Can communities promote better healthcare outcomes?

A recent study in the Archives of Internal Medicine, “Effectiveness of a Barber-Based Intervention for Improving Hypertension Control in Black Men” is a great example of the power of communities to promote better healthcare outcomes.

In this study, the researchers led by Dr. Ronald G. Victor (Cedars-Sinai Heart Institute, Los Angeles) and Dr. Robert Haley (University of Texas Southwestern Medical Center) set up two groups of African American men who visited barbers — the “baseline” group received standard blood pressure pamphlets on their visits to the barber; the “intervention” group received blood pressure checks with their haircuts and were prompted to follow-up with a physician.

The study found that while blood pressure results improved with both groups, there was more improvement with the intervention group — 11% in the baseline group versus 20% in the intervention group.

The power of this study is that it illustrates the effect that community involvement can have in improving health outcomes — African American barbers delivering a hypertension message to African American men, who as a group are particularly at risk of having high blood pressure. As Dr Haley concluded:

The barbers were the heroes of this story. They really stepped forward and made it part of their barber practice. They helped us show that social settings can be an integral part of health care in the black male population.

However, without taking anything away from this study, the difficulty is that it might may be hard to replicate with other barbers. Imagine, if you will, going to your local Super Cuts, for example, and having your blood pressure taken. Would you the customer find this strange or ok?

Moreover, certain retail outlets and diseases just won’t mix — for example, the local McDonald’s might not be the best place to promote lower cholesterol (my apologies to McDonald’s and fast food chains).

Rather, the value is not in thinking of retail locations vis-a-vis a particular disease. The value of this study is in illustrating how positive health outcomes can be promoted by:

  • using trusted members of the community
  • to deliver a message that has meaning to that community
  • in a manner that community is used to hearing

Boxcutters Gem #733 – Use trusted members of the community to deliver a message that has meaning to that community in a manner that community is used to hearing.

    2 Responses to “Can communities promote better healthcare outcomes?”
    1. This data can’t be taken lightly as it does show a level of effectiveness. Actually, this kind of initiative has been done many times over – see Association of Black Cardiologists ( and National Medical Association ( While I agree that not all shop operators – beauty salons AND barber shops are equally able to produce great outcomes it has been shown that the playing field can be leveled with appropriate staff training up front.

      In addition, there have been numerous faith-based organizations that have produced positive outcomes. I am sure there are countless others that I don’t cite here. I agree these are examples of trusted members of the community able to deliver healthy messages and promoting healthy behavior. But that IS the significance – patients are diagnosed in the provider’s office then go home to continue treatment on their own Patients live in their community and in the community is where the opportunity is to simply reinforce the messages heard when diagnosed.

      Let’s throw in the issue of cultural relevance to complicate this. Data show there are cultural barriers not always realized by a provider of a different ethnicity, how most patients are treated. However, in the comfort of the community those barriers may come down and a patient could be more open to listening and acting on the very same messages they heard in their provider’s office.

    2. Michael Wong says:

      @dialdoctors comments:
      “This can be a wonderful measure. After all most people already get their advice from peers not necessarily doctors.”

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