Collections > Electronic Theses and Dissertations > A Process Evaluation of the North Carolina BEAUTY and Health Project

This dissertation is a process evaluation of a community-based participatory research study, the North Carolina BEAUTY and Health Project. The BEAUTY Project was a beauty salon-based cancer prevention study for African American women designed to test the effects of two intervention strategies - stylist training workshops (STW) & targeted health magazines (THM) - on three primary behavioral outcomes: dietary fat, fruit and vegetable, and physical activity. To help interpret the BEAUTY Project main results, this dissertation had two aims: 1) Evaluate implementation of the BEAUTY Project to determine the extent to which the intervention strategies were implemented as intended; and 2) Assess the relationship between the implementation measures and the BEAUTY Project outcomes. For aim one, comparing salons assigned to the STW strategy to those that were not (STW versus non-STW) with a variety of analytic methods, the study examined different aspects of intervention implementation, including stylist exposure to the training workshops, stylist delivery of intervention to customers, observed intervention-related health talk between stylists and customers, and customer exposure to the intervention strategies. The results of this study provide evidence of STW implementation problems including moderate to low stylist exposure to training with declining attendance over time; failure of stylists to deliver targeted health messages to customers; lack of increased intervention-related health talk observed in STW salons than in non-STW salons; and, low levels of customer-reported intervention-related health talk with stylists, including from those in STW salons (vs. customers in non-STW salons). For aim two, multilevel modeling was used to re-evaluate intervention effects by incorporating implementation variables as predictors. Implementation variables related to the STW strategy (e.g., customer-reported health talk with stylist, stylist training dose received) are not associated with the primary outcomes. In contrast to results for the stylist training workshop strategy, customers who received targeted health magazines reported moderate to high exposure and magazine exposure had a significant and positive effect on fruit and vegetable consumption. Future research in beauty salons should focus on exploring and refining the role of cosmetologists as intervention partners, as well as further developing and refining process evaluation methods and measures.