271213 Using photovoice to explore the social, cultural, and environmental context in which Creole women in Bluefields, Nicaragua, experience health

Sunday, October 28, 2012

Emma McKim Mitchell, PhD, RN , School of Nursing and Health Studies, University of Miami, Coral Gables, FL
Richard Steeves, PhD, RN, FAAN , School of Nursing, University of Virginia, Charlottesville, VA
Background: Little is known about the health experiences of women living in the geographically isolated Coastal city of Bluefields, Nicaragua. Of the six ethnic groups living there (Mestizo, Creole, Miskitu, Garifuna, Rama and Mayangna), the Creole population disproportionately migrates from Bluefields to economically support family members who remain.

Purpose: To explore Creole women's health experiences within this context.

Methods: Ethnographic methods (including participant observations and semi-structured key-informant interviews) and photovoice techniques were used to explore the social, cultural, and environmental context in which Creole women experienced health. Twelve Creole women (ages 18 – 45) participated in focus groups, used cameras to document “health”, and were interviewed about the meaning of each photo. Selected photos were presented in a city-wide photoshow designed to raise awareness of priority health issues to this group. Data were analyzed for emergent themes. A multi-pronged approach to address rigor included promoting transparency of research decision through auditable trails.

Results: A total of 142 photos were taken. Themes included: concern over barriers to healthcare access specific to Creole women; the necessity of preserving culturally specific health practices in a context of significant Creole migration out of Bluefields; and concern over city-wide environmental health issues such as water and sanitation.

Conclusions: The process of taking, describing, and showing photos provided insight into the social, cultural, and environmental context in which this minority group of women experienced health. Culturally specific information is essential to address disparities when developing public health interventions focused on prevention and wellness.

Learning Areas:
Public health or related nursing
Public health or related research
Social and behavioral sciences

Learning Objectives:
By the end of this session, the participant will be able to: 1) Describe the social, cultural, and environmental context in which Creole women experience health disparities in Bluefields, Nicaragua. 2) Describe how photovoice techniques can be used with ethnographic methods to explore the social, cultural, and environmental context in which Creole women experience health.

Keywords: Photovoice, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal investigator on this dissertation research study funded by NIH/NINR, and worked with my co-author (dissertation chair) to conduct this community based participatory research study. I have worked in the city where this study took place for over 5 years on several educational, developmental, and research initiatives in partnership with the Bluefields Indian and Caribbean University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.