Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration

Abstract

BackgroundAfrican American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention.MethodsA qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m2). Content analysis was used to analyze these focus group data.ResultsThree key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman’s hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants.ConclusionFindings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.

Chemical/straightening and other hair product usage during childhood, adolescence, and adulthood among African-American women: potential implications for health

“…A recent systematic review and several descriptive, as well as qualitative studies found that costly, time-consuming hair maintenance was a barrier to physical activity among African-American adolescents and women. [18][19][20][21][22][23][24][25][26][27][28][29][30][31] Thus, hair maintenance practices can lead to issues related to weight gain and weight loss maintenance among African-American adolescents and women who have a high prevalence of overweight and obesity. [32][33][34] Although studies have identified unfavorable health behaviors and outcomes related to hair product usage among African-American women, these studies often characterized usage during childhood and adulthood as ever versus never, which likely missed changes in use behaviors over time.…”

Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women

“…Extant research shows that many AA women are hesitant to engage in PA because perspiration can negatively influence their hairstyles [51,52]. While this issue has been predominately reported among women with relaxed or chemically straightened hairstyles, our recent qualitative work [53] underscored that hair concerns are a salient issue for many AA women regardless of hairstyle (i.e., natural styles, wigs, braids). The time and money AA women invest into their hairstyles further compounds this issue [51,52], as styling can take several hours, and salon visits can cost women several hundred dollars.…”

“…A screenshot of one of these modules is presented in Figure 2. These multi-media PA promotion materials were developed through an extensive review of the PA promotion literature [51,52] and our formative research with AA women [50,53]. During the first 3 months, new PA promotion modules will be delivered weekly.…”

Primary Care Provider Understanding of Hair Care Maintenance as a Barrier to Physical Activity in African American Women

“…Subsequent studies regarding the efficacy of interventions such as low-maintenance hair styling practices and motivational interviewing may give insight to evidence-based strategies for helping AA females increase their physical activity. 14,15 Provider education has the potential to improve the physician-patient relationship, which could have a lasting impact on the long-term health outcomes of AA females.…”