Understanding community food environment through Photovoice: a participatory action research project in Madrid

PhotoVoice is a participatory action research method enabling participants to capture and reflect the strengths and concerns of their community through photography. It promotes critical reflection about relevant issues through... [ view full abstract ]

PhotoVoice is a participatory action research method enabling participants to capture and reflect the strengths and concerns of their community through photography. It promotes critical reflection about relevant issues through group discussion on their own photographs and may generate concrete policy recommendations. Our aim was to gain a deeper understanding of the community food environment as perceived by the residents of a low-income Madrid (Spain) district.

This study ran throughout 2015, as part of the Heart Healthy Hoods project (hhhproject.eu). 24 residents, between 40 and 75 years living in two neighborhoods of the study area participated in four different groups. Participants were asked to photograph all the features related to the food environment in their neighborhood. Each group underwent at least 5 group meetings, where we used the SHOWED mnemonic method to guide group discussions on their pictures. Each meeting was audio taped and transcribed verbatim. Participants analyzed all their photographs in the last meeting identifying barriers and opportunities for healthy eating.

Participants identified themes and coded the 163 photographs they took with 32 final photographs chosen for the photobook and exhibition. Through a consensus-building process principal emerging categories of the local food environment were identified by the group participants. Six main topic areas were derived from these categories by the research team using the qualitative analytical technique of successive approximation: 1) Cultural diversity, 2) Ageing, 3) Poverty and economic crisis, 4) Food trade, 5) Social relationships, and 6) eating in moderation.

Participants were the main actors throughout the study and were highly satisfied with their involvement in the project. Finally they generated 16 concrete policy recommendations that were shared with local policy-makers in an open meeting. The relevance of this project lies in the innovative approach in public health research allowing for citizen immersion.