Toward an Intergenerational Model for Tobacco-Focused CBPR: Integrating Youth Perspectives via Photovoice

Abstract

The growing prominence of community-based participatory research (CBPR) presents as an opportunity to improve tobacco-related intervention efforts. CBPR collaborations for tobacco/health, however, typically engage only adults, thus affording only a partial understanding of community context as related to tobacco. This is problematic given evidence around age of tobacco use initiation and the influence of local tobacco environments on youth. The CEASE and Resist youth photovoice project was developed as part of the Communities Engaged and Advocating for a Smoke-free Environment (CEASE) CBPR collaboration in Southwest Baltimore. With the broader CEASE initiative focused on adult smoking cessation, CEASE and Resist had three aims: (1) elucidate how youth from a high-tobacco-burden community perceive/interact with their local tobacco environment, (2) train youth as active change agents for tobacco-related community health, and (3) improve intergenerational understandings of tobacco use/impacts within the community. Fourteen youth were recruited from three schools and trained in participatory research and photography ethics/guiding principles. Youth met at regular intervals to discuss and narrate their photos. This article provides an overview of what their work revealed/achieved and discusses how including participatory youth research within traditionally adult-focused work can facilitate intergenerational CBPR for sustainable local action on tobacco and community health.

Outcomes and Intentionality of Action Planning in Photovoice: A Literature Review

“…Ten studies included adults, with two of the studies focusing on the young adult population (Bharmal et al, 2012;Musoke et al, 2016) and one on mother-daughter pair participants (Miller & Vaughn, 2015). The remaining studies had participants who were adolescents, with a few including elementary school-age children (Petteway et al, 2019;Wilson et al, 2008). The majority of studies had mixed genders but seven included only women and one included only men (Bharmal et al, 2012).…”

“…Outcomes that affected multiple systems throughout the community were policy advocacy, funding support for future projects, new interven-tions and research projects, and increased community capacity. Advocacy activities led to financial support for future projects or studies (Beh et al, 2013;Nucho & Nahm, 2018;Perez et al, 2016;Petteway et al, 2019), catalyzed further assessment of the study topic (Balvanz et al, 2016;Haque & Eng, 2011), or led to changes in organizational policies (Rhodes et al, 2015). Ten studies resulted in new interventions or dramatic changes to an existing intervention-whether through a built environment intervention (Adams et al, 2012;Beh et al, 2013;Bisung et al, 2015;Haque & Eng, 2011) or a programmatic intervention (Adams et al, 2012;Bharmal et al, 2012;Moya et al, 2014;Rhodes et al, 2008;Wilson et al, 2008).…”

“…Ten studies resulted in new interventions or dramatic changes to an existing intervention-whether through a built environment intervention (Adams et al, 2012;Beh et al, 2013;Bisung et al, 2015;Haque & Eng, 2011) or a programmatic intervention (Adams et al, 2012;Bharmal et al, 2012;Moya et al, 2014;Rhodes et al, 2008;Wilson et al, 2008). Studies that built community capacity did so by expanding the network of organizations in a community or building context for organizations to work together (Adams et al, 2012;Bisung et al, 2015;Haque and Eng, 2011;Miller and Vaughn, 2015;Moya et al, 2014;Musoke et al, 2016;Nucho & Nahm, 2018;Pearce et al, 2017;Perez et al, 2016;Petteway et al, 2019;Rhodes et al, 2008;Rhodes et al, 2015;Suffla et al, 2012) In addition to the variety of outcomes, action plans were developed in multiple ways-with participants, key stakeholders, researchers/facilitators, and community participants (Balvanz et al, 2016;Miller & Vaughn, 2015;Rhodes et al, 2008;Rhodes et al, 2015;Suffla et al, 2012;Wilson et al, 2008; see Table 2). Communities typically had ownership over action planning; there were only three studies in which researchers had primary responsibility for the outcomes (Adams et al, 2012;Bharmal et al, 2012;Suffla et al, 2012).…”

Smoking and Unemployment: A Photo Elicitation Project

“… 8 - 15 The few publications of photovoice applied in tobacco control have largely focused on youth advocacy efforts. 16 - 19 …”

“…[8][9][10][11][12][13][14][15] The few publications of photovoice applied in tobacco control have largely focused on youth advocacy efforts. [16][17][18][19] For our purposes here, we engaged participants using photography as a discussion starter and narrative tool to gain a better understanding of the experience of job-seeking when one smokes and to inform tobacco cessation treatment development. Similar photo elicitation methods have been used in addiction research to study clients' perceptions of treatment settings; the experiences of unhoused veterans with regard to substance use, treatment, and recovery; nutritional choices of mothers in residential substance abuse treatment; and determinants of smoking initiation among indigenous youth.…”