By Laine Zizka
It was an alarming trend.
Janie Robinson, now an associate professor in TCU Nursing, watched as beds filled up with African-American males with kidney failure every Sunday night in the cardiac unit of a Louisiana hospital.
“Their kidneys had failed,” Robinson said. “Over the weekend, they had [drunk] too much water or fluid and, since their kidneys couldn’t function, they had to have emergency dialysis. This was just continual, every Sunday night.”
She wanted to know why.
When Robinson dug deeper, she found there was a need for research related to African-Americans and kidney disease. Studies had been done on mixed populations, but she felt research onAfrican Americans was lacking, despite that population having the highest rates of kidney failure.
In 2009, both Robinson and Glenda Daniels, an associate professor in TCU Nursing, began working at TCU. Daniels, who has a background in gastroenterology, soon found herself partnered with Robinson by their mutual mentor.
“One of our mentors here, Dr. Charles Walker, met with us to see if there was some kind of overlap – a parallel with her interest in renal disease and my interest in gastroenterology,” said Daniels.
The two narrowed in on the fact that African-American males have a high rate of end-stage renal disease. It raised questions about how to deliver preventative care to participants.
The answer was simple: barber shops.
“We had no idea,” said Robinson of the cultural significance of barber shops. “I don’t complain anymore when my husband says he’s going to get a haircut. If they have something to talk about, it takes hours.”
It’s that camaraderie that makes the barbershop a perfect place for frank discussions and a free-flow of information. The respect and the reputation the barber has in his shop lent an unquestioned trust in the researchers among participants.
“We are targeting a place where people feel respected, like the barbershop, and they have a tendency to listen,” Daniels said.
As they performed their research, an interesting trend emerged. Almost every man was willing to participate, but their post-survey questions led Robinson and Daniels to believe there was a lack of knowledge within the community about healthy practices.
“In most cases with African-American males, when they go to the doctor, it’s because they are gravely ill,” said Robinson.
A lack of knowledge and willingness to go to the doctor is only the beginning of the problem. Many of the men they spoke to lacked the proper resources to make the necessary changes in their life.
“Research shows that individuals with end-stage renal disease have four, five, six people in the household,” Daniels said. “They’re the head of the household and they make $797 a month – can you imagine? That’s how difficult it is.”
Still, the two ask, how did this trend develop? Daniels has had family members with end-stage renal disease who lived in healthy environments. Something had to have caused that.
They look to a combination of variables, from a lack of education related to kidney disease, to a genetic predisposition, to a gap in the research in health sciences and the health care system as a whole. However, if education could be used to prevent cases of end stage renal disease, that would be a success.
“There are other things you can do before you get to the point where you need medicine,” said Daniels. “It could be education from their healthcare providers [to] identifying something earlier and sending them to a kidney specialist early,”
While the concept of doing research in barbershops is nothing new, the pair would like to return to the barbershop to inform and work with the community, practicing an innovative kind of preventative care.
Moving forward, the pair intends to tailor their intervention and outreach efforts to the community’s knowledge and perceptions of health.
“We would like individuals to change their lifestyle,” said Robinson. “Just because a person knows about something, doesn’t mean that they will do what they need to do. We hope that, by us coming to the barbershop, they will gain the knowledge and skills needed to influence a healthy lifestyle.”