Centering Community Voices in Research: How Photovoice Turns Experience into Data

Pamela Rothpletz-Puglia—a professor in the Department of Interdisciplinary Studies at Rutgers School of Health Professions—has long been a practitioner of qualitative and mixed-methods research, and is a firm believer in participatory problem-solving approaches to health. “When families co-produce solutions to health issues that fit the context of their lives, those solutions are far more likely to be successful,” she asserts, speaking from 20 years of experience as a registered dietitian practicing in Newark. Rothpletz-Puglia’s REACH project, Dismantling the “Kids’ Food” Archetype, took just such an approach to the issue of ultra-processed kids’ food, which is heavily marketed in cities with low-income and minority residents. “This targeted marketing encourages diets with limited variety, which creates resistance to new food, ultimately increasing lifetime risks of obesity and chronic disease,” says Rothpletz-Puglia. Her project, an assessment of the children’s food culture and environment in Newark, was informed by the participation of local mothers of young children, who used cameras (provided by the study) to document the environment. Dr. Denise Rodgers, founding principal investigator of REACH, discusses the social and cultural pressures that contribute to fast-food consumption. "When we look at the epidemic of type 2 diabetes we’re seeing in children, it’s often because their families abandon the foods that they came to this country eating, because of price, pressures, convenience, and so on." The Leaguers, Inc., a local social services agency serving the Newark community, and longtime partner of Dr. Rothpletz-Puglia, worked with the team to recruit 25 Newark mothers in the multi-phase study employing photovoice. “They created the data by taking the photos,” explains Rothpletz-Puglia. The group of mothers took an initial set of photos and participated in focus-group discussions afterward to talk about why they took each photo. These rich conversations not only helped the study team devise an appropriate nutritional education intervention, but raised critical awareness among the participants. The shift became evident in the discussions that followed the second group of photos. “The photos were similar, but the reasons they took them were different,” says Rothpletz-Puglia, who was struck by the change. “Mothers became critically conscious and critically aware of the environment, noticing things like advertising.”