Youth Photovoice Project:
“Creating Safe Neighborhoods”
Manchester, NH
A partnership between the City of Manchester,
UNH, and Dartmouth
Background
• Marginalization from decision-making
processes mirrors the health disparities
observed worldwide with respect to
infrastructure investments, exposure to
violence and environmental hazards,
and rates of chronic disease
• Participatory Action Research (PAR)
methods, such as Photovoice, can
facilitate the co-creation of culturally
relevant strategies to address complex
health issues
– e.g., intersection of violence prevention
and chronic disease prevention
Context:
Institutional Policy Changes in Manchester, NH
Manchester implemented institutional policy
changes to build cross-sector collaboration
around issues of violence prevention and
healthy neighborhood environments:
•Crime Prevention Through Environmental
Design (CPTED)
•Community Policing
•Neighborhood Revitalization Projects
•Safe Routes to School
•Safe Havens
•‘One Touch’ Healthy Homes program
Objectives
As part of a Community-Based
Participatory Research study, we
conducted a Photovoice project in
Manchester, NH to:
1) Explore youth perceptions of
relationships between safety, active
living, and healthy eating in the context
of their daily lives
2) Understand barriers/enablers of health
in their neighborhoods
Methods
• Fourteen adolescents (ages 13-19)
were recruited to participate in a
Photovoice project for six weeks
• n=12 were from refugee
resettlement families from various
countries (including Sudan, Somalia,
Tanzania, and Rwanda); one was
White and one African American.
Photovoice: Facilitated Dialogue
Discussion of photos was facilitated using
the “SHOWeD” method:
• What do you See here?
• What’s really Happening?
• How does this relate to Our lives?
• Why does this problem/strength exist?
• What can we Do about this?)
Field notes and audio recordings were
collected to capture dialogue.
Sources: Strack RW, Magill C, McDonagh K. Engaging Youth Through Photovoice. Health Promotion Practice. 2004; 5(1):49-58;
Wang C, Burris MA. Photovoice: Concept, Methodology, and Use for Participatory Needs Assessment. Health Education & Behavior. 1997;
24(3):369-387
Photovoice:
Guiding Questions
• What things in your neighborhood
make you feel healthy? Unhealthy?
• What do you see when you go
outside to play?
“I took this picture of cigarette signs on a gas station next to
Pulaski Park. Smoking is bad for you, yet the advertising is big and
eye-catching. It’s weird that these ads are so close to a place that is
healthy and good. “
−S.R, 16
“This is a picture of an alleyway by Union and Central. This
shows the laziness by people. We need to work together to fix
this. “
–W.P., age 15
(Manchester police reviewed this photo, and marked this scene as an arson hazard to be
addressed).
Trash in alleys where kids play
–W.P., 15
“This is the back of my house by my neighbor’s apartment. This
is how it looks but it’s not how my family wants our house to
look like. What really makes my family angry is that we told our
landlord and he didn’t do anything about it.”
-
C.I., girl, 16, West Side
“This is sidewalk in my neighborhood. It’s not safe, someone
could cause a crash if they were riding a bike and got off to
avoid a crack. It makes me feel people don’t care about our
place.”
− S.R., 16
“Why can’t this vacant lot be used for a community garden or a sports field?”
− S.R., 16
“This picture is of a mural in my school that was never
finished. I took this picture because I feel it makes our school
look unprofessional because, why start something and never
finish? I don’t think it sends a good message to the students. ”
- T.L., girl, 15, West Side
Residents of this home built their own ramp for a handicapped
resident, after repeated requests to the landlord and months of
carrying the person up the stairs in order to go inside the
house-(Caption by RM, Research Assistant and Manchester resident)
The hole in the ceiling of this rental home started out small, but
after kids picking at it for a month it became this big. Residents of
this household moved out to protect their health, after repeated
requests to the landlord to fix the ceiling... . -(Caption by RM,
Research Assistant and Manchester resident. Many older buildings
contain lead paint.)
The ceiling at this household was peeling and no effort was
made by the landlord to get it fixed. It was fixed the day before
the home inspector arrived. ..
-(Caption by --RM, Research Assistant and Manchester resident)
“I love this picture because I think it is beautiful. It shows the beauty of the
West side of Manchester. It shows that some people’s thoughts about the
West side are wrong. If you are looking for the good in something, you will find
it. But if you are focused on the bad, you will only see the negative”.
T.L., girl, 15, West Side
“This is Pulaski Park and the basketball court. It’s a place
that keeps me active. I wish there could be more parks, more
ball courts, and that they’d keep them fixed up.”
– N.M.,17
“This is a torn basketball hoop at our park. We
fixed it with duct tape.”
-S.R., boy, East Side
‘The Bishop’ -- I like hanging out there with friends, just
talking about our days, and having fun.
– W.G.,14
This school (West side) allows my family
to use the outdoor athletic fields…I go there to work out.
“I took this picture of the B.R.I.N.G. I .T! Nursing program
at Hillside Middle School. This picture is special to me
because it shows that there are good programs that can
help keep kids off the streets and doing something
productive with their time.”
