Evaluating Environmental Change using Photovoice: Lessons Learned from Kaiser Permanente's Community Health Initiative

Many obesity-prevention efforts focus on making positive changes to the community-level food and physical activity environments; for example, increasing the availability of healthy food in stores, or making neighborhoods safer and more walkable. Creative methods are needed to document the environmental changes brought about by these interventions and to communicate the results to a range of audiences. We are using Photovoice - a community-based approach to documentary photography - as part of the evaluation of the Community Health Initiative, a community-based obesity prevention effort sponsored by Kaiser Permanente. Photovoice is typically used as an advocacy tool to engage both community residents and political leaders in policy and environmental solutions to public health issues. We are piloting an innovative way to apply Photovoice as a qualitative evaluation method, which includes asking members of community collaboratives to participate in a second round of photographs and captions to document changes to their community environment, reflect on the potential impact of those changes and plan for future advocacy efforts. This presentation will describe the experience of using Photovoice as an evaluation tool in three low income, largely minority communities in Northern California, presenting results (photographs and captions) and lessons learned.