Eleven people in Sweden spent a few weeks photographing how their daily life had changed after having had a stroke. It sounds like the preparations of a thematic art exhibit, but this project was initiated by rehabilitation researchers at the University of Gothenburg to help them better understand how a stroke affects people’s lives.
This research method is called “photovoice”, and has been in use since the 1990s to better understand the needs of communities and highlight issues that may not be easy for people to address in face-to-face meetings with researchers, for various reasons. The first photovoice study used the method to study women’s health issues in a rural community in China. It helped participants to focus on topics they wanted to address, and gave them space to think about it while they were in their communities.
It’s not just about the photos. An important part of the photovoice method involves the follow-up discussion, where participants are asked to describe some of the photos they took – and why they picked these images. This helps highlight what the issues are, and how important these issues are perceived to be in the eyes of the participants.
Some other recent projects that used the photovoice method include the study of disaster risk perception among native Hawaiians on O’ahu, research into adolescent drug use at the US-Mexico border, and social connectedness of parents of young children living in highrise buildings in Australia. They’re all very different studies, but have in common that the most valuable pieces of information have to do with how people live their daily lives, and that can be difficult to assess from a distance. Photography gives people a tool to capture their lives as they live them.
The Swedish study is not the first to use the photovoice method to look at the effects of stroke, but every community is different, and not all the existing studies were relevant to people living in Sweden. For example, one of the existing photovoice research projects on the effects of stroke was specifically looking at elderly people from Asian communities in North America.
After analysing the photos and discussing them with participants, the researchers learned that most people had found inventive ways to adapt to life after stroke. One person’s photos showed how they used clamps to keep fabric flat while ironing. Another had used ribbons to distinguish two nearly identical kitchen tools that they were no longer able to tell apart otherwise. One of the common themes that several people mentioned was a difficulty navigating the streets while walking. Uneven streets or rapidly changing pedestrian crossing lights made it harder for them to get around than it used to be. That was something that some of the previous photovoice studies in other countries also picked up.
By giving people a disposable camera (or asking them to take photos using their phones) they become active participants in the research, rather than just subjects. For many photovoice projects, that empowerment is often a driving force for people to participate. They get the sense that they’re making a difference.
This method of having people take photos of their environment isn’t without its flaws. For one, the process of categorising and sorting through photos and conversations is always somewhat subjective. Critics of the technique have pointed out that it might give participants too high expectations – they now expect change, even if the goal of a study might have just been to catalogue the problems that exist, and perhaps recommend a change, but not carry out the processes to fix the situation.
Even though it’s not a perfect method, photovoice adds to the understanding that researchers have of certain communities. In the case of the study of people living with stroke in Sweden, it highlighted that several participants were suffering from depression, which made it more challenging to get back in their routine. The researchers used the study as a starting point to recommend a further investigation into the aftercare of people with stroke.
Finally, even though the main goal of photovoice projects is to learn more about people in a certain community, the pictures do make for interesting exhibit material. According to the research paper in PLOS One, the participants in the Gothenburg study on life after stroke are also planning to use their photos to highlight accessibility issues in a future exhibit in the city.