- T.L., girl, 15, West Side (BRING IT= Bringing Refugees, Immigrants and
Neighbors Gently Into Tomorrow)
“This is an African dish that my family makes,
using fresh ingredients we get at the Farmer’s market”
-Girl, age 15, East Side
Key Findings(1)
• Photovoice greatly enhanced our
understanding of immigrant/refugee teens’
perceptions of neighborhood safety, health,
and active living, especially with respect to
juxtapositions of perceived barriers and
enablers of health that often coexisted in close
geographical proximity.
– Youth recognized that they were targets of
advertising for beer and cigarettes near parks and
neighborhood corner stores.
Key Findings(2)
• Photos revealed vacant lots, empty storefronts, and
unused spaces in the city, which teens described as
giving a poor impression of their neighborhoods.
• Youth consistently voiced their frustrations with
landlords who did not take better care of apartment
buildings (e.g., broken doors and windows, heat that
didn’t work, inaccessible entrances, litter and debris in
yards and alleyways).
• Youth viewed these issues as essential to healthy living,
and since many of their parents had limited English
skills, teens were often responsible for negotiating with
landlords.
Key Findings (3)
• Compared to boys, girls’ perceptions of vulnerability
constrained their geographies in ways that limited
their ability to engage in physical activity
• As Photovoice sessions progressed, participants began
to discuss ways that they could initiate change.
– Boys voiced higher comfort levels in reporting crime and
disorder to police.
– Girls began speaking about reaching out to resettlement
mentors, guidance counselors, teachers, and the student
council to offer recommendations.
An Art Exhibit and a community-wide Photovoice training
session was held at the end of the study to enable to
community members to conduct future Photovoice projects
themselves.
Creating Safe Neighborhoods for Active Living
A research study conducted in Manchester 2011-2012
Partners: The University of New Hampshire, The Prevention Research Center at Dartmouth, City of Manchester Health Department, Manchester Police Department, Manchester Weed & Seed
The City of Manchester, in partnership with researchers at the University of New Hampshire and The
Prevention Research Center at Dartmouth, was awarded a grant from the Robert Wood Johnson
Foundation to learn about how families in Manchester feel about the safety and health of their
neighborhoods, especially for youth. With rates of childhood obesity increasing, national attention
has focused on strategies that simultaneously increase physical activity, promote healthy lifestyles,
and reduce violence. Manchester’s public health initiatives combined with evidence-based criminal
justice programs, such as Weed & Seed, were recognized as being innovative models for bringing
citizens, law enforcement, public health, and other partners together to create safer, healthier
neighborhoods.
The youth’s photos and narratives revealed a holistic interpretation of “health” (e.g., physical,
mental, environmental). They identified many community assets, such as the Boys and Girls’
Club, the YMCA, Salvation Army, several parks, churches, Farmer’s Markets, and programs
such as “Teen Night”, “BRING IT”, community policing, and the Manchester Police Athletic
League (MPAL), which they described as being important to their health. They emphasized the
importance of outdoor and indoor facilities for play, but indicated that these spaces were not
always safe, clean, accessible, or affordable. Housing issues, access to healthy foods, bullying
in schools, exposure to advertising for unhealthy products in public spaces, and cultural
sensitivity were concerns that emerged from the youth’s photos and discussions.
This study was conducted from January 2011- January 2012, in two specific neighborhood areas:
Wilson St. and Rimmon Heights. Children in these neighborhoods have been shown to be at greater
risk of obesity compared to the city as a whole. To gain a better understanding of how to make
neighborhoods healthier places to live, work, and play, the project included a teen “Photovoice”
project for youth living in these neighborhoods. Several City departments expressed interest in giving
youth more opportunities to share their concerns about issues they faced in their daily lives so that
collaborative solutions could be developed.
We are grateful to the City of Manchester, and the representatives from City departments,
residents, and youth who generously worked with us on this project in hopes of creating
strong partnerships to make Manchester a safe and healthy place to live. We share their
commitment to “Believe in a Healthy Community” (http://www.manchesternh.gov/website/
LinkClick.aspx?fileticket=omDcfgsVQ4k%3D&tabid=700), and hope that these youth’s images
will spark a conversation to achieve that vision. We are also indebted to the artistic talent of
Ross Bachelder, manager of the frame shop and Franklin Gallery at Ben Franklin Crafts in
Rochester, New Hampshire for creating the display of the youths’ photos and captions.
Photovoice is a research process that gives cameras to teens (ages 13-18) and asks them to take
photos that tell a story of their neighborhood and things that are important in their lives.
Approximately 15 youth participated in the project. The teens followed a structured curriculum for
approximately 6 weeks, and created a photo exhibit to showcase their images. They selected 4-8
photos each week for group discussions using the “SHOWeD” method:
What do you See here?
What’s really Happening?
How does this relate to Our lives?
Why does this problem/strength exist?
What can we Do about this?
If you have comments you’d like to share, please write them in the journal next to the exhibit.
Thank you,
Dr. Semra Aytur, PhD (University of New Hampshire)
Dr. Karen Schifferdecker, PhD, MPH (Prevention Research Center at Dartmouth)
Rebecca Butcher, PT, MS, MPH ‘12 (UNH-M and Center for Program Design and
Evaluation
at Dartmouth)
Support for this research was provided in part by a grant from the Robert Wood Johnson
Foundation through its national program, Active Living Research RWJF I.D. 68495.
The Prevention Research Center at Dartmouth is a member of the Prevention Research
Centers Program, supported by the Centers for Disease Control and Prevention
cooperative agreement 1U48DP001935-01.