There have been other efforts that use the barbershop as a site for health education, typically focused on HIV/AIDS prevention in cities such as Memphis and Atlanta. The Centers for Disease Control and Prevention run an initiative, Business Responds to AIDS (BRTA), that teams with private businesses to promote HIV and AIDS education. A large part of that effort focuses on black barbers and beauty professionals as a conduit into that community.
However, Victor’s studies are the first initiatives that train barbers to do the initial medical screening rather than partnering with local healthcare workers. In many ways, barbershops are the ideal location for medical outreach—they have a large and frequent customer base. “Barbers are trusted peers. They have a lot of respect in their community, more than healthcare workers,” Victor says.
In addition to loyal clientele and a privileged position within the African American community, Victor sees other benefits to using the barbershop as a venue for hypertension intervention. “The chair is perfect for measuring blood pressure,” explains Victor, who cites the high, straight back typical of barber chairs. Customers are also relaxed while sitting in the chair, and Victor advises barbers to take clients’ blood pressure at the end of the haircut, rather than when they first sit down.
Victor and his associates are currently writing the training manual to teach barbers how to measure blood pressure. The training also includes a module on the ethics of human research. “Barbers have a good instinct about dealing with customers,” Victor maintains. “We would like them to recruit [participants] but not be coercive or step over the line. They have a good feel for these kinds of issues.”
Victor’s study will also teach the technical aspects of measuring blood pressure, including how to choose the right size cuff, how to get an accurate reading, and how to interpret the results. Customers who have their blood pressure taken will be given a bar coded membership card to track their meetings with their barbers and whether they sought follow-up care with one of the partner health facilities.
Victor hopes that if the study proves to be effective, they can scale the project to a national level. “The idea would be that at the end of the study we develop business models that are sustainable,” he says. With the launch of the Affordable Care Act, there is increased pressure on healthcare providers to find ways to cut costs without compromising quality. Insurance-plan reimbursements are also tied more closely to specific outcomes.
Victor is hoping barbershop blood pressure measurements will eventually be seen as a legitimate enough path for early intervention that insurance plans will want to adopt this model as well. The earlier study concluded that if similar programs were introduced into the estimated 18,000 black barbershops in the U.S., it would result in 800 fewer heart attacks in the first year, 500 fewer strokes, and 900 fewer deaths.
It’s not hard for both customers and barbers to see the benefits. Basil Hewitt, an engineer getting a trim on a recent Sunday at LA’s Headmasters, saw the upside immediately. “It’s pretty cost-effective if you can get to people where they’re at,” he says. “In the long run, we’re all paying for these health consequences so if we can get to it early, every American is going to save money.”