Interesting news from a new study on reducing blood pressure. A few years ago, researchers had trained barbers “to check blood pressure and refer people with high levels to physicians.” It only had a small effect, they thought, because too often the physicians didn’t prescribe blood pressure medication. So this time, researchers tried a different approach:
The control group consisted of barbers who encouraged lifestyle modification or referred customers with high blood pressure to physicians. In the intervention group, barbers screened patients, then handed them off to pharmacists who met with customers in the barbershops. They treated patients with medications and lifestyle changes according to set protocols, then updated physicians on what they had done.
They also tweaked the process to handle the inevitable bumps in the road.
When barbers weren’t consistently screening customers by measuring their blood pressure, pharmacists stepped in to do that. When labs slowed things down, pharmacists brought measuring tests to the barbershops.
The end result:
Six months into the trial, systolic blood pressure (the higher of the two blood pressure measures) in the control group had dropped about 9 mm Hg (millimeters of mercury) to 145.4, which is still high. In the intervention group, though, blood pressure had dropped 27 mm Hg to 125.8, which is close to “normal.” If we define the goal of blood pressure management to be less than 130/80, more than 63 percent of the intervention group achieved it, compared with less than 12 percent of the control group.
It gets better. The rate of cohort retention — measuring how many of the patients remained plugged into the study and care throughout the entire process — was 95 percent.
According to the New York Times, the researchers believed there were several important lessons that could be learned from the results of this series of studies.
Getting barbers involved meant health messages came from trusted members of the community. Locating the intervention in barbershops meant patients could receive care without inconvenience, with peer support. Using pharmacists meant that care could be delivered more efficiently.
I think there’s also a valuable lesson here for Makers All. If emerging tech is going to provide real opportunities to communities that our society has basically written off, we need to plug into the parts of that community that people already trust. Learning complex new tech can be really intimidating, especially because you’re probably going to spend a lot of time falling on your face when you first get started. Feeling safe and knowing there are people who’ve got your back is half the battle. Barbershops and beauty salons, churches — all of these institutions could play an important role.
Community institutions aren’t magic. As the study also showed, it will take the right mix of institutions as well as a feedback loop to tweak the process as we learn what’s working and what’s not. But if we’re smart about how we do it, a community-oriented approach has tremendous potential.