King's College London

Can salons help with early detection of high blood pressure and diabetes in communities? The BELONG study

The study will examine whether hairdressers in salons can promote a culturally adapted online platform to encourage clients to improve their cardiovascular health. The hairdressers will be supported by community champions, and nurses/health care assistants at the local GP Practices.

Heart disease and strokes cost the NHS around £9 billion per year, are highest in deprived areas, and are under- diagnosed in women and ethnic minorities. We will invite women attending salons in deprived South and West London neighbourhoods to join the study. Our feasibility study showed salons hairdressers successfully promoted heart health awareness for clients.

Work Package 1 (Set up) will consult hairdressers, clients, surgery nurses and health care assistants using online workshops or email feedback to develop a feasible action plan, and assess which salons and GP practices are suitable to participate.

In Work Package 2 (Main trial), 30 salons and 6 GP practices will participate in a 2-arm parallel cluster effectiveness-implementation trial- testing whether salon Community Health Assistants, CHAs can encourage clients to improve CVD risk prevention via the online platform. Salons (clusters) will be randomised to co-designed complex intervention (salon assistant and usual care) or control arms (usual care: health promotion materials used by local GP practices). Women attending salons in deprived East, South London neighbourhoods will be invited by salon assistants to join the study. The main outcome will be participants attendance at their GP for a health check-up.

Work Package 3 (Process Evaluation) will assess whether salon CHAs can promote the use of the ONLINE platform by clients to improve their heart health. We will ask salon CHAs and clients about what enabled or prevented use, including any technological, financial or cultural factors. We will ask nurses and staff at the surgery about their experiences of supporting the hairdressers. We will collect data on recruitment of salons, hairdressers, clients, use of the online tool, attendance to GP for a health check-up, and follow up for 12 months.In Work Package 4 (Economic Evaluation) we will determine whether our intervention is good value for money.The study has been designed in consultation with hairdressers, including a salon owner Co-I, and clients, and includes targeting salons that have clients from diverse ethnic groups. Community stakeholders and hairdressers will be invited to join an expert stakeholder group. We will set up a participant advisory group to hear about their views. We will publicise the results through community online forums, and jointly produced audio-visual and written materials for salons, communities and health professionals.