The BEauty and health community LOuNGes (BELONG) study: overview and preliminary findings

Problem

Avoidable mortalities caused by cardiovascular disease (CVD) have decreased in the last decade, yet in the most deprived areas of the United Kingdom, mortality rates remain four times higher than in the least deprived areas. CVD mortality is also higher among women from the Caribbean, Central and Western Africa and Southern Asia than for women born in European countries. In England, health checks services to improve CVD detection and management are freely available but their uptake has been below expected targets, with socioeconomic and ethnic inequalities. Previous research has suggested that community salons are ideal places for health promotion interventions.

Approach

Informed by social capital theory and systems-thinking, we will use a mixed-methods approach to explore the feasibility of recruiting, training, and retaining hairdressers in community salons to support NHS health check uptake. In phase 1, we have identified relevant areas for intervention delivery and conducted interviews guided by WHO health systems building block, and concept mapping methodology to identify barriers, facilitators, and opportunities for intervention development, delivery, and evaluation. In phase 2, we will co-develop with hairdressers, educational resources on CVD prevention that will be embedded in an online application (App) and a training package to increase hairdresser's readiness to engage in conversations with their clients about health and signpost them to relevant resources. For phase 3, a stepped-wedge approach will be used to explore the impact of the intervention on NHS health check uptake and to assess the feasibility of a larger trial. Qualitative data will also be collected to explore the experiences of community salons, GP surgeries and clients with the intervention.

Findings

To date, 7 salons in South London have confirmed interest and 2 in West London. Readiness assessments with salons (n=8) indicated interest and support for the intervention and limited activities conducted by community salons or in collaborations with health organisations around health promotion in the past. We have engaged multisectoral stakeholders (e.g., hair and beauty industry, the healthcare sector and advocacy groups working with minoritized populations) and discussions highlighted the potential of community salons in health promotion, the need to provide appropriate training and support, as well as to explore wider community links and partnerships to increase salons’ engagement and more opportunistic offer of NHS health check services and to consider systemic barriers for low NHS health check uptake.

Consequences

Our findings highlight the potential of community salons in health promotion and the need to better prepare and support community salons for CVD prevention and to strengthen the link between salons, health care organisations and the wider community. Future work will include results from the co-development of culturally tailored materials and the feasibility of training and retaining community salons and GP practices.