From the Journals

Barbers have role in encouraging diabetes screening in black men



Shave and a haircut … and a blood glucose test? A study shows that barbershops owned by black proprietors can play a role in encouraging black men to get screened for diabetes.

In research letter published in the Jan. 27 edition of JAMA Internal Medicine, Marcela Osorio, BA, from New York University and coauthors wrote that black men with diabetes have disproportionately high rates of diabetes complications and lower survival rates. Their diagnosis is often delayed, particularly among men without regular primary health care.

African American barber shop gisele/Getty Images

“In barbershops, which are places of trust among black men, community-based interventions have been successful in identifying and treating men with hypertension,” they wrote.

In this study, the researchers approached customers in eight barbershops in Brooklyn, in areas associated with a high prevalence of individuals with poor glycemic control, to encourage them to get tested for diabetes. All barbershops were owned by black individuals.

Around one-third of the 895 black men who were asked to participate in the study agreed to be screened, and 290 (32.4%) were successfully tested using point-of-care hemoglobin A1c testing.

The screening revealed that 9% of those tested had an HbA1c level of 6.5% or higher, and 16 of these individuals were obese. Three men had an HbA1c level of 7.5% or higher. The investigators noted that this prevalence of undiagnosed diabetes was much higher than the 3.6% estimated prevalence among New York City residents.

The highest HbA1c level recorded during testing was 7.8%, and 28.3% of those tested had a level between 5.7% and 6.4%, which meets the criteria for a diagnosis of prediabetes.

“We also found that barbers were important health advocates; although we do not have exact numbers, some customers (who initially declined testing) agreed after encouragement from their barber,” the authors wrote.

Of the 583 men who declined to participate, around one-quarter did so on the grounds that they already knew their health status or had been checked by their doctor, one-third (35.3%) said they were healthy or didn’t have the time or interest, or didn’t want to know the results. There were also 26 individuals who reported being scared of needles.

“Black men who live in urban areas of the United States may face socioeconomic barriers to good health, including poor food environments and difficulty in obtaining primary care,” the authors wrote. “Our findings suggest that community-based diabetes screening in barbershops owned by black individuals may play a role in the timely diagnosis of diabetes and may help to identify black men who need appropriate care for their newly diagnosed diabetes.”

The study was supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Two authors declared grants from the institute during the study, and one also reported grants from other research foundations outside the study.

SOURCE: Osorio M et al. JAMA Intern Med. 2020 Jan 27. doi: 10.1001/jamainternmed.2019.6867.

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