Photovoice

Authour: Trevor Haldenby
Edited by Christine Keene

Problem

It can be difficult for researchers to observe some of a community’s most important behaviors, particularly when that community is wary of outsiders, isolated, underserved, oppressed or operating without written language. In these situations, observational research conducted by outsiders can result in a skewed and inaccurate view of the community, which can then result in a poor understanding of its needs, assets and cultural values. Furthermore, researchers entering a community who attempt action-oriented research or social change may have difficulty ensuring that the progress made in their presence will remain in effect or continue to develop upon their departure from the community. Without a powerful emotional picture of a community and its constituents, policymakers may misrepresent or fail to consider many of its most important aspects when making relevant decisions.

Solution

Photovoice, a participatory research methodology first formally articulated by Caroline Wang and Mary Anne Burris (1997), provides a process by which people can “identify, represent, and enhance their community through a specific photographic technique” (p. 369). The method builds on a history of earlier participatory needs assessment work in healthcare and social health education, on theoretical literature from the fields of feminist theory and documentary photography, and on a number of practical photographic traditions (Wang & Burris, 1997). The method is based around the provision of cameras and associated physical and theoretical infrastructure to individual community members. These individuals are then prompted to capture visual representations of their everyday lives so that researchers working with the community might gain insight into previously invisible practices and assets, helping the community to better engage in critical dialogue around the problems and opportunities it faces.

Use When

This methodology is most useful when employed at the front-end of a project, as well as during the evaluation and analysis stage to gauge success and validity.

Use For

Activity-focused research, needs assessment, problem-finding, problem-solving, solution implementation activity, project analysis and evaluation. Photovoice has been used successfully in projects related to issues as diverse as infectious disease, health education, homelessness, economic barriers, sexual domination, diasporas, population isolation and political violence (Catalani & Minkler, 2010).

Process

Researchers begin their use of photovoice in a community as active facilitators, but by the end of the program, they should have passed on much of the facilitation role to individual community representatives. Many of the steps identified below can be considered creatively, as photovoice employs rapidly changing technology in the context of participatory research in a way that is unique among research methodologies. In their original articulation of photovoice, Wang & Burris explicitly state that the technique should be “creatively and flexibly adapted to the needs of its users” (1997, p.383).

The first step is to identify a community, or group within a community, that has an expressed interest in improving one or more conditions of that community.

1) Demographics – Clearly define the demographics and region of the community. Create a list of participants that is representative of the gender, age, occupational and economic diversity of that community. If there are other demographic criteria of particular relevance to the community, consider them as well.

2) Budget – Ensure funding for the purchase of as many cameras as there will representatives. Also consider the costs associated with taking the images, image development, transportation of equipment and a method by which photographers can communally examine each other’s work (a slide or data projector, for example).

3) Introduction – Bring the group of community representatives together, and explore with them in an accessible and inclusive way why they have been chosen as representatives and how photovoice works as a research methodology. Address any questions or concerns from the group, if possible. Once the group has agreed upon a mutual understanding of the research process and purpose, move forward with training.

4) Training – Brief community representatives on the technical and conceptual operation of the cameras secured for them. Important technical elements include recommendations for the safe operation of the camera and introductions to basic photographic concepts, such as portraiture, posed versus unposed photographs, and wide versus telephoto lenses. Wang & Burris (1997) suggest minimizing the amount of time spent on specifically technical and aesthetic training, while research conducted by Catalani & Minkler (2010) suggests that prolonged and increasingly rich training exercises tend to produce more engaged participants in the long term. Discussions around photographic ethics and power dynamics should also be conducted before any shooting begins. Questions such as, “How is it acceptable to photograph a person?” and “Would you take someone’s picture without telling them?” are good starting points.

The first photographic assignment should expand participants’ knowledge of photographic principles while considering community cultural values in suggestions of subject matter and setting. Photographers should set out into their communities with open minds and a focus on capturing scenes that are relevant to their everyday lives. While the photographers should be encouraged to seek out important situations, they should also be encouraged to consider the mundane or obvious as relevant subject matter.

5) Viewing – Once the photographers have shot the images, they should return the images to the facilitators. Facilitators should develop the images as promptly as possible, and return prints to the individual community representatives who shot the photographs. An additional set of each photographer’s images should be converted into a medium for communal viewing and reflection. Photographers may want to keep individual copies of their own photographs or give them to other members of the community, so it is important not to only produce a version made for communal viewing.

6) Discussion – Once the images are developed and the photographs are delivered, it is time for the discussion phase of the process. To begin this phase, ask each photographer to choose a subset of their roll that they find particularly interesting or relevant for group discussion.

In a group meeting, all community representatives should view the work of all others. When a photograph is displayed, the photographer should be encouraged to tell the story of and behind the picture: why/when/where was it taken, as well as who/what is doing it. Group discussion during this storytelling process, and the application of captions or written accompaniments to each image, are encouraged. This is the contextualization part of the discussion phase.

