Photovoice and Public Health Nursing: Why this Tool is Ideal for Informing Policy and Practice with the Voice(s) of Populations and Communities

National policies and objectives are intended to improve the health of populations and reduce the spread and impact of disease, illness, and disability (e.g., Healthy People 2020 in the U.S.). Often, the subsequent initiatives to create effective interventions and programs are implemented via a complex web of distributed finances, resources, responsibilities, and authority. Whether nationally driven or locally inspired, programmatic efforts will not maximize optimal results when they lack input from those who are presumed to benefit as participants in a program or recipients of a service. The voices of those at greatest risk or vulnerability rarely reach policy/decision makers despite being the sources of epidemiological data that reflect health and behavior trends used to directly inform public health priorities.

It is in this context that the photovoice approach originated, with inspiration from feminist theory and theory of the oppressed (Paulo Freire). Photovoice is a systematic participatory process that yields the ‘voice' of a collective group about a mutual community concern and generates policy recommendations. Photographs from the participants are the primary vehicles through which perspectives, ideas, and recommendations emerge. Facilitated group processes ensure diverse voices are represented and photograph meanings are accurately expressed.

Photovoice has been successfully used to inform leading global public health nursing priorities, including substance use, parent-adolescent relationships and migration influences, environmental exposures, street youth needs, and broadly, community assessments of needs and priorities. This presentation will explain the photovoice process and identify strengths, limitations, and considerations using shared examples from the U.S., Mexico, and Brazil.