Photovoice Blog Series
Blog #3: The Research Process
By Ogai Sherzoi
Ogai brings with her valuable experience in patient and public engagement (PPE) with immigrant and refugee communities, through her master’s thesis, which involved understanding perceptions of mental health and unique barriers to accessing mental health services. In this series, Ogai guides the reader through the photovoice participatory research method, and provides step-by-step examples of ways to engage participants throughout the research process.
Reflexivity
In qualitative research, reflexivity is the practice of continuous reflection by the researcher regarding their own values, preconceptions, and behaviour, recognizing the impact they may have on the research process and interpretation of findings. Reflexivity in research is crucial, as it not only helps to deconstruct oneself as a researcher and individual, but also impacts the research relationship [1]. In this study, prior to beginning the research process, I used reflexivity to become more aware of my own social location and privilege, so I could balance and share power with the participants and avoid unconsciously using oppressive practices. Keeping a journal throughout the research process helped me to remain aware of my own social location and biases. (Editor’s note: we will discuss the concept of reflexivity in more depth in an upcoming blog — stay tuned!)
Participant Meetings
The six individuals engaged in this project participated in 1.5 hour-long group meetings, with topics listed below (for the full step-by-step process see my published thesis) [2]:
- 1st Meeting: Participants discover photovoice
- 2nd Meeting: Cameras & instructions are provided
- 3rd Meeting: Sharing photos & stories
- 4th Meeting: Choosing photos & stories to share
- 5th Meeting: Feedback and debriefing
Developing Research Questions & Data Collection
Research questions developed with conversations with Artbeat Studio staff were just a starting point. Participants were informed that they could change, add, remove, or refine any of the questions, or the overall direction of the research. I wanted to make sure the research I was doing was meaningful and relevant to the experiences and realities of the participants, and captured their community concerns. In the end, participants decided they liked the proposed direction of the research, with questions regarding:
- Their perceptions of mental health and illness,
- Barriers to accessing mental health services, and
- What they believed were the perceptions of mental health and illness of other members of their community.
Participants were given cameras and 10 days to collect photos and stories.
Data Analysis
Stage 1: Group Analysis
After 10 days with the cameras, participants submitted their photos and stories, and we began the initial stage of data analysis. As a group, we used a unique photovoice method of analysis that involves three major components [3]:
- Selecting Photographs: participants chose photos that best represented challenges and strengths faced in their community, and those that best represented their lived experiences. These chosen pictures and stories were eventually displayed at the exhibition held at Artbeat Studio Central.
- Contextualizing: participants contextualized the photographs when they shared their stories, lived experiences, and the meaning behind their photographs. It was through group dialogue that the participants were able to effectively share their individual and group experiences.
- Codifying: participants searched for common themes and threads through photos and stories.
Stage 2: Thematic Analysis
For the second stage, I used thematic analysis to identify, analyze, and report themes (patterns) in the data. This method was specifically chosen for its flexibility, lack of ties to specific underlying theories and epistemologies, and usefulness in providing accounts of rich, detailed, and complex qualitative data analysis [4]. It involves three major components, described in greater detail in my thesis:
- Familiarize yourself with data
- Generate initial codes
- Search for themes
Dissemination (Art Exhibition & Launch)
Artbeat Studio hosted the final exhibit, including the initial launch. The art exhibit was not only the actionable piece for the project, but also provided a great avenue for dissemination and translation of knowledge. Attendees described photovoice as a humane and non-objectifying form of research, and spoke to how photos connect us in a way that can’t be achieved through words alone. They also indicated how much the project increased their awareness and understanding of barriers faced by members of the immigrant and refugee community.
Debriefing and Feedback
Feedback is an integral part of the photovoice project, and was incorporated into all the meetings and stages of the research. In the final meeting, I presented participants with a brief summary of the findings and performed member checking — ensuring that the summary reflects the meanings that participants were trying to convey with their photos — to ensure the accuracy and validity of the summarized data.
What Did Participants Think of the Photovoice Method?
Group Consciousness
Using photovoice gave participants the opportunity to creatively express themselves and their stories artistically. Participants said they became more aware of their individual and collective skills, courage, and voices. One participant mentioned how immigrants and refugees dealing with mental health problems have a lot to offer, yet they are silenced, not heard, and put to the side in society.
“We need a society where the voices and creativity of immigrants and refugees are included, as they deserve to shine” — Photovoice participant
Individual Impact
The photovoice method provided a platform for participants to come together, share with the community, and voice their concerns, having a positive impact on their self-efficacy and feelings of contributing to mobilizing change for their community. Participants described feeling proud of their work and contributions, and valued the importance of this topic and the changes that the project could bring about. Being present at the exhibit allowed participants the opportunity to connect to a wider community and talk about their photos and stories. For both participants and observers, the exhibit created sense of empathy and a way for community members who weren’t part of the project to be involved.
Compensation & Recognition
Compensation is a critical component of patient and public engagement. Although each participant was compensated with a gift card and provided with bus tickets and refreshments for meetings, I observed that what was even more meaningful to them was being presented with a certificate of achievement tailored to the strengths and skills they brought to the project.
References
- Hertz R. Reflexivity & voice. 1997. Thousand Oaks, CA: Sage Publications.
- Sherzoi O, Cheung M & Heinonen T. Photovoice: Exploring Immigrants and Refugees’ Perceptions and Access to Mental Health Services in Winnipeg (master’s thesis). 2017. Retrieved from MSpace, http://hdl.handle.net/1993/32075.
- Wang C & Burris M. Photovoice: Concept, methodology, and use for participatory needs assessment. Health Educ Behav, 1997;24(3): 369–87.
- Braun V & Clarke V. Using thematic analysis in psychology. Qual Res Psychol, 2006;3(2): 77–101.
About the Author
Ogai Sherzoi is a knowledge broker in patient and public engagement at the George & Fay Yee Centre for Healthcare Innovation (CHI).
