Title: Using photovoice to ensure a right to health: Eliciting resident perspectives through the life course to support Healthy Eating Active Living (HEAL) policies
Authors: Semra Aytur, Anna Adachi-Mejia, Emily Dollar, Beth Wheeler, Sara Rainer, Stephanie Kelly, Alyssa Henry, Emily Counts
Description: The National Prevention Strategy recognizes healthy eating/active living (HEAL) policies as priority areas for preventing chronic disease. The practice of evidence-based public health policy requires understanding the needs, values, and perceptions of community members who will be affected by policies and interventions. We describe how data collected through photovoice, a participatory action research method, can support the development and implementation of HEAL policies. Photovoice integrates participant-initiated photography and facilitated dialogue about perceptions of health. We synthesize data from several photovoice/photo-elicitation projects conducted in New England over the past 5 years pertaining to healthy eating/active living, neighborhood safety, sleep, and adaptive sports participation. Participants ranged in age from pre-adolescent through older adult; they included rural residents, urban refugees, and youth with disabilities. We present lessons learned about how photovoice can facilitate resident empowerment and engagement with respect to multi-sectoral policies and planning processes. These lessons relate to federal policies (e.g., implementation of the National Prevention Strategy, the Individuals with Disabilities Act, and Section 504 of the Rehabilitation Act of 1973 (ensuring equitable school athletic opportunities for students with disabilities)); state policies (e.g., implementation of the New Hampshire (NH) State Health Improvement Plan and the NH HEAL plan); municipal policies (e.g., joint-use agreements; strategies to promote access to safe parks/recreational spaces); and clinical-community strategies (e.g., enabling primary-care providers to better support patients in achieving physical activity goals). Photovoice can inform our understanding of barriers, enablers, and contextual differences that must be considered when developing/implementing policies to support healthy behaviors.