USING PHOTOVOICE TO ENSURE A RIGHT TO HEALTH: ELICITING RESIDENT PERSPECTIVES THROUGH THE LIFE COURSE TO SUPPORT HEALTHY EATING ACTIVE LIVING (HEAL) POLICIES Semra Aytur, 1 Alyssa Henry , 1 Emily Dollar, 2 Sara Rainer, 5,1 Beth Wheeler, 6 Emily Counts, 1 Stephanie Kelly, 2,4 Anna Adachi-Mejia 2,3,4 1 University of New Hampshire, 2 The Geisel School of Medicine at Dartmouth, 3 The Norris Cotton Cancer Center, 4 Dartmouth ’ s Prevention Research Center, the Health Promotion Research Center at Dartmouth (HPRCD), 5 Institute on Disability, 6 Foundation for Healthy Communities
INTRODUCTION • The National Prevention Strategy (NPS) recognizes four strategic directions for improving population health: Healthy and Safe Community Environments • Clinical and Community Preventive Services • Empowered People • Elimination of Health Disparities • • State-level public health plans also emphasize chronic disease and injury prevention • Vertical integration of national, state, and local policies/plans requires understanding the needs, values, and http://www.surgeongeneral.gov/priorities/prevention/strategy/#The Strategic Directions perceptions of community members • Photovoice and photo-elicitation methods can facilitate this understanding
OBJECTIVE: • To synthesize data across multiple photovoice/ photo-elicitation projects in order to amplify our collective voice and identify important contextual issues pertaining to policy development, implementation, and evaluation.
METHODS • We synthesized data from 7 photovoice/photo-elicitation projects conducted over the past 6 years in New England pertaining to healthy eating/active living (HEAL), neighborhood safety, sleep, alcohol/substance use, and other public health priorities • Photovoice participants ranged in age from pre-adolescent through older adult; included rural residents, urban refugee/immigrant youth, and persons with disabilities • A multi-disciplinary team consisting of academic researchers, practitioners, clinicians, educators, community organization leaders, and students submitted content • Two team members (a medical student and a health policy/nursing student) synthesized the data from various photovoice projects and identified policy-relevant themes • The team developed cross-cutting implications and summarized key lessons learned
YOUTH PHOTOVOICE PROJECT: “ CREATING SAFE NEIGHBORHOODS ” MANCHESTER, NH Source: Aytur, A., Butcher, R., Carlson, C., & Schifferdecker, K. (2014). Creating safe neighborhoods for obesity prevention: Perceptions of urban youth . In: Brennan, V., Kumanyika, S., & Zambrana, R. (eds). Obesity Interventions in Underserved US Populations: Evidence and Directions. Johns Hopkins University. (November, 2014). ISBN 978-1-4214-1544-4 Funded by the Robert Wood Johnson Foundation ’ s Active Living Research program.
Project Description: Fourteen refugee/immigrant adolescents (ages 13-19) participated in a Photovoice project for six weeks to explore youth perceptions of relationships between safety, active living, and healthy eating in the context of their daily lives. Health Issues: Neighborhood safety and perceptions of opportunities for physical activity and healthy eating in two urban neighborhoods in Manchester, NH Lessons Learned & Themes: • Project enhanced understanding of immigrant/refugee teens ’ perceptions of neighborhood safety, health, and active living. • As Photovoice sessions progressed, participants began to discuss ways that they could initiate change (e.g., serving on Youth Council; engaging school staff).
