Heart disease and strokes cost the NHS around £9 billion per year. Cardiovascular conditions are a major driver of health inequalities: they are more likely to impact people living in deprived areas and are under-diagnosed in women and people from ethnic minorities.
In this study, ARC researchers will examine whether hairdressers in London can successfully promote messages to prevent heart disease and stroke by encouraging their clients to visit their GP for a health check-up. The hairdressers will be supported by nurses and health care assistants at local GP practices. This is an approach that has been successfully trialled in America, but not the UK.
The aim of the research is to determine the feasibility of recruiting, training and retaining hairdressers in salons - supported by nurses at local GP practices - to promote use of a culturally adapted online application to increase the uptake of NHS Health Checks and early detection of high blood pressure and diabetes in women living in deprived and ethnically diverse neighbourhoods.
Dr Mariam Molokhia, clinical reader in epidemiology & primary care at King’s College London, who is leading the study, says:
Hair salons are community health assets with untapped potential for embedding key health-promoting practices into everyday life in a culturally familiar and trusted context
Researchers will invite women attending hair salons in deprived and ethnically diverse areas of south and west London to join the study. The research will be carried out in three phases:
Phase 1 (Readiness): the team will consult hairdressers, clients, surgery nurses and health care assistants using online workshops or email feedback to develop a feasible action plan. This plan will identify culturally appealing content that can be used to adapt the online tool, how the tool can be accessed by users, and which salons and GP practices are suitable to participate.
Phase 2 (Intervention development): hairdressers will co-develop the online tool to fit their needs. The researchers will ask clients to try using blood pressure monitors at home with instructions about when to seek help from a nurse. They will train hairdressers in the use of the online tool and simple health promoting messages so they can respond to queries from clients. They will develop a plan of action with stakeholders for testing if hairdressers can encourage clients to have a check-up.
Phase 3 (Feasibility): the team will work with eight hairdressing salons and four GP practices. They will see whether hairdressers can promote the use of the tool by clients to book and attend their GP for a health check-up. They will ask hairdressers and clients about what enabled or prevented use, including any technological, financial or cultural factors. They will ask nurses and staff at the surgery about their experiences of supporting the hairdressers. The team will also collect data on recruitment of salons, hairdressers, clients, use of the online tool, attendance to GP for a check-up, and the numbers who continue to take part for six months.
If successful, these data will be used to design a larger study to examine if the tool reduces the chances of heart disease among women in deprived communities and whether it is good value for money.
This study has been designed in consultation with hairdressers, including a salon owner as co-investigator, and clients. The study targets salons that have clients from diverse ethnic groups. Community stakeholders and hairdressers will be invited to join an expert stakeholder group. The research team will publicise the results through community online forums, and jointly produced audio-visual and written materials for salons, communities and health professionals.
The research team are collaborating with community groups supporting ethnically diverse women (eg South Asian Health Foundation, BME Health Forum), professional salon groups (eg National Hair & Beauty Federation and the British Beauty Council), GPs, commissioners and policymakers with collaborative partnerships, and NHS engagement and improvement to discuss translation.
This study is funded by the NIHR Research for Patient Benefit (RfPB) Programme: NIHR202769. The project is due to complete by the end of 2023.