A Literature Review to Evaluate the Choice and Use of Visual Methods

Although a growing number of projects have been implemented using the community-based participatory research method known as photovoice, no known systematic review of the literature on this approach has been conducted to date. This review draws on the peer-reviewed literature on photovoice in public health and related disciplines conducted before January 2008 to determine (a) what defines the photovoice process, (b) the outcomes associated with photovoice, and (c) how the level of community participation is related to photovoice processes and outcomes. In all, 37 unduplicated articles were identified and reviewed using a descriptive coding scheme and Viswanathan et al.'s quality of participation tool. Findings reveal no relationship between group size and quality of participation but a direct relationship between the latter and project duration as well as with getting to action. More participatory projects also were associated with long-standing relationships between the community and outside researcher partners and an intensive training component. Although vague descriptions of project evaluation practices and a lack of consistent reporting precluded hard conclusions, 60% of projects reported an action component. Particularly among highly participatory projects, photovoice appears to contribute to an enhanced understanding of community assets and needs and to empowerment.

Scientific research occurs within a set of socio-political conditions, and in Canada research involving Indigenous communities has a historical association with colonialism. Consequently, Indigenous peoples have been justifiably sceptical and reluctant to become the subjects of academic research. Community-Based Participatory Research (CBPR) is an attempt to develop culturally relevant research models that address issues of injustice, inequality, and exploitation. The work reported here evaluates the use of Photovoice, a CBPR method that uses participant-employed photography and dialogue to create social change, which was employed in a research partnership with a First Nation in Western Canada. Content analysis of semi-structured interviews (n=45) evaluated participants' perspectives of the Photovoice process as part of a larger study on health and environment issues. The analysis revealed that Photovoice effectively balanced power, created a sense of ownership, fostered trust, built capacity, and responded to cultural preferences. The authors discuss the necessity of modifying Photovoice, by building in an iterative process, as being key to the methodological success of the project.