 2021 (Pro00106307). Intervention components were developed in partnership with community partners in the first year. Data collection for phase 1 began in April 2022. Data collection for phase 2 began in May 2022. The study will be complete by October 2022.

CONCLUSIONS

Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks. The findings of this study have the potential to be generalizable to other populations.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/34556.

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

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 .

Perspectives of Black women in the United States on salon-based intervention to promote the uptake of pre-exposure prophylaxis (PrEP) for HIV

AIMS AND OBJECTIVES

To understand Black women's perspectives on a pre-exposure prophylaxis (PrEP) education intervention in a salon setting.

BACKGROUND

Black women have a significant lifetime risk of acquiring HIV. Pre-exposure prophylaxis (PrEP) is an effective prevention approach in reducing that risk. Despite this, Black women are least likely to use PrEP.

DESIGN

This was a qualitative study to identify Black women's perspectives on acceptability of a PrEP education intervention in a salon setting using hair stylists. The paper adhered to the COREQ checklist in reporting.

METHODS

Seven focus groups among Black women (n = 44) living in north-central North Carolina were conducted. Ethical approval was obtained. The interview guide included questions on knowledge of PrEP and barriers and facilitators to a PrEP promotion programme in a salon setting.

RESULTS

Conventional content analysis considered content in relation to themes of facilitators, barriers and women's preferences for intervention delivery. Facilitators included the salon characteristics, social culture and relationship with the stylist. Women noted concerns of accuracy of content from stylists and privacy as barriers.

CONCLUSIONS

Participants' trust with their stylists make a PrEP education salon-based intervention feasible. Salon-based interventions are not one-size-fits-all and researchers interested in this setting should tailor interventions to the individual salon. Interventions for PrEP in a salon setting should be culturally appropriate, confidential and consider the potential reach to the social networks of Black women in the salon.

RELEVANCE TO CLINICAL PRACTICE

The insights shared by Black women can contribute to developing a PrEP uptake intervention as a way of reducing new cases of HIV.

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.

The role of a cosmetologist in the area of health promotion and health education: A systematic review

Background: Contemporary cosmetology, apart from beautifying and caring for the human body, deals also with prevention aimed at maintaining health and physical fitness as long as possible. The profession of a cosmetologist so understood is closely related to the modern concept of health promotion, the part of which is health education. The objective of this review was to evaluate whether a cosmetologist may be a health promoter, and whether a beauty salon mayserve as a place for conducting educational programs.

Methods: A systematic review was done using several electronic databases such as PubMed(including MEDLINE), Web of Science Core Collection, Scopus, Embase, and Academic Search Ultimate (EBSCO) and related keywords. The studies published in English between 2008 and 2018 which had specifically mentioned the role of a cosmetologist in the area of health promotion and health education were included.

Results: In total, 7 articles met the study criteria. It was found that cosmetologists have the potential to promote pro-health activities. The results of this review also suggest that beauty salons are suitable places for increasing pro-health awareness and can be successfully used to conduct educational programs about healthy lifestyle, as well as skin, breast and cervical cancer prevention.

Conclusion: A well-educated and aware of health risks cosmetologist seems to be the right person to transmit and spread knowledge about the proper lifestyle in her workplace and the local environment. A beauty salon, as a place of social interaction, may constitute an area of implementation of pro-health educational programs.

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.