It’s a sunny afternoon at the In the Cut barbershop on Tremont Street just outside the Roxbury Crossing T Stop.
The customers inside are a mix of locals and college students coming in to get haircuts, shaves and beard trims and to swap stories with the barbershop staff.
There’s also something you don’t typically see in an inner-city barbershop—a clinical research coordinator from Mass General Brigham who is offering to take blood pressure readings for customers while they wait for a cut.
The coordinator is part of a research study called Pressure Check, which is being conducted by four healthcare systems—including Mass General Brigham—in partnership with local communities.
The goal of the study is to identify the best way to manage high blood pressure, or hypertension, in high-risk populations that may face challenges in accessing medical care. This type of preventive care, reducing cardiovascular disease burden, is aligned with Mass General Brigham’s For Every Patient initiative, which commits to delivering high-quality, personalized care rooted in equity.
Uncontrolled blood pressure puts people at increased risk of developing heart disease, brain disease, and kidney disease, yet only one in four people have their blood pressure under good control (blood pressure under 130/80 mmHg).
Blood pressure control is worse in populations who traditionally face healthcare inequities, including the African American and Latinx communities.
“What we know from the literature in previous studies is that Black, Brown and low-income populations are at higher risk for having uncontrolled hypertension or even undiagnosed hypertension,” says Patricia Masson, PhD, RN, a nurse scientist from Massachusetts General Hospital and a member of the Pressure Check team. “So this study is really centered in the community.”
“We are at 10 locations throughout the greater Boston area as far north as Lynn, down to Blue Hill Ave in Dorchester, Roxbury, Charlestown, everywhere,” Masson says. “We set up our equipment and offer to take blood pressures of the people that they serve. And it’s a completely voluntary study.”
The Boston arm of the study is being led by Massachusetts General Hospital cardiologists Pardeep Natarajan, MD, MMSC, Oyere Onuma, MD, MSc, Michael Honingberg, MD, and Joycelyn Carter, MD, MPH. The study itself is led by investigators at Yale University in New Haven, with collaborators in Boston, Houston and Norfolk, Va.
Testing Three Approaches to Managing High Blood Pressure
While the Pressure Check team will take blood pressure readings for anyone who wants one, they are looking to recruit participants with an average resting blood pressure of 135/85 mmHg or higher.
“I think what’s important about the study is that you have to spend time talking to people, because first and foremost, we want to make sure they are safe,” Masson says.
“If their blood pressure is dangerously high, we’re going to talk to them about either going to the emergency room or getting them seen within the next day or so. “
Upon enrolling in the study, each participant receives a blood pressure monitoring cuff and a Bluetooth device that allows them to take blood pressure readings at home and transmit them to the study team.
The participants are then randomized into three arms of the trial.
“There’s a control group where we send them back to primary care providers for treatment and let them [the providers] know that we’re watching the participants’ blood pressure as part of the study,” Masson explains.
In the second arm of the study, participants meet remotely with a nurse practitioner and cardiologist assigned to the study for assistance in monitoring and managing their blood pressure.
The third arm of the study includes remote meetings with the nurse practitioner or cardiologist as well as a connection to a community health worker, who can help participants with any obstacles that arise in their access to care, such as a lack of access to housing or difficulty acquiring medication.
The Importance of Community Connections
In Boston, the community recruitment sites for Pressure Check include Harvest on the Vine Food Pantry in Charlestown, Abundant Life Church in Cambridge, Crosstown Church International in Boston, the Demakes Family YMCA in Lynn, Roxbury YMCA, La Colaborativa in Chelsea, the Top Notch and In the Cut barbershops in Boston and Simina’s African Hair Braiding in Boston
“I think it’s important to see that we’re meeting the community where it needs to be met as opposed to the other way around” says Pamela Leins, co-owner of the In the Cut Barbershop and a member of the community advisory board for the study. “We’re using the culture of the barber shop as something we can leverage for even greater good for the Black and Brown community.”
“I’ve been a nurse for a long time,” adds Masson. “It’s fascinating to see that we’re starting to make our way back to community-based care, which is really important if you want to prevent disease.”
About the Mass General Research Institute
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