Barber-Based Intervention for Hypertension in Black Men

非西班牙裔黑人男性因未被发现、未治疗和未得到控制而遭受和死亡的比例不成比例 高血压：一种慢性无症状的疾病，需要经常监测、处方 药物治疗，以及由正规医疗提供者提供的持续护理。为了改进高血压检测， 在黑人男性的治疗和对照中，我们提出了一项随机对照试验来评估知情的 和可行的基于行为理论的干预，由理发师、有影响力的同行进行，他们将继续 监控客户的血压(BP)，传递旨在改变风险认知的健康信息 和关于医疗保健利用的社会规范，并为医疗保健方面的预期变化提供社会支持- 寻找行为和BP。我们的主要假设是持续的高血压检测和医疗转介 由有影响力的同龄人在接受社区环境(理发店)实施的计划将改变社会 规范医疗保健利用，促进就医行为，从而降低老年人的血压 血压偏高的常客。具体的行为目标是：1)增加对 理发期间的BP和对读数升高的认识；2)增加对常规医疗的新转诊 未经治疗的高血压的提供者，以及3)增加未接受治疗的患者的后续医疗预约 高血压。为了实现这些目标，社会认知理论/社区承诺(同伴 接触和建模干预策略)将推动干预，护士将在其中培训和 监督理发师测量血压，并在每次理发时向理发店客户传递健康信息 参观。为了验证我们的假设，24家以前没有研究过的理发店将经过一组- 随机化协议。每两个月将有四家新店入驻。串联横截面BP 调查(每次为期8周)将由训练有素的面试者进行，以获得准确的快照 24家理发店在10个月干预期前后的高血压控制 包括以理发师为基础的干预或没有积极干预。多层次分析方案利用 分层建模，以解决理发店内观察的群集和其他重要的 协变量。由于传播的潜力很大，提出了详细的传播计划；有 美国主要城市中心的18,000多家黑色理发店。

Non-Hispanic Black men suffer and die disproportionately from undetected, untreated, and uncontrolled hypertensiona chronic asymptomatic medical condition that requires frequent surveillance, prescription medication, and continuity of care by a regular medical provider. To improve hypertension detection, treatment, and control in Black men, we proposea randomized controlled trial to evaluate a well-informed and feasible behavior theory-based intervention conducted by barbers, influential peers who will continually monitor their customers' blood pressure (BP), deliver health messages designed to change risk perception and social norms about healthcare utilization, and provide social support for desired changes in healthcare- seeking behavior and BP. Our major hypothesis is that a continuous high BP detection and medical referral program conducted by influential peers in a receptive community setting (barbershops) will change social norms about healthcare utilization, promote treatment-seeking behavior, and thus lower BP among the regular customers with high BP. The specific behavioral objectives are to: 1) Increase the measurement of BP during haircuts and the recognition of elevated readings; 2) Increase new referrals to regular medical providers for untreated hypertension, and 3) Increase follow-up medical appointments for under-treated hypertension. To accomplish these objectives, Social Cognitive Theory/Community PROMISE(Peers Reaching Out and Modeling Intervention Strategies) will drive the intervention in which nurses will train and supervise barbers to measure BP and deliver health messages to barbershop customers at each haircut visit. To test our hypothesis, a cohort of 24 previously unstudied barbershops will go through agroup- randomization protocol. Four new shops will be enrolled everytwo months. Serial cross-sectional BP surveys (each lasting 8 weeks) will be conducted by trained interviewers to obtain accurate snap-shots of hypertension control in each of the 24 barbershops before and after a 10-month intervention period consisting of either barber-based intervention or no active intervention. The multilevel analysis plan utilizes hierarchical modeling to address clustering of observations within barbershops and other important covariates. A detailed dissemination plan is proposed as the potential for dissemination is high; there are over 18,000 Black barbershops in major urban centers acrossthe United States.