Youth as change agents for healthy neighborhood environments: The manchester photovoice project

Marginalization from decision-making processes mirrors the health disparities observed worldwide with respect to infrastructure investments, exposure to violence and environmental hazards, and rates of chronic disease. By enabling people to become change agents within their own communities, Participatory Action Research methods such as Photovoice can facilitate the co-creation of culturally relevant strategies to address the intersection of violence prevention and chronic disease prevention. The city of Manchester, NH, has implemented institutional policy changes to build cross-sector collaboration around issues of violence prevention, neighborhood revitalization, and active living. However, little is known about immigrant/refugee youth's perceptions of these issues. We conducted a Photovoice project to: 1) explore youth's perceptions of relationships between safety, active living, and healthy eating in the context of their daily lives; and 2) understand barriers/enablers of health in their neighborhoods. Fourteen adolescents (ages 13-19) were recruited to participate in a Photovoice project for six weeks (n=12 were from refugee resettlement families). Themes revealed by youth's photos and narratives included: 1) unhealthy indoor/outdoor home environments; 2) landlord-tenant conflicts; 3) violence in parks, schools, and neighborhoods; 4) advertisements for beer and cigarettes in areas where youth play; 5) the importance of youth leaders as change agents. The Photovoice process generated a community dialogue that allowed youth to voice their concerns and share their photos with community stakeholders through an art exhibit. Youth from the community are currently leading their own undergraduate research project to promote healthy home environments, in partnership with the health department.