Keeping at-risk youth at the center: lessons learned from a community-based participatory research Photovoice project in Taiwan
Youth in the foster care and juvenile justice systems have numerous unmet health needs and long-term negative health outcomes. Photovoice is a qualitative research method in which participants produce photographs and narratives to communicate their perspectives. While Photovoice has been used in various contexts relating to at-risk youth, no known study has been conducted among youth in the foster care or juvenile justice systems. However, numerous challenges exist for the inclusion of at-risk youth in research. Thirteen youth from a group home in Taiwan for teenage boys in the foster care and juvenile justice systems participated in this yearlong study which utilized a strengths-based approach to examine resiliency, their needs, and sources of support. After receiving in-depth training, participants spent three months taking photos and writing accompanying narratives relating to the research questions. Then, via facilitated individual and group discussions, participants selected photo-narrative pairings relating to five key themes, which were then used in exhibitions for local stakeholders. This article describes nine key lessons learned to keep at-risk youth at the center of future similar research studies through protecting, representing, and empowering them: 1) consider ethical challenges, 2) identify community partners, 3) develop mutual trust with participants, 4) use symbolism, 5) have a strengths-based approach, 6) allow participants to direct the process, 7) maximize time to develop participants’ introspective skills, 8) disseminate study results widely, and 9) include participant empowerment as a key objective. Conducting research with at-risk youth is challenging but vital to identifying ways society can best support them. Photovoice remains a meaningful way for marginalized communities to articulate their needs and share their experiences and perspectives. Recognizing and addressing logistical and ethical challenges early can ultimately lead to more impactful studies for at-risk youth both individually and systemically.
Ahrens, K. R., Garrison, M. M., & Courtney, M. E. (2014). Health Outcomes in Young Adults From Foster Care and Economically Diverse Backgrounds. Pediatrics, 134(6). https://doi.org/10.1542/peds.2014-1150
Barman-Adhikari, A., DeChants, J. P., M. Brydon, D., Portillo, A., & Bender, K. (2019). On the fringes: How youth experiencing homelessness conceptualize social and economic inequality–A Photovoice study. Journal of Community Psychology, 47(4), 924–942. https://doi.org/10.1002/jcop.22164
Barnert, E. S., Perry, R., Azzi, V. F., Shetgiri, R., Ryan, G., Dudovitz, R., Zima, B., & Chung, P. J. (2014). Incarcerated Youths’ Perspectives on Protective Factors and Risk Factors for Juvenile Offending: A Qualitative Analysis. American Journal of Public Health, 105(7), 1–7. https://doi.org/10.2105/AJPH.2014.302228
Bashore, L., Alexander, G. K., Jackson, D. L., & Mauch, P. (2017). Improving health in at-risk youth through Photovoice. Journal of Child Health Care, 21(4), 463–475. https://doi.org/10.1177/1367493517734391
Blackman, A., & Fairey, T. (2007). The Photovoice Manual: A guide to designing and running participatory photography projects.
Brazg, T., Bekemeier, B., Spigner, C., & Huebner, C. E. (2011). Our Community in Focus: The Use of Photovoice for Youth-Driven Substance Abuse Assessment and Health Promotion. Health Promotion Practice, 12(4), 502–511. https://doi.org/10.1177/1524839909358659
Bryan, K., Freer, J., & Furlong, C. (2007). Language and communication difficulties in juvenile offenders. International Journal of Language & Communication Disorders, 42(5), 505–520. https://doi.org/10.1080/13682820601053977
Cameron Morse, W., Nielsen-Pincus, M., Ellen Force, J., & Wulfhorst, J. D. (2007). Bridges and Barriers to Developing and Conducting Interdisciplinary Graduate-Student Team Research. Ecology & Society, 12(2), 1–14. http://www.ecologyandsociety.org/vol12/iss2/art8/
Coffey, C., Veit, F., Wolfe, R., Cini, E., & Patton, G. C. (2003). Mortality in young offenders: a retrospective cohort study. BMJ (Clinical Research Ed.), 326(7398), 1064. https://doi.org/10.1136/bmj.326.7398.1064
Creighton, G., Oliffe, J. L., Ferlatte, O., Bottorff, J., Broom, A., & Jenkins, E. K. (2018). Photovoice Ethics: Critical Reflections From Men’s Mental Health Research. Qualitative Health Research, 28(3), 446–455. https://doi.org/10.1177/1049732317729137
