Photovoice: Assessing the Long-Term Impact of a Disaster on a Community's Quality of Life

Boosting Resilience: Photovoice as a Tool for Promoting Well-Being, Social Cohesion, and Empowerment Among the Older Adult During the COVID-19 Pandemic

This paper examines how older adults who participated in an online photovoice-based group intervention program reported their experience. In a qualitative-phenomenological study, in which 13 older-adult people participated, data were collected through semi-structured in-depth interviews and analyzed through content analysis. The findings point to three central themes: a) Challenges-technical difficulties, difficulties in finding a subject for photography, investing time in photography, and an emotional-intellectual effort to put their experience into photography; b) Growth: New knowledge and skills-acquiring new knowledge, acquiring skills, experiencing skills regardless of age, and empowerment; c) Meaning-reflexivity, the ability to project feelings onto images, connection to the outside world, mindfulness, ability to choose, creativity, and critical consciousness. The findings share the way in which the use of creative visual engagement with photography contributed to coping with various challenges and enabled various gains within the process among the older-adult participants.

"We're Still Here": A Photovoice Study of Mothers' Perspectives 6 Years after the Flint Michigan Water Contamination Event

Purpose: This study explored the lived experiences of pregnant and parenting women after the water contamination event in Flint, Michigan (Flint Water Contamination Event [FWCE]), by helping them visualize their everyday challenges, assets, and family health concerns.

Methods: The photovoice methodology was utilized in this study. Individual participants met with researchers to discuss their photos using the SHOWeD method. Researchers analyzed the photographs, accompanying narratives, and discussion session transcripts using descriptive coding and thematic analysis.

Results: Data analysis revealed five themes: (1) having a healthy pregnancy and well children is a central concern in everyday life, (2) children serve as social and practical resources for family, (3) meeting children's need for safe water is a significant concern, (4) the community and its households battle to get safe affordable water, and (5) there are resources available in the community to support mothers.

Conclusion: While much information is still being collected and published in the aftermath of the FWCE, this study was the first to use the photovoice method to allow pregnant and parenting women to express their concerns about how the FWCE continues to affect the health and care of their families.

Estimation of Health-Related Quality of Life Losses Owing to a Technological Disaster in Brazil Using EQ-5D-3L: A Cross-Sectional Study

OBJECTIVES

In 2015, a dam collapsed at Samarco iron ore mine in the municipality of Mariana, Brazil, and contaminated more than 600 km of watercourses and destroyed almost 1600 acres of vegetation. Nineteen people died and more than 600 families lost their homes. This study aimed to estimate health-related quality of life (HRQoL) losses owing to this disaster.

METHODS

We collected data from a probabilistic sample of 459 individuals aged 15 years or older. Household face-to-face interviews were conducted in December 2018. Pre-event data were not available for this population, so respondents were asked to evaluate at present and in retrospect their health status using EQ-5D-3L. The Minas Gerais societal value sets for EQ-5D-3L health preferences, estimated in 2011, were used to calculate utility losses. The health loss estimation from EQ-5D will form the basis for the calculation of compensation payments for the victims.

RESULTS

Approximately 74% of the study population suffered some HRQoL loss. On average, EQ-5D index values decreased from 0.95 to 0.76. The greatest effects were observed for the anxiety/depression dimension, followed by pain/discomfort. Before the tragedy, the proportion of individuals with severe anxiety/depression and pain/discomfort was equal to 1% rising to 23% and 11%, respectively.

CONCLUSIONS

Catastrophic losses owing to the Samarco disaster were found. The EQ-5D-3L instrument showed feasibility and sensitiveness to measure HRQoL losses owing to a negative health shock in a low-income Brazilian population.

