Â鶹ÊÓƵ

Supervisors:

• Dr Riya Patel rp526@leicester.ac.uk
• Dr Ash Routen
• Professor Gregory Maniatopoulos 

Project Description:

Multiple long-term conditions (MLTC), are a major and growing public health challenge, and are not distributed evenly across the population. They are more common, occur earlier, and are often more complex among people living with socioeconomic disadvantage and among some minoritised ethnic groups. This creates a strong case for prevention and earlier detection outside traditional clinical settings, particularly for groups who may experience barriers to primary care access, low trust in services, competing social pressures, or delayed diagnosis.

Barbershops have emerged as promising community-based settings for health promotion, screening and referral, especially among Black and minoritised men. They are socially embedded, trusted, highly accessible spaces where regular attendance and established barber–client relationships can support informal conversations about health. Studies from the United States have shown that barbershop-based interventions can improve hypertension detection, referral and control, with the strongest evidence coming from trials in which barbers acted as trusted health promoters and were linked to clinical professionals such as pharmacists. 

There is also preliminary evidence from the UK that suggests barber-led blood pressure awareness and support interventions are acceptable and feasible among men from Black and minority ethnic communities. However up until now the focus of these evaluations has been mainly on single conditions, particularly hypertension, diabetes awareness, obesity-related risk and, in some cases, HIV testing. Far less is known about whether barbershops can support broader screening for MLTC risk, where cardiovascular, metabolic, respiratory and mental health risks may cluster.

The primary objective of this PhD therefore is to develop and test a barbershop-based MLTC screening intervention. This PhD aims to address health inequalities experienced by men and ethnic minority communities who are more likely to develop early onset MLTC. 

Year 1: A systematic review
To conduct a systematic review of health-focused interventions delivered in barber-shop settings.
Year 2:  Co-production of an intervention through applying qualitative methods
To undertake qualitative research with key stakeholders to develop a barbershop-based intervention.
Qualitative study guided by TDF and RE-AIM, and co-production workshops informed by the 3C’s framework in line with BCW. 
Year 3: feasibility and acceptability testing of the intervention
Objectives: To conduct a feasibility study to assess trial feasibility via recruitment and refusal rates, retention and engagement rates for participation. 
To qualitatively explore acceptability of trial procedures and engaging with the intervention with a sample of participants and drop-outs from the trial.
To qualitatively explore participants experiences and barber’s perceptions delivering a brief screening intervention.

References:
Linnan, L. A. (2019). Growing evidence for barbershop-based interventions to promote health and address chronic diseases. American Journal of Public Health, 109(8), 1073.

Victor, R. G., Lynch, K., Li, N., Blyler, C., Muhammad, E., Handler, J., ... & Elashoff, R. M. (2018). A cluster-randomized trial of blood-pressure reduction in black barbershops. New England Journal of Medicine, 378(14), 1291-1301.

Barna, M. (2019). Barbershop Interventions Improving Health Outcomes. American Journal of Public Health, 109(11), 1479-1479.

Palmer, D., & Dolby, S. (2026). Trusted Community Spaces for Suicide Prevention: Evaluating the Ambassador Barbers, Salons, and Tattoo Studios Project in the London Borough of Bexley, UK. American Journal of Men's Health, 20(1), 15579883251410534.