Table 2 Themes identified through inductive analysis and exemplar quotes

Motivation to seek healthcare among Black men exists, yet barriers such as fear, trust, and access persist.

Participants described numerous barriers that impede their ability or the ability of members of their community to seek care from the healthcare system, often leading to negative associations about healthcare. These barriers included time, cost of visits, unreliable transportation to healthcare facilities, potential psychological effects of bad news, feelings of fear, or a lack of health insurance. While barriers exist, participants expressed motivation for health and often described changes to their healthcare interactions ascribed to the study.

“We need more of this. This is a beautiful start. We… need more awareness programs for everybody to reach out. And make it more open to people so they feel more comfortable going to see their doctors. Hospitals are crowded right now, they booked up. And a lot of people scared of that medical fee. So when you get somebody to come out in the neighborhood and provide you with a blood test or something like that or blood pressure, it helps… Honestly, if I’m not sick or injured, I don’t do usually check-ups because… I don’t know. I don’t like going to the doctor. I mean that’s just the most honesty I can be. It’s like because sometimes you just don’t want to feel, I mean find out if something is wrong or not… You don’t want to search out that something wrong when you don’t feel like something wrong.” – Participant 36 (Age: 48)

Knowledge about health status is empowering, reassuring, and precipitates health behavior change

The knowledge received about individual health status seemed to alleviate worry, stress, or anxiety about health and often facilitated or helped to promote self-efficacy and empower lifestyle change(s) and increased interactions with the healthcare system.

“I understand what’s going on with my body more. You know what I’m saying? Sometimes when you’re always working, you know and back and forth on different jobs and stuff like that, you don’t pay any attention to your health. Now, actually looking at the length and seeing that this could be actually life-threatening… it’s time to really look in the mirror and change your life a little bit... I might be able to turn this around. Yeah, but it’s gonna take a lot of dedication to myself. And I do love myself so.” – Participant 32 (Age: 47)

Community-based education intervention enhanced knowledge of cardiovascular disease

Participants often reported how the study helped to provide enhanced information about chronic disease, specifically PAD and hypertension, and often promoted further learning about health.

“Once I found out what PAD is and so on and so forth, you know it deals with diabetes, hypertension, high cholesterol, yeah, that’s the entire black community, so yes. Yeah it went together. It had a good correlation.” – Participant 9 (Age: 46)

Convenience of accessing health care resources in the barbershop

Accessibility and comfort of the barbershop helps overcome barriers to seeking care, such as mistrust or fear of the healthcare system, time burden of regular visits, and socioeconomic barriers.

“I was glad it was here and it was easily accessible. I didn’t have to go to the hospital and pay for parking, and actually it was right in line with what I was doing… I think it’d be a good idea if y’all could do something on a similar scale for other healthcare needs for guys in the community, ‘cause people just come through the barbershop and with their regular schedule, but it’s kinda hard … to schedule in a doctor’s appointment because it’s gonna take much more time because you gotta park, get there, wait… But if it’s already in line with what I’m doing anyway, I can swing right through here… and just paying for everything… And then just having time, because most people in the community gotta work as many hours as possible to make ends meet, so I don’t have an extra two hours to go there, but I might have enough time to slide through ‘cause I gotta get a haircut for where I’m working at, so I gotta keep myself particularly groomed, so this is like a part of work. You know what I mean. So, but I don’t have time to go to the doctor.” – Participant 9 (Age: 46)

Despite disparities, participants advocate for health of community

Participants regularly mentioned knowledge, either pre-existing or ascribed to the study, about health disparities in the black community and propensity to seek healthcare. Although disparities persist, participants seem to serve as ambassadors of the health of others in the community.

“Black people we do a lot of high cholesterol, high blood pressure. It brings the worry next to us to see that it is an epidemic – I mean not an epidemic, but it is a serious matter. And it does affect us more than it affects a lot of others. Racist. Okay? It is ‘cause we do suffer, I don’t know if it’s our way of cooking, our way of living, but it definitely affect us because we always have high blood pressure. Diabetes runs heavily amongst African Americans. So yeah, it’s very good because we should be aware. Some people just take it for granted. And it’s beautiful for you to take it out to our neighborhoods and let anybody just find out about it…” – Participant 36 (Age: 48)

Positive study feedback provided by participants

Participants expressed an overall positive experience with the study, including interactions with the study team, satisfaction with health screenings, convenience, and simplification of material. This facilitated engagement in the study and general satisfaction. The large majority said they would participate again, and frequently expressed wanting to see a similar model expanded to address health needs of the community.

“I’m a person of showmanship. And if you got the right people running it in the barbershop or in the neighborhood, then just in that alone would bring me back. There was no stress. It was a comfortable meeting. You talked to me, not at me. Saying this is what you’re supposed to do – you didn’t do none of that. You made every visit very comfortable.” - Participant 32 (Age: 47)

Participation driven by both a desire to know health status and altruism

The number one reason that participants listed as their reason to participate in the study was to gain knowledge about their health status. Participation in this study was a convenient and accessible way of learning about health status. Participants also mentioned participating not only for the benefit of the community, but also for the sake of research or the medical community. Finally, while compensation was helpful, it was a secondary gain, or “added bonus.”

“Again, I get this done. I just did this to show some other people, you know, you should do it… So that does push people towards to have that benefit done. You got a role model figure that’s there – ‘that role model’s gonna get me there.’” – Participant 3 (Age: 61)