Health promotion and Black women: Enacting trust from the chair

Background: Health intervention delivery by beauty salon stylists is an emerging public health strategy to promote wellness behaviors among Black women. Beauty salons are deemed promising places to perform health interventions because: stylists are trusted community members; clients frequently visit stylists; and stylists understand clients' family context and history. However, research is limited about the specific nature of relationships between stylists and Black women clients. Therefore, to inform health intervention prevention design in community settings, this ethnographic study explored development and maintenance of interpersonal relationships in beauty salons. Methods: Over six months, the researcher performed an ethnographic investigation which employed purposeful sampling and participant-observation techniques in three beauty salons. Fourteen in-depth interviews were conducted with clients (n = 10) and stylists (n = 4). Field note, memo, and interview data were managed and analyzed using Nvivo8. Results: Trust emerged as a key component to relationship-building. Clients and stylists enacted trust beyond initial assessment of technical skill and hair style preferences. They created and maintained trust through four processes: revealing personal vulnerabilities; negotiating subject boundaries; nurturing emotional bonds; and asserting professional credibility. Trust is therefore co-constructed and mutually understood in these relationships. Discussion: Reciprocal commitments by stylists and clients nurture trust in the beauty salon, which facilitates an environment for health information delivery. This study informs public health practice because it reveals the multidimensionality of trust when promoting well-being among Black women. Practitioners aiming to understand trust-building in Black communities can develop and test health promotion interventions in varied environments.