Dovey-Pearce, G., Walker, S., Fairgrieve, S., Parker, M., & Rapley, T. (2019). The burden of proof: The process of involving young people in research. Health Expectations. https://doi.org/10.1111/hex.12870
Garcia, A. P., Minkler, M., Cardenas, Z., Grills, C., & Porter, C. (2014). Engaging Homeless Youth in Community-Based Participatory Research. Health Promotion Practice, 15(1), 18–27. https://doi.org/10.1177/1524839912472904
Goddard, T., Cranston, N., & Billot, J. (2006). Making It Work: Identifying the Challenges of Collaborative International Research. International Electronic Journal for Leadership in Learning, 10(1), 1–5. http://ecite.utas.edu.au/62354
Heath, R. A., & Priest, H. M. (2016). Examining experiences of transition, instability, and coping for young offenders in the community: A qualitative analysis. Clinical Child Psychology and Psychiatry, 21(2), 224–239. https://doi.org/10.1177/1359104515581715
Hopkins, T., Clegg, J., & Stackhouse, J. (2016). Young offenders’ perspectives on their literacy and communication skills. International Journal of Language & Communication Disorders, 51(1), 95–109. https://doi.org/10.1111/1460-6984.12188
Hsiao, V., Chen, S., & Withers, M. (2019). Understanding perspectives and lived experiences of at-risk Taiwanese teenage boys through photovoice. Journal of Global Health Science, 1(2). https://doi.org/10.35500/jghs.2019.1.e40
Jeffords, C. R. (2007). Gaining Approval From a Juvenile Correctional Agency to Conduct External Research. Youth Violence and Juvenile Justice, 5(1), 88–99. https://doi.org/10.1177/1541204006295163
Kantrowitz-Gordon, I., & Vandermause, R. (2016). Metaphors of Distress. Qualitative Health Research, 26(8), 1031–1043. https://doi.org/10.1177/1049732315575729
Koball, H., Dion, R., Gothro, A., Bardos, M., Dworsky, A., Lansing, J., Stagner, M., Korom-Djakovic, D., Herrera, C., & Manning, A. E. (2011). Synthesis of Research and Resources to Support at-Risk Youth. http://www.acf.hhs.gov/programs/opre/index.html.
Kovacic, M., Stigler, S., Smith, A., Kidd, A., Vaughn, L., Kovacic, M. B., Stigler, S., Smith, A., Kidd, A., & Vaughn, L. M. (2014). Beginning a Partnership with PhotoVoice to Explore Environmental Health and Health Inequities in Minority Communities. International Journal of Environmental Research and Public Health, 11(11), 11132–11151. https://doi.org/10.3390/ijerph111111132
Palibroda, B., Krieg, B., Murdock, L., & Havelock, J. (2009). A Practical Guide to Photovoice: Sharing Pictures, Telling Stories, and Changing Communities. In Prairie Women’s Health Centre of Excellence. http://www.pwhce.ca/photovoice/pdf/Photovoice_Manual.pdf
Pischke, E. C., Knowlton, J. L., Phifer, C. C., Gutierrez Lopez, J., Propato, T. S., Eastmond, A., de Souza, T. M., Kuhlberg, M., Picasso Risso, V., Veron, S. R., Garcia, C., Chiappe, M., & Halvorsen, K. E. (2017). Barriers and Solutions to Conducting Large International, Interdisciplinary Research Projects. Environmental Management, 60(6), 1011–1021. https://doi.org/10.1007/s00267-017-0939-8
Ruth Alsop, & Nina Heinsohn. (2005). Measuring Empowerment in Practice: Structuring Analysis and Framing Indicators. http://bit.ly/37cKsSV
Sanon, M.-A., Evans-Agnew, R. A., & Boutain, D. M. (2014). An exploration of social justice intent in photovoice research studies from 2008 to 2013. Nursing Inquiry, 21(3), 212–226. https://doi.org/10.1111/nin.12064
Sprague, L., Afifi, R., Ayala, G., & El-Nasoor, M. L. (2019). Participatory praxis as an imperative for health-related stigma research. BMC Medicine, 17(1), 32. https://doi.org/10.1186/s12916-019-1263-3
Teti, M., Murray, C., Johnson, L., & Binson, D. (2012). Photovoice as a community-based participatory research method among women living with HIV/AIDS: ethical opportunities and challenges. Journal of Empirical Research on Human Research Ethics : JERHRE, 7(4), 34–43. https://doi.org/10.1525/jer.2012.7.4.34
Wallerstein, N. B., & Duran, B. (2006). Using Community-Based Participatory Research to Address Health Disparities. Health Promotion Practice, 7(3), 312–323. https://doi.org/10.1177/1524839906289376
Walsh, C. A., Hewson, J., & Shier, M. (2008). Unraveling Ethics: Reflections from a Community-based Participatory Research Project with Youth. The Qualitative Report, 13(3), 379–393. https://nsuworks.nova.edu/tqr/vol13/iss3/4
Yu, C., Lou, C., Cheng, Y., Cui, Y., Lian, Q., Wang, Z., Gao, E., & Wang, L. (2019). Young internal migrants' major health issues and health-seeking barriers in Shanghai, China: a qualitative study. BMC Public Health, 19(1), 336. https://doi.org/10.1186/s12889-019-6661-0
Copyright (c) 2020 Journal of Health and Caring Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.