Curriculum development in health and the built environment: creating a multidisciplinary platform to enhance knowledge and engagement

Purpose –

Our lived experiences are complex, dynamic and increasingly connected locally and globally through virtual realities that call for an evolution and responsiveness from the field of architecture education. To ensure future built environments are designed to nurture healing and health, this paper aims to address a critical need in architecture education to integrate knowledge of health and social-behavioral disciplines in students' course work. The authors will outline the process of preparing a new multidisciplinary course on health and the built environment (HBE) at the School of Architecture and Planning at Morgan State University in Baltimore, USA, as an effort to challenge the barriers of discipline-specific pathways to learning in the field of architecture.

Design/methodology/approach –

The central question is how to develop an active learning pedagogy to foster a multidisciplinary learning environment focused on the "practice" (how to) of human-design-oriented approaches to improve the capability of built and natural environments to promote health and healing. The course intentionally centered on the real-life experiences of students to ground their new understanding of health and well-being fields. The course proposal went through an extensive peer-review process of reviewers from the National Institute of Health (NIH) and other departments at Morgan State University to ensure a balance between health- and architecture-specific curricula with a transdisciplinary approach to understanding complex health issues.

Findings –

This paper shows the effectiveness of tools and techniques applied in the course to challenge architectural students to integrate various health and behavior perspectives in their designs and to apply health and healing principals to their current and future design projects.

Originality/value –

While there are courses in American universities that offer a traditional introduction to health concerns related to the built environment, there is limited focus on the perspective of the design field approach to improve health and healing outcomes.

Long-Term Impact of Disasters on the Public Health System: A Multi-Case Analysis

As past events have shown, disasters can have a tremendous impact on the affected population’s health. However, research regarding the long-term impact on a systems level perspective is still scarce. In this multi-case study, we analyzed and compared the long-term impacts on the public health system of five disasters which took place in Europe: avalanche (Austria), terror attack (Spain), airplane crash (Luxembourg), cable-car tunnel fire (Austria), and a flood in Central Europe. We used a mixed-methods approach consisting of a document analysis and interviews with key stakeholders, to examine the various long-term impacts each of the disasters had on health-system performance, as well as on security and health protection. The results show manifold changes undertaken in the fields of psychosocial support, infrastructure, and contingency and preparedness planning. The holistic approach of this study shows the importance of analyzing long-term impacts from the perspective of the type (e.g., disasters associated with natural hazards) and characteristic (e.g., duration and extent) of a disaster, as well as the regional context where a disaster took place. However, the identified recurring themes demonstrate the opportunity of learning from case studies in order to customize the lessons and apply them to the own-disaster-management setting.

'This is the place where I can be alone, no tension:' Photovoice evidence for adolescent perceptions of their microsystem and psychological adjustment

Adolescents experience myriad emotions which occur in relation to their immediate social space which may shape their perceptions of members within the microsystem. The photovoice method uniquely provides participants with the means to capture their life through the lens of a camera while also enabling them to express emotions and meanings they attach to their particular life situations. We explore the various emotions adolescents attach to the spaces they occupy and how they link them to socialization in the context of the microsystem. This study was conducted in rural and urban areas of Udupi taluk, southern India. A total of 21 participants, ranging from early to late adolescence participated and provided multiple forms of data with 112 photographs, 21 journals on their daily interactions and one-on-one interviews facilitated using the SHOWeD model. The analytical method involved compiling visual data from photographs, journal content and interview data pertaining to each participant as a single data file, developing codes using ATLAS.ti, version 8, and further developing sub-themes and themes as they emerged into narratives. Our study was able to elicit emotions and meanings that adolescents attached to social interactions with gendered nuances specific to the Indian cultural setting. Future applications of the photovoice methodology on research among adolescents have also been discussed.

Using Photovoice to Explore Quality of Life Factors of Adults With Crouzon Syndrome

In the United States, one in 60,000 adults live with Crouzon Syndrome (CS) and facial malformations. Phenomenological studies about their lived experiences and quality of life are lacking. The purpose of this participatory action research study was to gain a richer understanding of the perceived biopsychosocial and socioecological factors that impact quality of life for adults living with CS using Photovoice. Another aim was to develop a conceptual framework of quality of life for those experiencing CS to enhance tailored health education and services. A purposeful sample of nine adults with CS were recruited from U.S. national surgery centers and support groups. Participants used photography to represent their experiences and participated in individual interviews and focus groups. Data were analyzed with the participants using thematic analysis, and 44 themes emerged which informed the development of a quality of life conceptual framework and action plan described in this article.

