An evaluation of salon and primary care staff perspectives for CVD prevention in ethnically diverse women in hairdresser and beauty salons

Problem

Cardiovascular disease (CVD) prevention shows health and gender disparities, particularly among the economically disadvantaged and some ethnic minority groups. Cardiovascular disease affects 3.6 million women in the UK and annual CVD-related health care costs the NHS in England about £9 billion. Beauty salons for health promotion have shown promising results in the United States as environments where women feel comfortable exchanging advice due to long-standing positive rapport and relationships. Integrating community structures into existing primary care pathways can provide a sustainable process to address inequalities in access to health care with significant patient and NHS benefits.

Approach

our practices have been selected in South London using GIS and online directories mapped to neighbouring salons in socioeconomically deprived and ethnically diverse areas. Insights for focus group discussions were drawn from our qualitative evaluation of the salon and GP staff CVD health promotion training carried out previously. Two focus group discussions were held (2 practices for each discussion) made up of at least one nurse, one HCA, and one administration staff member from each Practice. In-depth interviews were carried out with one GP from each Practice (n=4) separately to avoid any hesitations from the other surgery staff to openly discuss issues. One focus group discussion was held with the salon staff. Thematic analysis will be used to generate insights into their experiences of health promotion, why women are being under-diagnosed with cardiovascular diseases, and barriers and opportunities for better engaging these groups. Data from focus groups and individual interviews will be analysed using reflexive thematic analysis; a foundational analytic method in qualitative research that supports the identification, analysis and reporting of patterns (themes) within data with NVivo 12 software. We will identify concordant and discordant views from practice and salon staff and reasons behind these.

Findings

We aim to explore understandings from salon and primary care staff of why women are being under-diagnosed with cardiovascular diseases, and barriers and opportunities for better engaging these groups. Focus groups and interviews will inform a culturally adapted complex intervention to reduce cardiovascular risk and promote uptake of NHS health checks amongst eligible women.

Consequences

Our findings will guide the co-development and signposting of a complex health intervention incorporating culturally tailored CVD health promotional materials in a culturally equitable and accessible manner.