Thirty Years of Implementing the Photovoice Method: Insights From a Review of Reviews

"I won't ever feel normal": experience reported through photovoice by children with chronic kidney disease

BACKGROUND

Much of the global chronic kidney disease burden is experienced in low- and middle-income countries. Children living with chronic kidney disease (CKD) face medical and social challenges, and they need support at the individual and family levels. This study aimed to explore children's experiences living with kidney replacement therapy (KRT) who attend the largest pediatric nephrology department in Guatemala.

METHODS

This qualitative study used photovoice and asked children to take pictures that represented what is like to live with CKD. Each child and their caregiver underwent an interview where the photos were used to elicit and facilitate discussion. The interviews were recorded, transcribed, and then analyzed using thematic analysis.

RESULTS

Eight children and their mothers participated in the study. Three themes were identified: interactions with the health system, changing and difficult family dynamics, and strains on social interactions. Children face social challenges including self-isolation and alienation. The family dynamics and familial structures often are forced to change, inducing stress. This is all exacerbated by the difficulties that arise in navigating the Guatemalan health system.

CONCLUSIONS

Photovoice techniques are a feasible way to understand the experiences of children and their families who face CKD. The disease affects all aspects of life and recognizing this while advising and administering care can help provide a comprehensive level of care. Health systems need to make efforts aimed at improving the quality of care as well as the multidisciplinary support available to children and their families.

Leveraging local knowledge to contextualize the opioid epidemic within HEALing Communities Study communities: A Photovoice protocol

Since its inception 30 years ago, Photovoice has gained increasing popularity as a research method and more recently has been incorporated within randomized controlled trial (RCT) designs. Photovoice is a participatory action research method that pairs photography with focus group discussions to record community strengths and concerns, build critical consciousness, and reach policymakers. Adherence of Photovoice implementation to these original tenets of Photovoice varies. This article provides the Photovoice protocol developed by the authors to improve the methodological rigor of Photovoice integration into RCTs and help contextualize the landscape for the HEALing Communities Study (HCS: NCT04111939), a greater than $350 million investment by the National Institute on Drug Abuse along with the Substance Abuse and Mental Health Services Administration to reduce opioid overdose deaths in 67 of the hardest-hit communities in four states (Kentucky, Massachusetts, New York, and Ohio). The product of a cross-state collaboration, this HCS Photovoice protocol provides ethical and methodological tools for incorporating Photovoice into RCT designs to enhance community engagement, communication campaigns, and data-driven decision-making about evidence-based practice selection and implementation.

Arts-based research with immigrant and racialized older adults: A scoping review

This scoping review aims to describe the range of research studies using arts-based data collection methods with immigrant and racialized older adults. A secondary aim is to identify challenges and strengths of using these approaches with this population. This review uses Arksey and O'Malley's five-stage scoping review framework with a final number of 16 references included for the study. Enhanced social connectedness, increased transparency and quality of findings, and self-empowerment were key strengths of using arts-based approaches for data collection. Challenges identified included resource limitations, cultural and language barriers, and barriers to meaningful engagement. Only a small number of studies have utilized arts-based methods with immigrant and racialized older adults. Arts-based approaches require unique methodological adaptations with this population but have the potential to increase engagement in research activities, authenticity of research findings and empowerment of older adults.

Using Photovoice to Improve Engagement in Community Health Assessments Addressing Behavioral Health

Behavioral health disorders are well-known to have close links with the social determinants of health, yet little is known about how impacted communities perceive these links. Qualitative participatory methods can not only provide insight into how communities conceptualize these relationships but also empower those with lived experience to contextualize their perspectives and formulate calls to action. This study used Photovoice as a participatory method to supplement the Clark County Health Department Community Health Assessment and determine priority facilitators and barriers contributing to the behavioral health of Clark County, KY, residents. A secondary aim was to gain a greater understanding of how the Photovoice methodology impacts community engagement efforts in Community Health Assessments. Twenty-three Clark County residents participated in four Photovoice groups involving five weekly sessions, which included photograph "show and tell," critical group dialogue, participatory analysis, and planning for dissemination. Secondary analysis of Photovoice focus group discussions revealed behavioral health facilitators and barriers were most influenced by (1) public sector unresponsiveness, (2) strong partnerships formed between community and grassroots organizations, and (3) the siloed division of responsibility between agencies and across sectors. The authors also found the Photovoice method successfully enhanced engagement and empowered those with lived experience to frame their perspectives of the behavioral health landscape. This project has implications for enhancing community engagement and empowerment in behavioral health-focused public health assessments and shaping policy to promote multi-sector collaboration.

