A couple of times each week, cardiologist Chileshe Nkonde-Price ditches her white coat and sets up an impromptu "research laboratory" at TraChic Hair Studio in Lansdowne, Pa.
She's a physician-researcher but doesn't spend much time peering into a microscope; instead Nkonde-Price is hunting medical breakthroughs amid the hiss of hot curling irons and the smell of hair dye.
"It was actually when I was at the hair salon myself and I was sitting under the hood, and I heard stories about health, stories about family, stories about solutions, and I thought: the truth is here," said Nkonde-Price, a cardiologist at the University of Pennsylvania.
Exploring the 'why?'
Heart disease is on the rise among African American women, and once black women have heart trouble they are more likely than white women to die from it.
That's disturbing, but frankly, old news.
"There was nothing out there saying the why," said Nkonde-Price.
She searched current medical literature on black women and heart disease, but came away unsatisfied.
Nkonde-Price's investigation at the hair salon is an opportunity to go beyond what prior research on black women and heart disease has primarily focused on.
During her chats with salon clients, Nkonde-Prices pushes a little and often asks the same question several times in different ways.
In the down time, between getting her hair washed and coiffed, client Sheveen Greene agreed to talk with Nkonde-Price.
The 28-year-old said she goes to the gym regularly, but that's wasn't enough for Nkonde-Price. The cardiologist wanted specifics on what it takes for Greene to make that healthy choice.
"In the clinical setting we don't ask that," Nkonde-Price said. "As doctors we tend to just say: do you or don't you exercise. And then when someone tells us the answer, we give a prescription: 'You should exercise more.'"
At the salon, Nkonde-Price soon found out that Greene and her best friend go to the same gym.
"So, I find it easier sometimes when she's going," Greene said. "I feel a little bit more motivated to go as well because I have a gym buddy, we just went together."
Pushing patients towards healthier habits
The hair salon study is part of the Robert Wood Johnson Clinical Scholars Program, which supports physicians who want to research ways to improve the health system.
Salon owner Tracey Johnson said her shop was a good fit for the study.
"Stylists are psychologists slash hairstylists, so we can talk about any and everything... relationships, children, what's happening in the world today," Johnson said. "All types of conversations happen in a hair salon."
Nkonde-Price said the biggest insight from her study may be that doctors--or other health care providers—need to ask better questions to move patients toward healthier habits.
Continuing the research
Greene was prepping for her wedding day, but said she felt it was important to participate in a study on black women and health.
"I think there's a stigma about telling people your business, some people just aren't OK with that, I think culturally, it's stays in the like family, so what happens in our house stays in our house," Greene said.
"So if there's diabetes in my house it stays here, if there's the inability to eat healthily, it stays here. Could you imagine if we shared that knowledge?" Nkonde-Price said.
Nkonde-Price said she's convinced that if she can speak with enough women she'll figure out how to better "sell" them healthier habits and perhaps, lower their risk for heart disease.
"I'm hearing stories of black women that are making it work," she said.
The research is still underway—and Nkonde-Price is looking for other hair salons to visit and clients to interview. In the meantime, she's developed a fitness challenge for some of the women she's met along the way. It's called "Change My Steps."