photovoice as an arts-based participatory research approach

Photovoice as an Arts-Based Participatory Research Approach Nasim Haque Wellesley Institute

1 September-27-11 | www.wellesleyinstitute.com

Lillian Wright Maternal-Child Institute Faculty of Health, York University

September 23, 2011

2 September 23,2011 | www.wellesleyinstitute.com/sjtinitiative.com

1. Learn what Photovoice is and how it can be used

2. Discuss the Photovoice methodology and the ethical issues inherent to the approach

Learning Objectives


Photovoice methodology was developed in 1992 by Caroline C. Wang and her colleagues as a means for women living in rural villages in China to communicate important health messages to policy-makers.

“What experts think is important may not match what people at the grassroots think is important.”

– Caroline Wang (1996)

Background

4 September 23, 2011 | www.wellesleyinstitute.com/sjtinitiative.com

SJT Initiative is a 5 yr CBPR Initiative

Research Question: What implications do neighbourhoods have on the health & wellbeing of immigrants?

Results: Inform policy & support social change at neighbourhood

level

About St James Town Initiative

9/27/2011

5

Population & Neighbourhood •14,666 Residents on 0.23 km2 of Land •64,636 People / km2

•(Unofficial Estimate: 25,000) •64% Immigrants •18 Aging High-Rise Buildings •Over 50 languages spoken

St. James Town

Community Action

Strategies & Activities

Participatory Research

skill enhancing opportunities

student internships

Work with multiple

stakeholders

SJT Initiative Website

1) Adult Photo Voice

2) Community Mapping

3) Concept Mapping

5) Focus groups/interviews (CAC)

SJT Residents Action Group

COMMUNITY ENGAGEMENT

6) Sample Survey (CIHR funded)

4) Youth Photo Voice

Multi-pronged Approach


• Action research is “learning by doing” - a group of people identify a problem, do something to resolve it, see how successful their efforts were, and if needed, try again

• Photovoice is an arts-based qualitative research technique and a good example of participatory action research

What is Participatory Action Research?

8

What is Photovoice?

Photovoice asks you to take photographs of things that are important to you - and to tell the story of why these things are

important. The visual images & accompanying stories are the tools used

to reach policy- and decision-makers.

9

Why use Photovoice?

• Powerful way to approach empowerment and advocacy • Rewards of taking photographs are immediate • Photography is fun and creative • Taking photographs can change participants’ perceptions

about their social and physical environment • Basic photography is easy to learn and accessible to all • “A picture is worth a thousand words” • Images are understood regardless of language or culture • Policy makers & program planners cannot deny reality

when images are staring them in the face

10

A few examples: • Children and youth in difficult circumstances e.g. orphans, children

forced into job market, children and youth living under the threat of violence because of war or crime

• Homeless adults and families • People with disabilities or mental health issues • People with chronic diseases/medical conditions e.g. HIV, TB etc. • Members of racial, ethnic, linguistic, or cultural minorities • People who are discriminated against because of class, caste, way of life • The urban poor, whose concerns and strengths are often different from

those of the larger society • Women and men, to highlight gendered social and health issues

Who should use Photovoice?

11

• When Photovoice can change people’s opinions about themselves and their environment

• When a disadvantaged group’s situation or problem needs to be publicized

• When change is necessary, & PV can inform policy makers • When a community assessment is needed or in progress • When you need to document the process of or gather data for an

evaluation of an intervention or program • When you need to document a site, an event, or a way of life that is

threatened or about to disappear

When might you use Photovoice?


The stages of Photovoice include: 1. Conceptualizing the problem 2. Defining broader goals and objectives 3. Securing resources for the project 4. Formulating the theme/s for taking pictures 5. Identifying community partners & establishing relationship 6. Recruiting PV participants & target audience members 7. Planning the project with community – include PV participants 8. Beginning the project: Training staff and participants

• Training has two components : (1) technical & (2) ethical and safe photography

How to put together a PV project?


9. Distribution of cameras and taking pictures 10. Photovoice group meetings at regular intervals 11. Selecting photographs for discussion/storytelling 10. Documenting the stories 11. Formulation of captions by consensus 12. Data analysis to identify issues, themes, and theories 13. Dissemination: Preparing a PV exhibit 14. Encouraging Social Action and/or Policy Change

contd.. Process


One way of exploring photographs • What do you See here? • What’s really Happening here? • How does this relate to Our lives? • Why does this problem/condition/strength exist? • How could this image Educate the community/policy makers/ etc? • What can we Do to improve the situation, or two enhance these

strengths?

