"Poems in the Entrance Area": Using Photo-Stories to Promote HIV Medication Adherence

Image to Action: Past Success, Ongoing Questions, and New Horizons for Photovoice Exhibits

When participants define and share their lives through photovoice, they can potentially become empowered as experts in their health needs. Images from photovoice exhibits confront gaps between what researchers and policy makers assume people need and what people show that they need. The exhibit is bridge to action across the socioecological spectrum and a way that photovoice studies have helped affect change at individual, interpersonal, community, institutional, and policy levels. However, for this nontraditional modality of research to be most effective in achieving its goals, substantial buy-in from participants, researchers, and policy makers is necessary. Despite the great potential of photovoice exhibits, difficulties in translating findings to social action, ethical quandaries related to participant privacy and representation, and not knowing the overall impact of exhibits on viewers can severely inhibit success. Consequently, we recommend four areas to consider for the future of exhibits: (1) understanding and measuring empowerment and change that happens for participants via photovoice exhibits, (2) considering innovative and new forms of exhibits and sharing information with the public, (3) documenting exhibit processes to produce lessons learned and guides for others, and (4) exploring the ethics and impact of exhibits on photovoice audiences.

Identifying evidence of the effectiveness of photovoice: a systematic review and meta-analysis of the international healthcare literature

Background

Photovoice (PV) was conceptualized in the early 1990s to engage community members in capturing/communicating their lived experience narratives through photography. However, no meta-analyses in health research have assessed whether PV achieves its purported effects.

Methods

We carried forward any relevant references from a previous review identifying PV studies before 2008 and searched MEDLINE, Embase, PsycINFO and Cochrane Central Register of Controlled Trials from 2008 up until October 2019. We included both published and grey literature, in any population or context. We assessed quality with the Effective Public Health Practice Project’s (EPHPP) tool and pooled studies using the standardized mean difference (SMD) and 95% confidence intervals (CIs).

Results

Twenty-eight studies were included, showing significant post-treatment effects only for health knowledge (SMD, 95% CIs = 0.41, 0.09 to 0.73, n = 16) and community functions (SMD, 95% CIs = 0.22, 0.03 to 0.40, n = 4). Strong heterogeneity was indicated for health knowledge, potentially explained by a larger effect in ethnic minority populations. There was insufficient follow-up data for health knowledge, while in follow-up for community functions the post-treatment effect was lost.

Conclusions

PV’s post-treatment effect on health knowledge did not translate into positive health behaviours or physical and mental health outcomes, longer-term community functions, or health service outcomes.