Effectiveness of a barber-based intervention for improving hypertension control in black men - The BARBER-1 study: A cluster randomized trial

Ronald G. Victor, Joseph E. Ravenell, Anne Freeman, David Leonard, Deepa G. Bhat, Moiz Shafiq, Patricia Knowles, Joy S. Storm, Emily Adhikari, Kirsten Bibbins-Domingo, Pamela G. Coxson, Mark J. Pletcher, Peter Hannan, Robert W. Haley

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Background: Barbershop-based hypertension (HTN) outreach programs for black men are becoming increasingly common, but whether they are an effective approach for improving HTN control remains uncertain. Methods: To evaluate whether a continuous high blood pressure (BP) monitoring and referral program conducted by barbers motivates male patrons with elevated BP to pursue physician follow-up, leading to improved HTN control, a cluster randomized trial (BARBER-1) of HTN control was conducted among black male patrons of 17 black-owned barbershops in Dallas County, Texas (March 2006-December 2008). Participants underwent 10-week baseline BP screening, and then study sites were randomized to a comparison group that received standard BP pamphlets (8 shops, 77 hypertensive patrons per shop) or an intervention group in which barbers continually offered BP checks with haircuts and promoted physician follow-up with sex-specific peer-based health messaging (9 shops, 75 hypertensive patrons per shop). After 10 months, follow-up data were obtained. The primary outcome measure was change in HTN control rate for each barbershop. Results: The HTN control rate increased more in intervention barbershops than in comparison barbershops (absolute group difference, 8.8% [95% confidence interval (CI), 0.8%-16.9%]) (P=.04); the intervention effect persisted after adjustment for covariates (P=.03). A marginal intervention effect was found for systolic BP change (absolute group difference, -2.5 mm Hg [95% CI, -5.3 to 0.3 mm Hg]) (P=.08). Conclusions: The effect of BP screening on HTN control among black male barbershop patrons was improved when barbers were enabled to become health educators, monitor BP, and promote physician follow-up. Further research is warranted. Trial Registration: clinicaltrials.gov Identifier: NCT00325533

Original languageEnglish (US)
Pages (from-to)342-350
Number of pages9
JournalArchives of Internal Medicine
Volume171
Issue number4
DOIs
StatePublished - Feb 28 2011
Externally publishedYes

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Hypertension
Blood Pressure
Physicians
Blood Pressure Monitors
Confidence Intervals
Health Educators
Pamphlets
Referral and Consultation
Outcome Assessment (Health Care)
Health
Research

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Effectiveness of a barber-based intervention for improving hypertension control in black men - The BARBER-1 study : A cluster randomized trial. / Victor, Ronald G.; Ravenell, Joseph E.; Freeman, Anne; Leonard, David; Bhat, Deepa G.; Shafiq, Moiz; Knowles, Patricia; Storm, Joy S.; Adhikari, Emily; Bibbins-Domingo, Kirsten; Coxson, Pamela G.; Pletcher, Mark J.; Hannan, Peter; Haley, Robert W.

In: Archives of Internal Medicine, Vol. 171, No. 4, 28.02.2011, p. 342-350.

Research output: Contribution to journalArticle

Victor, RG, Ravenell, JE, Freeman, A, Leonard, D, Bhat, DG, Shafiq, M, Knowles, P, Storm, JS, Adhikari, E, Bibbins-Domingo, K, Coxson, PG, Pletcher, MJ, Hannan, P & Haley, RW 2011, 'Effectiveness of a barber-based intervention for improving hypertension control in black men - The BARBER-1 study: A cluster randomized trial', Archives of Internal Medicine, vol. 171, no. 4, pp. 342-350. https://doi.org/10.1001/archinternmed.2010.390
Victor, Ronald G. ; Ravenell, Joseph E. ; Freeman, Anne ; Leonard, David ; Bhat, Deepa G. ; Shafiq, Moiz ; Knowles, Patricia ; Storm, Joy S. ; Adhikari, Emily ; Bibbins-Domingo, Kirsten ; Coxson, Pamela G. ; Pletcher, Mark J. ; Hannan, Peter ; Haley, Robert W. / Effectiveness of a barber-based intervention for improving hypertension control in black men - The BARBER-1 study : A cluster randomized trial. In: Archives of Internal Medicine. 2011 ; Vol. 171, No. 4. pp. 342-350.
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abstract = "Background: Barbershop-based hypertension (HTN) outreach programs for black men are becoming increasingly common, but whether they are an effective approach for improving HTN control remains uncertain. Methods: To evaluate whether a continuous high blood pressure (BP) monitoring and referral program conducted by barbers motivates male patrons with elevated BP to pursue physician follow-up, leading to improved HTN control, a cluster randomized trial (BARBER-1) of HTN control was conducted among black male patrons of 17 black-owned barbershops in Dallas County, Texas (March 2006-December 2008). Participants underwent 10-week baseline BP screening, and then study sites were randomized to a comparison group that received standard BP pamphlets (8 shops, 77 hypertensive patrons per shop) or an intervention group in which barbers continually offered BP checks with haircuts and promoted physician follow-up with sex-specific peer-based health messaging (9 shops, 75 hypertensive patrons per shop). After 10 months, follow-up data were obtained. The primary outcome measure was change in HTN control rate for each barbershop. Results: The HTN control rate increased more in intervention barbershops than in comparison barbershops (absolute group difference, 8.8{\%} [95{\%} confidence interval (CI), 0.8{\%}-16.9{\%}]) (P=.04); the intervention effect persisted after adjustment for covariates (P=.03). A marginal intervention effect was found for systolic BP change (absolute group difference, -2.5 mm Hg [95{\%} CI, -5.3 to 0.3 mm Hg]) (P=.08). Conclusions: The effect of BP screening on HTN control among black male barbershop patrons was improved when barbers were enabled to become health educators, monitor BP, and promote physician follow-up. Further research is warranted. Trial Registration: clinicaltrials.gov Identifier: NCT00325533",
author = "Victor, {Ronald G.} and Ravenell, {Joseph E.} and Anne Freeman and David Leonard and Bhat, {Deepa G.} and Moiz Shafiq and Patricia Knowles and Storm, {Joy S.} and Emily Adhikari and Kirsten Bibbins-Domingo and Coxson, {Pamela G.} and Pletcher, {Mark J.} and Peter Hannan and Haley, {Robert W.}",
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AU - Victor, Ronald G.

AU - Ravenell, Joseph E.

AU - Freeman, Anne

AU - Leonard, David

AU - Bhat, Deepa G.

AU - Shafiq, Moiz

AU - Knowles, Patricia

AU - Storm, Joy S.

AU - Adhikari, Emily

AU - Bibbins-Domingo, Kirsten

AU - Coxson, Pamela G.

AU - Pletcher, Mark J.

AU - Hannan, Peter

AU - Haley, Robert W.

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