SHOWED: Guideline for story writing


• Ensure activities are done in a fair, respectful & ethical way • Participants must have the opportunity to consent to participate in the

project, based on full and complete information about both the advantages and disadvantages of participating

• Participants must be made aware of expectations of participation. They should also be informed about how they can withdraw from participation

• Because Photovoice participants are co-researchers and co-creators of data, they must conduct themselves in fair, ethical and appropriate ways

• Participants should be familiar with process of informed consent

Ethics of Photovoice


• When is it ethical to take photos of individuals? • Should someone take pictures of other people without their

knowledge? • How do you ask permission to take a photo? • Should you ask subjects to sign a release form? • Should you offer them a copy of the picture? • How do you react if the subject refuses? • How do you protect yourself in dangerous situations, where people may

be engaged in illegal activity or may be aggressive?

Ethics of Photovoice Ask yourself before using your camera…


Training Workshop-1


Photo Journalist : Training Workshop-1


Important Stakeholders: Training Workshop-2

Community Forum & Expo: March 20, 2008

21

Community Forum & Expo: September 18, 2010

© The Wellesley Institute www.wellesleyinstitute.com | www.sjtinitiative.com 9/27/2011 22

Resident Group Presenting at Counselor ’s Office

Change & Action

23 9/27/2011

Audit of Bicycle Parking

Presenter

Presentation Notes

Bicycles are a primary mode of transportation in St. James Town. Our neighbourhood needs to have special bicycle rooms or sheds in each building. Maybe even a monitor to prevent stealing.

© The Wellesley Institute www.wellesleyinstitute.com | www.sjtinitiative.com

9/27/2011 24

Change & Action

A few examples of the range of information that can be collected

using Photovoice technique

25 September-27-11 | www.wellesleyinstitute.com

9/27/2011 26

SOCIAL ATTRIBUTES

Safety, Crime, Drugs, Fear

The picture shows a memorial of a residence of St. James Town whose life was robbed off him last year due to gun violence. The person who murdered “Juice” is yet to be found. It just comes to show that more security is needed in the area. A lot of undercover police are the area dressing up as drug dealers or buyers but they are usually easily spotted and pin pointed.

Presenter

Presentation Notes

The picture shows a memorial of a residence of St. James Town whose life was robbed off him last year due to gun violence. The person who murdered “Juice” is yet to be found. It just comes to show that more security is needed in the area. A lot of undercover police are the area dressing up as drug dealers or buyers but they are usually easily spotted and pin pointed. Instead of having undercover police which are easily figured out, we should have constant security in the area.

This is related to our lives because every day we are witness to some type of harmful carcinogens produced by these cigarettes. Whether second hand, or first hand smoke, living in St. James Town means a high chance of encountering cigarettes. Because of this more people are exposed to harmful chemicals.

SOCIAL ATTRIBUTES

As a child, one way I kept myself occupied with my time was through playing basketball. It not only kept me off the streets, but also wasted the majority of my time, keeping me active. If more community programs ran such activities, it would bring the community closer and keep children off the streets away from any type of violence. These activities are strengths in our community as children are kept away from trouble. (Youth,SJT. 2010)

PHYSICAL ATTRIBUTES

29

... In a neighbourhood such as St. James Town where most people live in high rise buildings and come from low income families it may not seem like the best idea to build more buildings when we don’t already have that much green space around. This issue relates to your lives because we need more things than buildings around our community, such as more parks, centres for youth but instead we invest in building and more buildings. (Youth,SJT. 2010)

Overcrowding PHYSICAL ATTRIBUTES

9/27/2011 30

These different flowers represent people from different places and the vase represents this country. If we arrange the flowers properly, they turn into a beautiful flower arrangement. If people of different backgrounds are given equal opportunities and are accepted, everyone benefits.

“The Tsismis Tree” Tsismis is a word in Tagalog that means gossip. This tree is treasured by many immigrants because we meet here to share experiences and support each other. Common spaces are important to the wellbeing of both individuals and the community.