"It's a learning curve throughout your entire life": Experiences and impact of FASD in adolescence explored in online photovoice research

BACKGROUND

Research into the lived experience and disability of Fetal Alcohol Spectrum Disorder (FASD) is sparse in adolescence, despite its relevance to supports and life outcomes.

AIMS

The study explored adolescents' lived experiences of FASD and access to support across home, school, and community.

METHODS AND PROCEDURES

An online photovoice study was undertaken with eight young people (age 12-19, in education), integrating an Interpretative Phenomenological Analysis (IPA) approach. The research process comprised two individual interviews, group training, individual photo-taking, and group sessions for photo analysis/ dissemination.

OUTCOMES AND RESULTS

Participant-led analysis of their photos identified how activities at home and in the community had functions of relaxation, sensory gratification, and enabled concentration. Researcher-led analysis found that young people identified with the disability of FASD through experiences at home and school. While they acknowledged the value of support and relationships, education was not always an inclusive experience.

CONCLUSIONS AND IMPLICATIONS

Participatory online research allowed insight into the impact of FASD as a disability and underlines a consistent need for support in adolescence and the transition into adulthood. Young people with FASD require explicit support to develop their advocacy skills to improve educational outcomes.

Meaning of nutrition for cancer survivors: a photovoice study

Background

Little is known about how cancer survivors perceive nutrition through the cancer experience and how those perceptions may influence their diet.

Aims

This study aimed to capture the meaning of nutrition for cancer survivors who are post-cancer treatment using a participatory photography method known as photovoice.

Methods

Wang and Burris's photovoice procedure was followed. Recruitment took place via email through existing links with participants from a previous quantitative study. The participants were tasked with taking photographs to represent the meaning of nutrition for them post-treatment. Group workshops and semistructured interviews were conducted to facilitate reflection, dialogue and analysis. Data analysis followed Braun and Clarke's six-phase thematic analysis.

Results

One man and seven women (n=8) across the Island of Ireland were recruited. Participants identified six themes (illustrated with photographs): (1) Fresh is Best, (2) Be kind to yourself, (3) Building Blocks. Be Informed., (4) Post-Treatment Healing Changes, (5) Chemo Rituals and (6) Food for the Soul-Healthy Mind. Healthy Body.

Conclusions

Participants displayed a holistic approach to a healthy lifestyle for recovery post-treatment and maintaining health. While diverse, participants made post-treatment nutritional changes by introducing and eliminating certain foods or food groups. All agreed that being informed and building nutrition knowledge are essential. It is important to clarify the implications cancer has had on diet and health when providing nutrition guidance to ensure that it is appropriate and specific.

Finding voice in a year of collective trauma: Case study of an online photovoice project with youth

In this article, we share findings from a qualitative case study of a virtual youth photovoice program implemented across three regions of the United States. The purpose of the program was to engage youth in research on a social issue relevant to them during an unprecedented year marked by two public health crises, COVID-19 and anti-Black racial violence. Results of an analysis of curriculum and archival program materials lend support for online strategies for youth engagement including individualized support and online audiovisual presentations with avatars. Racial justice and trauma-informed adaptations were designed to be responsive to youth needs for flexible programming and safe spaces. Themes captured in the first online gallery of youth photos include (1) tools for mental health, (2) meaningful connection, and (3) community advocacy, bringing attention to structural issues as well as family and community strengths. Findings suggest photovoice can be thoughtfully adapted for youth researchers and support individual and group storytelling in response to collective trauma.

"No One Should Feel Like They're Unsafe": Mobility Justice Photovoice as a Youth Advocacy Tool for Equitable Community Mobility

Mobility is an often overlooked social determinant of health that broadly affects people of color's health. This study aimed to examine personal and community mobility challenges and opportunities among youth of color and partner to advance equitable community mobility. We conducted a community-based participatory research photovoice study using mobility justice principles from November 2020 to May 2021 with 10 youth of color from South Seattle, Washington. We conducted thematic content analysis of verbatim transcripts. Youth recommended infrastructure changes and free transit to facilitate safe, accessible mobility. Youth reported feeling vulnerable riding public transit alongside people experiencing mental health issues, while recognizing the dangers police can bring to people with mental health challenges and/or communities of color. They emphasized the importance of youth voice and intergenerational community discussions to inform policy making. We coorganized an online forum with youth to exchange ideas for advancing equitable mobility with their community and city leaders. Youth expressed feeling empowered and deepening dedication to mobility justice. Leaders should implement policy and infrastructure changes to enhance equitable mobility by incorporating youth and mobility justice principles in decision-making processes, pay youth for their time, employ facilitators of color, and offer technology support.