Development of a culturally relevant intervention to promote informed decision making about colorectal and prostate cancer screening among Black men in barbershops

Cancer remains the second leading cause of death in the U.S. and the disparities between White and Black men, particularly concerning prostate and colorectal cancer incidence and mortality rates, are alarming. Barbershops are a promising setting to address cancer disparities by making information available in a safe and frequently visited place where barbers are trusted leaders in their community. The Trimming Risk in Men (TRIM) Project partnered with Black barbershop owners, barbers, customers, and community members to develop an appropriate and effective cancer prevention intervention for barbershops. The message development approach used in this study is based on the National Cancer Institute's “Stages of Health Communication” process. This paper will discuss qualitative data from 26 customers from eight barbershops who participated in a series of focus group discussions involving message development and message testing. Audiotape-recorded focus groups were transcribed verbatim, imported into qualitative data analysis software, and coded to systematically clarify key themes through qualitative content analysis. Key themes that emerged from this analysis included the safety of the barbershop as a place for Black men to express themselves, customer loyalty to barbers, the trust of the barber-customer relationship, and the use of positive messages and images of family, cars, and sports. Extracted themes were used to develop key health messages, print materials, and a pilot training workshop for barbers. Application of the “Stages of Health Communication” process is an effective way to involve the target audience in intervention development and to insure that health information is communicated appropriately.