• By Dartington SRU
  • Posted on Friday 29th January, 2010

Perhaps not worth quite a thousand

The approach isn't new and the findings are unremarkable, but the fact that the activity has been directed by public health and translational science specialists in important university departments and funded by the US National Center for Injury Prevention and Control suggests growing interest in visual representation as a focus for community-based participatory research. That painting and drawing can convey as much about young people's viewpoint and experience as any interview record or classroom focus group is widely recognized. It can be a valuable tool, for example, in counseling the child survivors of war and other disastersIn a trial involving researchers at John Hopkins and Pittsburgh Universities that reasoning has been combined with efforts to enable African-American children to play a bigger role in improving conditions – and in building social capital – in two neighborhoods in Pittsburgh and Baltimore.In their report just published online in Progress in Community Health Partnerships: Research, Education and Action, the researchers from University of Pittsburgh Medical Center and the Johns Hopkins Bloomberg School of Public cite Melvin Delgado at Boston University as a key source of the rationale for capturing the young person's perspective. They suggest that little of substance has been achieved since the early 1980s when Delgado included Hispanic adolescents in health policy making initiatives. But, as the field of community-based participatory research (CBPR) evolves, there is an increasingly urgent need to develop and new methods.The example in this case was "Visual Voices," developed at the Pittsburgh Department of Family Medicine by Michael Yonas. Since 1993 his experiments have involved around 1,300 young people in the underserved neighborhoods of eight US cities. The approach was tried with two small groups. The first project in Baltimore in the summer of 2007 was a research partnership funded by the Center for Injury Research and Policy at Bloomberg. The second, in Pittsburgh in the fall of following year, was funded by the Pittsburgh Clinical and Translational Science Institute.The process involved the students in a discussion of their rights and responsibilities in a relationship, and of the differences between flirting and sexual harassment. Afterwards they took part in painting and writing assignments and discussed the results "Whether they are painting or writing, it's often the same process. It presents an opportunity to express feelings about experiences, such as a father being shot, or dreams, such as being in Paris someday or having children and owning a home," Yonas explains. "They start to see that there are people around them who they can talk to, including their peers."The important finale involves "building the piece”. Participants look at everything they have made together and determine which pieces they want to include in a final collage and in what order – to create one "visual voice".The researchers say that the methods were being used primarily as a research data collection tool, but the approach can itself be viewed as an intervention, “for example to address the issue of dating violence among adolescent middle school children to facilitate discussion of violent experiences or to visualize and explore nonviolent solutions.”But they are forced to acknowledge the downside. "Visual Voices" work is time consuming and relatively costly. The insights – in this instance into perceptions about safety and mutual support – are rather meager. "Participation costs included frustration with the process, missing other opportunities, risking loss of anonymity, and loss of perceived control," they somberly conclude.See: Yonas M A and Burke J G, and Rak K et. al. "A Picture’s Worth a Thousand Words: Engaging Youth in CBPR Using the Creative Arts" Progress in Community Health Partnerships: Research, Education, and Action 3. 4 (2009) pp 349-358.

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