Editor's Note: This article originally appeared in Inside Duke Health.​

Your hair and scalp can reveal a lot about your overall health. And people visit a barbershop or hair salon regularly, building a trusting relationship with their barber or stylist. Ragan Johnson, DNP, FNP-BC, CNE, an associate clinical professor in the Duke University School of Nursing, is part of a research team studying if social networks, like salons and barbershops, could be relied on to impart important health information to African American men and women.

“As nurses, we are on the front lines. We see health disparities and we are conducting research that supports health equity," Johnson said. “I'm particularly interested in building interventions centered on unique community connections."

In partnership with Schenita Randolph, PhD, MPH, associate professor, Johnson has interviewed barbers, stylists and their patrons. They've found that patrons view their barber or stylist as a trusted confidante. And barbers and stylists learn about infection prevention as well as hair and scalp health in cosmetology school. If their stylist or barber were trained on related health topics and had a designation of that training visible, patrons would be open to talking more about health.

“Patrons told us they wouldn't want their stylist or barber to just list facts. And they would be interested in learning about multiple ways to be healthy – from HIV prevention to heart health," said Johnson.

Johnson and Randolph will begin developing interventions to support what they've learned. One of the reasons they are looking for alternative ways of getting health education into the community is that many providers find it uncomfortable to talk about certain topics, like sexual health. But these conversations are critical ways to educate patients and prevent infections.

In her research, Johnson has interviewed African American women who shared that their provider never asked about their sexual health. African American women have the highest rate of HIV among women in the United States. Yet, Johnson said research shows that providers fail to inform African American women about pre-exposure prophylaxis or PrEP to prevent HIV infection.

“We have a tendency to ignore the things we're are uncomfortable with, but we really need to get providers comfortable with sensitive topics like sexual health," Johnson said. “We need to make sure we are serving our patients."

At the School of Nursing, Johnson said nurse trainees undergo a training where they simulate taking a detailed sexual history. And through her research, Johnson is also exploring alternative ways to get information about sexual health out into the community. 

“With the research we are doing with hair salons and barbershops, we are asking people, 'what do you want?'" said Johnson. “We are learning how we can deliver a meaningful health intervention in a setting that makes them comfortable."​