By Laura Lorenz, PhD, MEd and Olivia Iovino, MSN, ARNP, FNP-C

A common question we are asked in our courses is “What populations and purposes are appropriate subjects for Photovoice projects?”  With a quick google search on Photovoice projects, you will find a wide variety of projects done with youth, women, homeless populations, veterans, seniors, people with chronic conditions and disabilities, groups in urban or rural settings, and groups of workers within an organization.  You will find projects performed all over the world, for research purposes or for community action.  Even with such a variety, though, we can find a simple answer –  Photovoice can be used for any group that you want to know more about.

Photovoice helps people to tell stories and communicate with others. As course participants and the literature have noted, it’s not always easy to communicate with words. This method is another way to explore perspectives – another type of intelligence gathering, if you will.

Photovoice helps people to advocate for their needs, preferences, and goals.  It generates data that provide a more complete or holistic view, and can complement other data.  Some Photovoice projects can be done for the purpose of providing insight into the lives of people whose voice and perspective have not been previously heard.  The photographs cross boundaries and help to “level the playing field” where there is a power imbalance, helping create actionable story-telling for social and political change.

For example:

• Photovoice was developed by Wang and Burris in the 1990’s for a regional development project in China with funding from the Ford Foundation to incorporate the views of village women¹⁰

• The method has been used with homeless populations¹¹

• With youth in the US¹³ and many other countries

• To understand the unique challenges and opportunities faced in rural nursing⁸

In the clinical setting, Photovoice can be used by people living with chronic health conditions and disabilities or facing other challenging circumstances – and by professionals and caregivers as well.  Photovoice can help contribute to our understanding of the continuum of care and what people are going through at all stages of the continuum – from helping us to understand people’s experiences with medical care and community services and supports, to social determinants that may contribute to prevention or exacerbate risk. In turn, findings from Photovoice projects can educate medical care professionals, policymakers, and also peers, family and the community. 

For example:

• Understanding lived-experience of brain-injury survivors in Massachusetts⁷

• Informing HIV prevention practices among recent US immigrants⁹

• The Department of Veteran Affairs has used Photovoice to explore their successes and identify areas for improvement in delivering patient centered care with two different studies: one focused on providers and their perceptions³, and a second study on patients’ views².

• Improving water and sanitation practices in Kenya⁴

Photovoice has been applied to process improvement in the workplace to gain perspectives of diverse stakeholders within an organization.  Purposes of studies have included reducing workplace injuries and incidents among custodians⁵, stimulating resilience among nurses to reduce burnout and promote retention¹, and to suggest quality improvements to enhance retention among nursing faculty at a university⁶.

In summary, there is a range of purposes for Photovoice projects, and they can be performed with any population or subpopulation for which you wish to gain a deeper understanding.  These purposes can include:

• Understand lived experience of the studied population

• Gain perspectives of local stakeholders and populations

• Raise awareness—among community members, policymakers, patients

• Inform or initiate action to improve prevention, policy, and practice

• Promote healing—of communities and individuals

To learn more about Photovoice including educational opportunities and consultations, visit www.photovoiceworldwide.com

References

1. Shin Yuh Ang  Thendral Uthaman  Tracy Carol Ayre  Siew Hoon Lim  Violeta Lopez A Photovoice study on nurses’ perceptions and experience of resiliency.  First published: 09 October 2018 https://doi.org/10.1111/jonm.12702
2. Balbale, S. N., Morris, M. A., & LaVela, S. L. (2014). Using Photovoice to explore patient perceptions of patient-centered care in the Veterans Affairs Health Care System. The patient, 7(2), 187-95.
3. Balbale, S. N., Turcios, S., & LaVela, S. L. (2014). Health care employee perceptions of patient-centered care. Qualitative health research, 25(3), 417-25.
4. Elijah Bisung, Susan J. Elliott, Bernard Abudho, Diana M. Karanja, and Corinne J. Schuster-Wallace, “Using Photovoice as a Community Based Participatory Research Tool for Changing Water, Sanitation, and Hygiene Behaviours in Usoma, Kenya,” BioMed Research International, vol. 2015, Article ID 903025, 10 pages, 2015. https://doi.org/10.1155/2015/903025.
5. Flum, M. R., Siqueira, C. E., DeCaro, A., & Redway, S. (2010). Photovoice in the workplace: A participatory method to give voice to workers to identify health and safety hazards and promote workplace change-a study of university custodians. American journal of industrial medicine, 53(11), 1150-8.
6. Kirkham A.  Enhancing Nurse Faculty Retention Through Quality Work Environments: A Photovoice Project. Nurse Econ. 2016 Nov-Dec;34(6):289-95.
7. Lorenz, LS and Kolb, B. (2009 September). Involving the public through participatory visual research methods. Health Expectations, 12, pp 262-274.
8. Challenges and Opportunities of Rural Nursing Preceptorship: A Photovoice Perspective Author/Creator Oosterbroek, Tracy, A – phd dissertation
9. Rhodes, S.D. and Hergenrather, K.C., “Recently arrived immigrant Latino men identify community approaches to promote HIV prevention,” American Journal of Public Health, vol. 97, no. 6, pp. 984–985, 2007.
10. Wang CC, Burris MA, Ping XY. Chinese village women as visual anthropologists: a participatory approach to reaching policymakers.  Soc Sci Med. 1996 May;42(10):1391-400.
11. Wang CC, Cash JL, Powers LS. Who Knows the Streets as Well as the Homeless? Promoting Personal and Community Action Through Photovoice. Health Promotion Practice, 2000, 1 (1), 81-89
12. Wang, C. C., Morrel-Samuels, S., Hutchison, P. M., Bell, L., & Pestronk, R. M. (2004). Flint Photovoice: community building among youths, adults, and policymakers. American journal of public health, 94(6), 911-3.