Using Photovoice to Understand Barriers to and Facilitators of Cardiovascular Health Among African American Adults and Adolescents, North Carolina, 2011-2012

Changes in perceptions of the alcohol environment among participants in a Photovoice project conducted in two districts with different socio-economic status

Perceptions of the alcohol environment may influence alcohol consumption patterns. The purpose of this study was to describe changes in perceptions of the urban alcohol environment as experienced by residents of two districts with different socio-economic status after taking part in a Photovoice study. The study was conducted in Madrid, Spain, in a district with a high socio-economic status (HSES) and another district with a low socio-economic status (LSES). A Photovoice project was conducted with 26 participants divided into four groups based on sex and district. Groups met over five sessions in which they discussed photographs taken by the participants themselves on the subject of alcohol in their neighbourhood. A qualitative, descriptive and thematic analysis of participants' discourses was performed to explore changes in their perceptions of the alcohol environment over the project sessions. Changes in perceptions of the alcohol environment were observed in all groups over the project. The process of change varied by districts' socio-economic characteristics and gender. Greater changes in perceptions of the alcohol environment were observed in HSES, especially among women, as the participants had a much more positive initial view of their alcohol environment. In LSES, participants showed a more critical perception of the alcohol environment from the beginning of the study, and this broadened and intensified over the course of the sessions. Changes in perceptions also varied by thematic categories, including some categories that were discussed from the start (e.g. socialising and alcohol consumption) and categories that only emerged in later sessions (e.g. alcohol advertising). Involvement in a Photovoice project has favoured a shift in the participant's perceptions of their alcohol environment towards more critical positions, widening their scope of perceived elements and raising their awareness of specific problems, such as alcohol advertising and social role of alcohol consumption in relation to alcohol exposure.

Residents perceptions of the alcohol environment: A participatory photovoice project in two districts with different socio-economic status in a large city

The purpose of this study was to present the alcohol environment as perceived by its residents in two districts of Madrid using the Photovoice participatory methodology. Secondly, we compared the results according to the socio-economic status of the districts. The study was conducted in the city of Madrid, Spain, in two districts with different socio-economic status. A total of 26 people participated, who took and discussed photographs about their alcohol environment. They grouped them into 33 final categories, such as the socialising role of alcohol or the alcohol advertising. Co-authors further grouped participants final categories into seven general areas. The participants in the Photovoice project have helped to deepen the understanding of the alcohol urban environment. These results may help to design more effective policies to prevent hazardous alcohol consumption.

Using Photovoice to Examine Physical Activity in the Urban Context and Generate Policy Recommendations: The Heart Healthy Hoods Study

A current challenge in physical activity research is engaging citizens with co-creating policies that support physical activity participation. Using Photovoice, a participatory action research method, the objectives of this study were to: 1) Identify community perceptions of urban built, social, and political/economic environment factors associated with physical activity; and 2) generate community-driven policy recommendations to increase physical activity. Two districts in Madrid of varying socio-economic status (SES) were selected. Overall, 24 residents participated in 4 groups stratified by sex and district (6 participants per group). Groups met weekly for 4 weeks to discuss and analyze their photographs. Participants coded photographs into categories, which were then regrouped into broader themes. The categories were transformed into policy recommendations using an adaptation of the logical framework approach. Participants took 161 photos, which were classified into 61 categories and 14 broader themes (e.g., active transportation, sport in the city). After this, participants generated a set of 34 policy recommendations to improve the urban environment to support physical activity (e.g., to redistribute sports facilities). Collaboration between citizens and researchers led to a deeper understanding of the community perceptions of urban built, social, and political/economic environment factors associated with physical activity in two districts of Madrid, while engaging citizens in recommending public policies.

Empowered to Self-Care: A Photovoice Study in Patients With Heart Failure

Introduction: Heart failure–related hospitalization is preventable through self-care but remains a common cardiovascular reason for rehospitalization. The purpose of this study was to explore the promotion of self-care in Singaporean patients with heart failure. Method: A descriptive qualitative design was adopted using Photovoice. Sixteen participants with heart failure were recruited from an outpatient cardiology clinic in Singapore. The participants were asked to take photographs that represented their promotion of self-care and used them in the subsequent interviews. Data were transcribed verbatim and analyzed using thematic analysis. Results: Four themes emerged: (1) accepting life; (2) appreciating life; (3) maintaining meaning in life; and (4) establishing a new normal life. The four themes provided insights into how they empowered themselves to self-care. Discussion: Participants were empowered to self-care through active and passive processes. Self-reflection served as an active process internally. Support from health care providers served as a passive process externally.

Eating Well While Dining Out: Collaborating with Local Restaurants to Promote Heart Healthy Menu Items

BACKGROUND

As Americans commonly consume restaurant foods with poor dietary quality, effective interventions are needed to improve food choices at restaurants.

PURPOSE

To design and evaluate a restaurant-based intervention to help customers select and restaurants promote heart healthy menu items with healthful fats and high quality carbohydrates.

METHODS

The intervention included table tents outlining 10 heart healthy eating tips, coupons promoting healthy menu items, an information brochure, and link to study website. Pre and post intervention surveys were completed by restaurant managers and customers completed a brief "intercept" survey.

RESULTS

Managers (n = 10) reported the table tents and coupons were well received, and several noted improved personal nutrition knowledge. Overall, 4214 coupons were distributed with 1244 (30%) redeemed. Of 300 customers surveyed, 126 (42%) noticed the table tents and of these, 115 (91%) considered the nutrition information helpful, 42 (33%) indicated the information influenced menu items purchased, and 91 (72%) reported the information will influence what they order in the future.

DISCUSSION

The intervention was well-received by restaurant managers and positively influenced menu item selection by many customers.

TRANSLATION TO HEALTH EDUCATION PRACTICE

Further research is needed to assess effective strategies for scaling up and sustaining this intervention approach.