Feasibility of a culturally tailored traction alopecia prevention curriculum in a diverse urban middle school: a pilot study

Background: Traction alopecia (TA) is a preventable form of hair loss that disproportionately affects individuals of African descent because of high-tension hairstyling practices. TA often begins in childhood, yet few interventions target early education. This pilot study aimed to evaluate the feasibility and preliminary impact of a culturally tailored TA prevention curriculum for middle school students. Objective: To develop and pilot a culturally tailored traction alopecia prevention curriculum for middle school students and evaluate feasability, acceptability and preliminary education impact. Methods: A 45-minute interactive curriculum on TA causes, prevention, and healthy hair care was delivered to students at an urban middle school. Pre- and postsurveys assessed knowledge, hair care practices, and attitudes toward scalp health. Data were analyzed descriptively because of variations in survey question phrasing. Results: Of 73 participants, 35 completed both surveys. Before the program, only 11.4% had heard of TA. After the session, 91.4% reported improved understanding of TA, and 34.3% were "very likely" to change hairstyling practices. Most participants (74.3%) rated the session 7/10 or higher in value, and 82.9% intended to share the information with family. Limitations: Findings are limited by the small sample size, single-school setting, and lack of long-term follow-up to assess sustained behavior change. Conclusion: This pilot curriculum was feasible, well-received, and increased awareness of TA. Future studies should refine the curriculum, standardize evaluation tools, and examine long-term behavior change to support equitable hair health education in at-risk communities.