SOCIAL ATTRIBUTES

Presenter

Presentation Notes

These different flowers represent people from different places and the vase represents this country. If we arrange the flowers properly, they turn into a beautiful flower arrangement. If people of different backgrounds are given equal opportunities and are accepted, everyone benefits. “The Tsismis Tree” Tsismis is a word in Tagalog that means gossip. This tree is treasured by many immigrants because we meet here to share experiences and support each other. Common spaces are important to the wellbeing of both individuals and the community.

9/27/2011 31

This tiny tunnel connects one of the poorest neighbourhoods in Canada, St. James Town, to one of the most affluent, Rosedale. The short journey of crossing the bridge is actually painful, arduous, and for the most part, impossible for the most, if not all, of the individuals living in SJT. Despite being highly educated, newcomers have difficulty gaining recognition, and consequently, employment.

ECONOMIC ATTRIBUTES

9/27/2011 32

Food Quality

How much can we trust our food supply? We don’t only care about the price of goods, we also pay attention to our health. We want to get good service when we go to the supermarket.

ECONOMIC ATTRIBUTES

“Anyone out there?” Our plea for help went unheeded and we were buried in an overwhelming wave of ‘that’s not our problem’. Anyone out there? Are you listening?


• Non threatening method • Usually not conceived as “research” • Engage disadvantaged population • Builds trust & empowers disadvantaged population • Transfer ownership of the project to participants • Help common voices heard by decision makers • Understand participants perspectives on health and other issues

through their lenses

Advantages of using Photovoice Technique


• The time commitment necessary may be daunting for participants and researchers

• Participants may have difficulty in presenting complex or abstract ideas through photographs

• Risk of losing or damaging cameras • Participants choose what to photograph – these choices can influence

research findings • Limitations of cross sectional design and qualitative design applies to

PV study design

Limitations of using Photovoice Technique


MCH professionals can apply Photovoice as an innovative participatory research methodology: 1. To engage community members in needs assessment 2. Community asset mapping 3. Program planning 4. In reaching planners and policy makers to advocate for strategies

promoting family, maternal, and child health as informed from a grassroots perspective

Can I use Photovoice in MCH?

USEFUL REFERENCES 1) Wang, C. and Y. Redwood-Jones. 2001. “Photovoice ethics: Perspectives from Flint photovoice.” Health Education and Behaviour, 28(5): 560-572. 2) Wang, C. and C. Pies. 2004. “Family, Maternal, and Child Health Through Photovoice.” Maternal and Child Health Journal, 8 (2): 95-102. 3) Wang, C., J. Cash and L. Powers. 2000. “Who Knows the Streets as Well as the Homeless? Promoting Personal and Community Action Through Photovoice.” Health Promotion

Practice, 1(1): 81-89. 4) Wang, C. 2003. “Using Photovoice as a participatory assessment and issue selection tool: A case study with the homeless in Ann Arbor.” In M. Minkler and H. Wallerstein. Eds.Community-based participatory action research for health.San Francisco:Jossey-ass. 5) Community Tool Box: http://ctb.ku.edu/ 6) Haque, N., & Eng, B. Tackling inequity through a Photovoice project on the social determinants of health: translating Photovoice evidence to community action. Glob

Health Promot, 18(1), 16-19. 7) Haque, N., Moriarty, E., & Anderson, E. (2008). Community Voices: Tackling Inequity through a Community Based Initiative on the Social Determinants of Health. Toronto: Wellesley Institute. www.sjtinitiative.com. 8) Haque, N., & Sun, E. (2011). Voices of Multicultural Youth: Impact of urban neighbourhood

on health and wellbeing Toronto: Wellesley Institute. www.sjtinitiative.com.

September 23,2011 | www.wellesleyinstitute.com/sjtinitiative.com

http://ctb.ku.edu/

http://www.sjtinitiative.com/

© The Wellesley Institute www.wellesleyinstitute.com | www.sjtinitiative.com 9/27/2011 38

ST. JAMES TOWN INITIATIVE

THANK YOU

For more info, visit www.SJTinitiative.com or www.wellesleyinstitute.com

photovoice as an arts-based participatory research approach

Education

use photovoice

stages of photovoice

photovoice group meetings

pv project

policy support social

mental health issues

important health messages

families people