Could Community-Based Diabetes Screenings Benefit Black Men?

Black men with diabetes are more likely than men in other racial groups to sustain diabetic complications and have a lower chance of living into their 70s. A study evaluated the benefits of a community-based diabetes screening program conducted in black-owned barbershops.

The study was conducted between September 19, 2017, and January 23, 2019, at eight Brooklyn, New York, black-owned barbershops in neighborhoods previously determined to have a significant rate of poor glycemic control. Customers were approached, and those who consented underwent point-of-care hemoglobin A1c (HbA1c) testing. Men were eligible for study inclusion if they spoke English, did not have a history of diabetes, and were aged 18 years or older. Men with blood disorders including sickle cell disease or who had recent blood loss were excluded from the findings. The A1CNow+ test (PTS Diagnostics) was used; the test provides results in as little as five minutes and has been established to have a 93% accuracy rating. No confirmatory test was performed at the time of the barbershop screening, but those with an HbA1c of 6.5% or greater were considered diabetic. Anyone who presented an HbA1c of 5.7% or greater received counseling about the significance of modifying their diet and exercise routine, as well as why medical management is important, and they were given contact information for primary care clinics in the area.

A total of 895 black men were asked to take part in the study; reasons for exclusions included a blood disorder (n=8) and an error code during testing and refusal to repeat the test (n=14).

In total, 312 (34.9%) consented to screening, and 290 (32.4%) were tested successfully. There were 583 men who did not consent to participate, of whom 331 (56.8%) provided a reason. Among those who gave a reason, the most common was because they already knew their health status or had been checked by a doctor (n=187; 56.5%); 117 men (35.3%) said they either were healthy, did not have the time or interest, or did not want to know the result; and 26 (7.9%) said they were scared of needles. One man said he did not want to be tested in a barbershop.

Of the men who agreed to and successfully completed testing, 26 (9%) had an HbA1c of 6.5% or higher, and three (1%) had an HbA1c of 7.5% or higher. A little over one-quarter of men (n=82; 28.3%) had an HbA1c between 5.7% and 6.4%, which is suggestive of prediabetes. The men with diabetes had a median age of 41 years (range, 22-65 years), most were obese (n=16; 61.5%), and 11 (42.3%) had a high school-level education or less.