A new study published Monday in the New England Journal of Medicine offers a clear reminder that you can get a lot of good done by meeting people where they are, rather than where you’d like them to be. It found that a health program organized through barbershops was very effective at helping non-Hispanic black men lower their blood pressure.
Researchers in Los Angeles recruited more than 50 black-owned barbershops to take part in a randomized experiment over almost two years.
The barbers were all trained to take the blood pressure of interested customers, and to nudge those with hypertension to see a doctor for a check-up as well as to eat healthier and become more active. But 28 barbershops were also asked to refer their customers to regularly meet with a specially trained pharmacist who would prescribe or adjust their blood pressure medication over a period of six months (the pharmacist would confirm with a physician to ensure they were giving safe drugs covered by insurance).
Oftentimes, the pharmacist would even meet the patient at the barbershop for their check-up. These pharmacist-supported barbershops, unlike the control group, would also have posters on the wall detailing authentic stories from past patients who enjoyed taking part in the study, known as the “Cut Your Pressure Too: The LA Barbershop Blood Pressure Study.”
In total, 319 black men from ages 35 to 79 with high blood pressure were enrolled in the study from 2015 to 2017. On average, their systolic blood pressure (the number on top that measures how hard our heart needs to contract while beating) was 152 milliliters of mercury, or mm HG. Both groups saw a meaningful drop in blood pressure within six months time, but those in the pharmacist-led group (132 volunteers) saw a whopping 27.00 mm HG decrease on average, as opposed to the 9.3 mm HG seen with the control group (171 volunteers). And nearly two-thirds of the pharmacist-led group had their overall blood pressure drop to below 130/80 mm HG (the ideal healthy reading being 120/70 mm hg).
“Bringing rigorous medicine directly to men in a barbershop, and making it so convenient for them, really made a difference,” lead author Ronald G. Victor, a cardiovascular physician at Cedars Sinai Medical Center as well as a professor at UCLA, told the Los Angeles Times.
Barbershops have been touted as a possible way to raise health awareness among black men for years now, since they’re a constant, trusted presence in the neighborhood (many in the study had visited their barbers every two weeks for a decade). Men in general are less likely to visit the doctor than women, while around 40 percent of black men in particular have high blood pressure—the highest of any racial or ethnic group among men. Black men are also less likely to have their hypertension controlled and have the highest death rate related to hypertension of any population group.
Victor and his team had in fact published a similar randomized barbershop study in 2011, which found modest improvements in those who had their blood pressure regularly monitored and were encouraged to stay healthy. But the new trial is the first to package drug therapy alongside the positive message. And the drastic improvements—more than double what Victor and his team had anticipated—suggest that it’s worth developing a scaled-up program in barbershops across the country.
Victor and his team are currently studying volunteers past the six month mark to see how long the changes last.