Stakeholders’ perspectives on the feasibility of adopting a Healthy Nail Salon Recognition Program in Philadelphia: A qualitative study

ABSTRACT Background The California Healthy Nail Salon Recognition Program is a statewide initiative to incentivize nail salons to adopt safer practices such as use of safer nail products without certain harmful chemicals, installation of ventilation systems, proper personal protective equipment use, and staff training. This public policy intervention is in response to the call to protect nail care workers, mostly women of color, who bear disproportionate burden of chemical exposure at work. Because there is interest from the community to adopt similar program in the Greater Philadelphia region, we conducted this formative research to document stakeholders’ perspectives on the feasibility of adopting the Healthy Nail Salon Recognition Program in Philadelphia. Methods We conducted semi-structured interviews with a purposive sample of 31 stakeholders in Philadelphia in 2021. Using the Consolidated Framework for Implementation Science as our theoretical framework, we developed the interview guide and analyzed the data using qualitative research method to identify key facilitators and barriers. Results Key facilitating themes were perceived need and benefits of program to improve workers’ health and working conditions, and willingness of stakeholders to leverage their organizational resources. Barriers included perceived high cost and time commitment from salon owners and employees, lack of funding and implementation leaders at the city government, community members’ willingness to be visible and advocate for the program affected by the stigmas of being immigrant workers, fear of interacting with authorities, as well as the impact of COVID-19 pandemic. Our results suggest successful adoption of the Healthy Nail Salon Recognition Program in Philadelphia will require outreach within the community to raise awareness of the benefits of the program and close partnership with community-based organizations to facilitate mutual understanding between the authority and the ethnically diverse nail salon communities.