An Official American Thoracic Society Workshop Report: Chemical Inhalational Disasters. Biology of Lung Injury, Development of Novel Therapeutics, and Medical Preparedness

This report is based on the proceedings from the Inhalational Lung Injury Workshop jointly sponsored by the American Thoracic Society (ATS) and the National Institutes of Health (NIH) Countermeasures Against Chemical Threats (CounterACT) program on May 21, 2013, in Philadelphia, Pennsylvania. The CounterACT program facilitates research leading to the development of new and improved medical countermeasures for chemical threat agents. The workshop was initiated by the Terrorism and Inhalational Disasters Section of the Environmental, Occupational, and Population Health Assembly of the ATS. Participants included both domestic and international experts in the field, as well as representatives from U.S. governmental funding agencies. The meeting objectives were to (1) provide a forum to review the evidence supporting current standard medical therapies, (2) present updates on our understanding of the epidemiology and underlying pathophysiology of inhalational lung injuries, (3) discuss innovative investigative approaches to further delineating mechanisms of lung injury and identifying new specific therapeutic targets, (4) present promising novel medical countermeasures, (5) facilitate collaborative research efforts, and (6) identify challenges and future directions in the ongoing development, manufacture, and distribution of effective and specific medical countermeasures. Specific inhalational toxins discussed included irritants/pulmonary toxicants (chlorine gas, bromine, and phosgene), vesicants (sulfur mustard), chemical asphyxiants (cyanide), particulates (World Trade Center dust), and respirable nerve agents.

Immediate Needs and Concerns among Pregnant Women During and after Typhoon Haiyan (Yolanda)

Introduction: Pregnant and postpartum women are especially vulnerable to natural disasters. These women suffer from increased risk of physical and mental issues including pregnant related problems. Typhoon Haiyan (Yolanda), which hit the Philippines affected a large number of people and caused devastating damages. During and after the typhoon, pregnant women were forced to live in particularly difficult circumstances. The purpose of this study was to determine concerns and problems regarding public health needs and coping mechanisms among pregnant women during and shortly after the typhoon.

Methods: This study employed a cross-sectional design utilizing focus group discussions (FGDs). Participants were 53 women (mean age: 26.6 years old; 42 had children) from four affected communities who were pregnant at the time of the typhoon. FGDs were conducted 4 months after the typhoon, from March 19 to 28, 2014, using semi-structured interviews. Data were analyzed using the qualitative content analysis.

Result: Three themes were identified regarding problems and concerns during and after the typhoon: 1) having no ideas what is going to happen during the evacuation, 2) lacking essentials to survive, and 3) being unsure of how to deal with health concerns. Two themes were identified as means of solving issues: 1) finding food for survival and 2) avoiding diseases to save my family. As the pregnant women already had several typhoon experiences without any major problems, they underestimated the catastrophic nature of this typhoon. During the typhoon, the women could not ensure their safety and did not have a strong sense of crisis management. They suffered from hunger, food shortage, and poor sanitation. Moreover, though the women had fear and anxiety regarding their pregnancy, they had no way to resolve these concerns. Pregnant women and their families also suffered from common health problems for which they would usually seek medical services. Under such conditions, the pregnant woman cooperated with others for survival and used their knowledge of disease prevention.

Discussion: Pregnant women experienced difficulties with evacuation, a lack of minimum survival needs, and attending to their own health issues. Pregnant women were also concerned about needs and health issues of their families, particular, when they had small children. Collecting accurate information regarding the disaster and conducting self-sustainable preparation prior to the disaster among pregnant women will help them to protect their pregnancy status, thereby improving their families’ chance of survival during and after disasters.