Effectiveness of a Barber-Based Intervention for Improving Hypertension Control in Black Men The BARBER-1 Study: A Cluster Randomized Trial
Effectiveness of a Barber-Based Intervention for Improving Hypertension Control in Black Men The BARBER-1 Study: A Cluster Randomized Trial
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DOI：
10.1001/archinternmed.2010.390
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发表时间：
2011-02-28
影响因子：
--
通讯作者：
Haley, Robert W.
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文献类型：
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作者：
Victor, Ronald G.;Ravenell, Joseph E.;Haley, Robert W.
背景资料：以理发店为基础的黑人男性高血压（HTN）外展项目越来越普遍，但它们是否是改善HTN控制的有效方法仍不确定。为了评估理发师进行的持续高血压（BP）监测和转诊计划是否能激励血压升高的男性顾客进行医生随访，从而改善HTN控制，在德克萨斯州达拉斯县的17家黑人拥有的理发店的黑人男性顾客中进行HTN对照的群集随机试验（BARBER-1）（2006年3月-2008年12月）。参与者接受了10周的基线BP筛查，然后研究地点被随机分配到一个对照组，接受标准的BP小册子（8家商店，每家商店77名高血压顾客）或一个干预组，其中理发师不断提供BP检查理发，并通过性别特异性的同行健康信息促进医生随访（9家商店，每家商店75名高血压顾客）。10个月后，获得随访数据。结果：干预理发店的HTN控制率比对照理发店增加更多（绝对组差异，8.8% [95%置信区间（CI），0.8%-16.9%]）（P= 0.04）;调整协变量后，干预效果持续存在（P= 0.03）。发现收缩压变化的边际干预效应（绝对组差，-2.5 mm Hg [95%CI，-5.3至0.3 mm Hg]）（P= 0.08）。结论：当理发师能够成为健康教育者，监测血压，促进医生随访时，黑人男性理发店顾客中血压筛查对HTN控制的影响得到改善。进一步的研究是必要的。
Background: Barbershop-based hypertension (HTN) outreach programs for black men are becoming increasingly common, but whether they are an effective approach for improving HTN control remains uncertain.Methods: To evaluate whether a continuous high blood pressure (BP) monitoring and referral program conducted by barbers motivates male patrons with elevated BP to pursue physician follow-up, leading to improved HTN control, a cluster randomized trial (BARBER-1) of HTN control was conducted among black male patrons of 17 black-owned barbershops in Dallas County, Texas (March 2006-December 2008). Participants underwent 10-week baseline BP screening, and then study sites were randomized to a comparison group that received standard BP pamphlets (8 shops, 77 hypertensive patrons per shop) or an intervention group in which barbers continually offered BP checks with haircuts and promoted physician follow-up with sex-specific peer-based health messaging (9 shops, 75 hypertensive patrons per shop). After 10 months, follow-up data were obtained. The primary outcome measure was change in HTN control rate for each barbershop.Results: The HTN control rate increased more in intervention barbershops than in comparison barbershops (absolute group difference, 8.8% [95% confidence interval (CI), 0.8%-16.9%]) (P=.04); the intervention effect persisted after adjustment for covariates (P=.03). A marginal intervention effect was found for systolic BP change (absolute group difference, -2.5 mm Hg [95% CI, -5.3 to 0.3 mm Hg]) (P=.08).Conclusions: The effect of BP screening on HTN control among black male barbershop patrons was improved when barbers were enabled to become health educators, monitor BP, and promote physician follow-up. Further research is warranted.