Trash in alleys where kids play. –W.P ., 15 “ I took this picture of cigarette signs on a gas station next to Pulaski Park. Smoking “ Why can ’ t this vacant is bad for you, yet the advertising is big lot be used for a and eye-catching. It ’ s weird that these ads community garden or a are so close to a place that is healthy and sports field? ” good. “ − S.R, 16 − S.R., 16
Policy/Practice Implications: • NH State Health Improvement Plan (SHIP): Obesity/diabetes, tobacco, injury prevention • NH Healthy Eating Active Living (HEAL) Healthy People, Healthy Places Plan • An Art Exhibit and a community-wide Photovoice training session was held at the end of the study to enable community members to conduct future Photovoice projects. • Manchester Neighborhood Health Improvement Strategy • Building on strong community engagement and cross-sector partnerships, the City of Manchester became a 2016 Robert Wood Johnson Foundation Culture of Health Prize Winner: http://www.rwjf.org/en/library/collections/coh-prize-winners/2016 -winner-manchester-nh.html Manchester Neighborhood Health Improvement Strategy: http://www.graniteuw.org/assets/pdf/compaign-toolkit/ Manchester_NHIS_2014.pdf
THROUGH THE LENS OF A CAMERA: EXPLORING THE MEANING OF PHYSICAL ACTIVITY PARTICIPATION AMONG YOUTH WITH DISABILITIES THROUGH PHOTOVOICE Patti Craig, Ph.D., CTRS/L and Semra Aytur, PhD, MPH (University of New Hampshire), in partnership with Northeast Passage (nepassage.org/)
Project Description: This Photovoice study explores the meaning of physical activity participation and competitive sport experiences among youth athletes with disabilities Members of the Northeast Passage Wildcats Sled Hockey team • Methods: Photovoice, semi-structured interviews, and focus groups were used to explore the meaning of sports participation from the perspective of youth with physical disabilities (n=8; ages 9-18). Health Issues: Physical activity, positive youth development Northeast Passage: http://nepassage.org/about/
Policy/Practice Connections: • Individuals with Disabilities Act • Section 504 of the Rehabilitation Act of 1973 (ensuring equitable school athletic opportunities for students with disabilities) • NH HEAL Healthy People, Healthy Places Plan: • Example: Goal: To active transportation and recreation • Objective 1: Ensure equitable access to options for getting around, and safe, high-quality places to play and be active. • Objective 2: Ensure access to indoor and outdoor recreation facilities within a reasonable distance.
“ I love playing basketball. I tried out for my school team but didn ’ t make it. I have to travel to CT to play on a wheelchair basketball team. ” (C.H.) “ This is a picture of the baseball and soccer field at my school. Lots of times in the fall & spring P .E. classes are held up here or we get extra recess here. Even though there is a paved “ This photo represents the sacrifices me walkway to the field, I can ’ t get through the gate in the fence and my family make to get me to a because it is too small. There is no other entrance. This makes Doctor ’ s appointment. I missed school & me mad because they make zero effort to include me, so I just my parents had to drive 1 hour & 30 stay inside and don ’ t want to be with them anyways. ” (C.H.) minutes to get me there. ” (A.D.)
“ This is a picture of my new bathroom. I am independent in my new bathroom because it is built for my needs. It builds self-confidence. ” (P.M.) “ This is a picture of my school ’ s playground. I have hardly been on this playground during the 8 years I have gone here because its really hard to push across the field to get there and then I can ’ t push in the bark mulch once I do get there. I feel like I missed out on a lot of fun. ” (C.H.) “ I am at the skate park dropping into the bowl. I ’ m the only one in a wheelchair here. But it ’ s ok because when I ’ m here I am like everyone else. I watch the skateboarders and BMX ’ ers and try to make my chair do what they do. I can do the same things but I just do it in a different way. ” (D.M.)
Lessons Learned & Themes: Intrapersonal Level Qualitative analysis of text and photos revealed themes associated with empowerment and Positive Youth Development: • Competence • Social competence • Cognitive competence • Vocational competence • Confidence • Connection • Character • Caring and Compassion “’ Grab a piece of chair. ’ My coach always says this at the end of basketball practice. We all grab onto Sources: Lerner R. M. (2004). Liberty: Thriving and civic engagement among American youth. Thousand each other ’ s chairs and do a little chant. ” Oaks, CA: Sage Roth, J. L. , & Brooks-Gunn, J. (2005). Positive Youth Development (D.M.) A View of the Issues. Journal of Early Adolescence; 25(1):10-16
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