Barbershop Intervention May Reach Men With Undiagnosed Diabetes, Prediabetes

An intervention involving hemoglobin A_1c (HbA_1c) testing in black barbershops could help identify undiagnosed diabetes and prediabetes in black men, according to new research published in JAMA Internal Medicine.

These findings are encouraging, especially because the prevalence of diabetic complications is disproportionately high in black men compared with men of other racial and ethnic groups.

“The diagnosis of diabetes is often delayed, especially among black men without a regular source of primary care. In barbershops, which are places of trust among black men, community-based interventions have been successful in identifying and treating men with hypertension*,” the authors of the study wrote.

They tested the efficacy of the intervention among English-speaking black men aged 18 years or older without history of diabetes who were customers in 8 barbershops owned by black individuals in Brooklyn, New York, from September 19, 2017, to January 23, 2019. The study excluded individuals with blood disorders and those who had recently experienced blood loss.

The A1cNow test, which provides results within 5 minutes and has a reported accuracy of 93% when correlated with HbA_1c testing of venous blood, was used to test participants’ glucose levels. However, confirmatory testing was not performed.

A total of 895 black men were asked to participate in the study, and of these men, 312 (34.9%) agreed to be screened, and 290 (32.4%) were successfully tested. Twenty-six (9.0%) were found to have an HbA_1c level of 6.5% or higher, signaling the presence of diabetes, and 82 (28.3%) participants were found to have an HbA_1c level between 5.7% and 6.4%, indicating prediabetes. Sixteen (61.5%) of the 26 men with undiagnosed diabetes had obesity.

“We found that approximately one-third of men approached in barbershops owned by black individuals in Brooklyn were willing to be screened for diabetes. We also found that barbers were important health advocates; although we do not have exact numbers, some customers (who initially declined testing) agreed after encouragement from their barber,” the researchers wrote.

They concluded that community-based screening for diabetes in black barbershops may aid in the timely diagnosis of diabetes and may help identify black men in need of appropriate care for newly diagnosed diabetes, especially among those living in urban areas who may face socioeconomic barriers to good health. Notably, the prevalence of undiagnosed diabetes in the study population was approximately 2.5 times higher than that of New York City residents overall (9.0% vs an estimated 3.6%).

—Christina Vogt

*Read how the "Barbershop Intervention" Improved Blood Pressure

Reference:
Osorio M, Ravenell JE, Sevick MA, et al. Community-based hemoglobin A1c testing in barbershops to identify black men with undiagnosed diabetes [Published online January 27, 2020]. JAMA Intern Med. doi:10.1001/jamainternmed.2019.6867.