The Teen Photovoice Project: A Pilot Study to Promote Health Through Advocacy

Purpose

This project was designed to pilot the use of a community-based participatory research (CBPR) method called Photovoice among impoverished young people in Los Angeles. Photovoice involves giving community members cameras with which to take pictures highlighting health issues that concern them. The current project's first goal was first to empower the adolescents involved to define key health problems using this visual tool and then to engage them in developing health advocacy projects.

Photovoice has its roots in the tradition of empowerment education. It aims to give voice through photos to people who might not ordinarily have the opportunity to convey their perspectives on important issues to those who can address the photographers' concerns. This approach has been used with hard-to-reach populations, disenfranchised groups, and others in the United States and internationally.

Steps Taken to Achieve the Project's Goals

Through The Teen Photovoice Project, young people from several poor neighborhoods in Los Angeles took pictures with health-related themes. They chose images to both define and then express to others their perspectives about the major forces that influence their health and health behaviors. The project received support from the UCLA/RAND Center for Adolescent Health Promotion (referred to as "the Center"). It is a prevention research center funded by the Centers for Disease Control and Prevention. Funding also came from the UCLA Robert Wood Johnson Clinical Scholars Program.

Participants received instructions to take pictures in their own communities of things that they felt influenced their health behaviors (while taking care that the process neither posed threats to their own safety nor violated anyone's privacy). The assignment was designed to stimulate dialogue among the participants through the later use of the photographs as springboards for discussion.

The young people worked in groups. Researchers helped them to interpret the combined pool of pictures through activities that promoted critical thinking about all the perspectives revealed by the images. The adolescents talked about their own and their peers' pictures and used qualitative research methods to analyze and understand their findings. The groups also worked to conceive and design social marketing campaigns to address their findings.

The young participants created three posters to voice their findings: (1) a poster that addressed the preponderance of unhealthy eating options in their community; (2) a poster that depicted factors related to the generation and the reduction of stress; and (3) a poster that displayed a calendar featuring both photographs and quotations, created by the teen photographers to raise awareness about stress among school staff and students. The young people promoted their products by displaying them at the California Science Center, their schools, and community centers.

Every youthful photographer revealed concerns about childhood obesity. Accordingly, one group focused their advocacy project on nutrition, food in their community, and how food issues affect the obesity epidemic.

Recommendations for Policy and Practice

In meetings that took place after the project was completed, the participants encouraged the Center to conduct more research on youth obesity. The Center's Community Advisory Board and community partners made the same recommendation.

Responding to this input, The Center partnered with the Los Angeles Unified School District in applying for a grant from the National Center for Minority Health and Health Disparities at NIH to conduct a CBPR project about prevention of youth obesity. The grant was funded in September 2005.

How the Findings Support the Recommendations

This project demonstrated that when young people participate in health advocacy and policy formation, they could play a key role in the development of strategies to support their own community's health. The inclusion of young people in the process of identifying community-level factors that help to shape health behaviors served as an important step in the advancement of programs to promote health.

Participants in this particular Photovoice Project played a significant role in both identifying community factors that affect...