7) Analysis – Photographers identify themes and codes in the images that appear again and again internally (within the work of an individual photographer) or externally (across the bodies of work of many photographers). These themes can then be categorized, making it easier to identify overarching issues and opportunities affecting the community. In Wang & Burris’s (1997) original work in the Yunnan province of China, for example, numerous photographs depicting water-related issues (e.g., a man stooping over a cistern, children climbing poles to replace electrical infrastructure for water purification, women boiling water in front of their homes) led to the realization that constructing clean water reserves in the community was more important and relevant than increasing access to written knowledge.

At this stage, the steps that facilitators and community members will take are more flexible and open to interpretation. If the project was intended as the lead-in to an action-oriented project, then these storytelling series and photographic records may be used to persuade policymakers and government officials of the importance of allowing the community to decide its own priorities. If the research was intended as a knowledge-acquisition activity for the community, then more time can be spent ensuring that community representatives have a sufficient understanding of the photovoice method and process to teach additional members of the community, or even members of other communities.

An important step to ensure that the project’s process and infrastructure support potential community-run activities in the future is to make the cameras and other equipment available to the community either free-of-charge or at a price appropriate to the community’s economic capability. The continued availability of equipment required for photovoice activities offers significant benefits to the community in terms of action, advocacy, community values and individual empowerment, even after the project’s outside facilitators and researchers have departed.

Examples:  Photovoice has been used in an array of needs assessment projects around the world, on every continent except Antarctica.
Wang & Burris (1997) conducted their initial research exploring the methodology in the Yunnan province of China, looking at how new approaches to needs assessment in a male-dominated community could improve the effectiveness of reproductive health programs.

Prior to this research, methodologies involving the provision of cameras to underserved communities and groups had been explored as photo novella and fotonovella (Wang & Burris, 1997, p.369).

Photovoice work is presently being carried out in Toronto as a part of the St. James Town Initiative, a project of the Wellesley Institute looking at the needs and community capacity of St. James Town, one of North America’s highest-density residential areas.

Variations

Catalani & Minkler (2010) note in their excellent review of the photovoice method that until very recently, no systemic appraisal of existing literature had been conducted by researchers. Their review examines 37 peer-reviewed articles focusing on photovoice in public health, the majority of them reflections on action-oriented projects. What their paper shows, particularly in its appendices, is a wealth of diversity in protocol and context for photovoice research. While the method formally emerged on to the community-based participatory research scene as an approach to community health needs assessment, it has since been applied to contexts as diverse as political violence, discrimination, language barriers, and diasporas. Much of the most interesting work still seems to be taking place in the world surrounding health care and health education.

Some of the most interesting insights in Catalani & Minkler’s (2010) paper are around comparative performance of photovoice projects. They note that approximately 1,006 participants were involved as photographers in the projects they reviewed, with a median community sample size per project of 13 (p.439). The median study length is approximately 3 months, and while no relationship was noted between group size and participant engagement, a correlation between project duration and quality of engagement was identified (Catalani & Minkler, 2010, p.439). Photovoice projects with a higher participant engagement rating also seemed more likely to employ the method during analysis at the back-end of the process, as well as during needs assessment at the front (p.444).

Catalani & Minkler (2010) note that in spite of the explosion of diversity in photovoice work, “most projects continue to be heavily influenced by Wang & colleagues’ early work” (p.438), lending support to the notion that although photovoice emerged relatively intact as an ethnographic research methodology, it owes a great debt to a number of earlier 20th century theoretical traditions and practices.

This should come as no surprise considering the introduction Wang & Burris gave to their methodology in their 1997 paper, citing as inspirations everything from Paulo Freire’s problem-posing education teachings to the depression-era U.S. Farm Security Administration’s orthodox documentary photography work (p.371).

What isn’t touched on in Catalini & Minkler’s review is the use of technology. Alongside the increase in contextual diversity for photovoice work in the last fifteen years has come a massive acceleration in the development of digital photographic technologies, increasingly affordable and easy-to-use video and non-linear video editing systems, and of course the ubiquitous cameraphone. There would appear to be a great opportunity at present to investigate how cameraphone and point-and-shoot digital camera technology could be leveraged in the creation of new photovoice projects, not only in terms of how information is collected, but also how it is shared and organized.

References
Catalani, C., & Minkler, M. (2010). Photovoice: a review of the literature in health and public health. Health Education & Behavior, 37 (3), 424-451.

Halifax, N. V.D., Yurichuk, F., & Meeks, J. (2008). Photovoice in a Toronto community partnership: exploring the social determinants of health with homeless people. Progress in Community Health Partnerships: Research, Education, and Action, 2 (2), 129-136.

Wang, C., & Burris, M. (1997). Photovoice: concept, methodology, and use for participatory needs assessment. Health Education & Behavior, 24 (3), 369-387.

The Wellesley Institute. (n.d.). Community voices: tackling inequity through a community initiative on the social determinants of health. Retrieved from http://sjtinitiative.com/download/PartI_Report_PhotoVoice_Final_dec23.pdf