African-American women suffer a disproportionate burden of morbidity and mortality compared to Caucasian women. Addressing racial/ethnic disparities in health requires the engagement of African-American women in the development of interventions that are culturally and contextually appropriate. Three age groups of African-American women who attend beauty salons (18-29; 30-49; 50+) were recruited into six focus groups. Participants reviewed a series of magazine pictures of African-American women and discussed their perceptions of beauty and health. In addition, we explored ideas for how to best intervene in beauty salons. Focus group discussions were recorded, transcribed, and analyzed with NVivo 2.0. After a thematic analysis of the substantive content of the transcripts, an iterative process based on grounded theory was used to summarize themes and make recommendations for intervening with contextually appropriate interventions. Beauty and health were each conceptualized as consisting of internal (confidence,
attitude, disposition) and external/behavioral elements (hair, dress, eating healthy, exercise). Younger women perceived beauty and health as consisting more of outer dimensions, whereas older women emphasized inner dimensions. From the linkage between beauty and health emerged a consistent theme of beauty "from the inside out," where inner aspects of beauty and health were connected with physical health and outer beauty. Participants shared ideas for specific strategies that would help the research team create culturally and contextually appropriate interventions for the beauty salon environment, including the stylist as role-model, materials that depict women with various sizes, shapes and weight loss goals, and graphics exhibiting diversity in terms of beauty and health. Engaging African-American women through focus groups is an important first step when building culturally and contextually appropriate interventions.