Picture This: Photovoice

Clip art is nice. Photovoice is better. Developed by Caroline C. Wang, of the School of Public Health at University of Michigan, Photovoice "...enables people to record and reflect their community's strengths and problems. It promotes dialogue about important issues through group discussion and photographs. Finally, it engages policymakers. ... Caroline C. Wang explains, 'What experts think is important may not match what people at the grassroots think is important.' … It entrusts cameras to the hands of people to enable them to act as recorders, and potential catalysts for social action and change, in their own communities...to promote an effective, participatory means of sharing expertise to create healthful public policy."

As a Research Associate at Harder+Company Community Research, I gained three years of Photovoice experience. Our team, which included partners from the AjA Project, was charged with evaluating the work of the First 5 Commission of San Diego (First 5 San Diego), a county government agency that funds programs and advocates for policy change to improve the lives of children ages 0-5.

In the first two years, parents involved in programs funded by First 5 San Diego took pictures to document their experiences before, during and after services. Interviews provided information for a one to two page case study of each family’s story. The case studies, paired with the photographs, appeared in First 5 San Diego’s FY 2003-2004 and FY 2004-2005 Annual Evaluation Reports.

In the third year, the project took a new direction under my leadership. Groups of parents created collective pieces. Their collages appeared in the FY 2005-2006 Annual Evaluation Report. Additionally, First 5 San Diego showcased the project at First 5 California's Statewide Conference in May 2005. Local and state Commissioners and First 5 supporters attended the exhibition at the San Diego Grand Hyatt. Parents’ photographs set the tone for the conference; columns were wrapped in banners and dozens of photographs lined the room. A brief write-up explaining the program accompanied each piece. There was also a video montage that brought parents’ voices alive.

Each year, parents celebrated the unveiling of their artwork at a “mini-exhibit” attended by First 5 San Diego staff, funded program staff and community leaders. Parents received framed pictures of their favorite photograph. Each program also received a picture (or a banner in year three) and electronic image files. Programs have used the images to create dynamic marketing materials to publicize their programs.

If your organization has a story to tell, you could use Photovoice. Whether you want to understand the community's strengths and problems, promote dialogue about important issues or engage decision-makers, you will find that Photovoice is a magical process, unlike any other.

Are you ready for your close up?

Multi-Million Dollar, Countywide Oral Health Initiative

The First 5 Commission of San Diego (First 5 San Diego) launched the Oral Health Initiative (OHI) in 2005 to address oral health of pregnant women and children under age six. First 5 San Diego has dedicated up to $5.1 million for OHI from its launch through FY 2009-2010. As a Research Associate with Harder+Company Community Research, I was charged with evaluating this complex initiative. Over three years, I accomplished the following:

• Worked closely with staff from First 5 San Diego, the lead contractor (the Council of Community Clinics) and over a dozen different partner agencies.
• Convened partners to collaborate in the initiative’s evaluation design.
• Developed the evaluation design, which linked OHI’s work to First 5 San Diego’s larger goals and objectives.
• Created practical, easy-to-use data collection tool in Excel. Coordinated the distribution of the data collection tool to all partner agencies, and trained partners in its use.
• Supervised a Research Assistant who oversaw partners’ monthly data submissions and provided support to the evaluation.
• Complemented partners’ data with qualitative findings from focus groups, interviews (with parents, dental professionals and policymakers), a case study and secondary data.
• Advised First 5 San Diego of emerging best practices and challenges.
• Wrote the OHI chapters for both First 5 San Diego’s FY 2005-2006 and FY 2006-2007 Annual Evaluation Reports. Chapters synthesized all of the aforementioned data and offered recommendations for the future.
• Presented each year’s findings to OHI stakeholders via a PowerPoint slideshow.
• Used each year’s findings to lead stakeholders in discussions of how to build on OHI’s successes and how to fortify areas of weakness.

This project is characteristic of my work: comprehensive, collaborative and usability-focused. How could these characteristics benefit your organization?

Teen Reproductive Health Project

As a Research Associate at Harder+Company Community Research, I wrote a successful proposal to evaluate Project Concern International’s (PCI) Project BRO (Brotherhood, Responsibility and Outreach), and executed the scope of work as a Co-Project Director.

Project BRO builds reproductive health and life skills among male youth, ages 12-19, in central San Diego. The project originally focused on African immigrant youth but expanded to include young men of many backgrounds, a number of whom are involved in the juvenile justice system.

The project was featured on Harder+Company's website as an example of the firm's excellent work (picture at right). There is a quote from the client in that piece which reads: "Within a month of collaboration, we had tangible results which led to increased learning and more professional reports to our funders." When I left Harder+Company to finish my Masters of Public Health in March 2008, PCI had already renewed its contract three times.

In order to incorporate the youth’s own voices into reports prepared for Project B.R.O.’s funder, the evaluation included focus groups with young men who had graduated Project BRO. PCI later requested additional focus groups, separate from the evaluation, to inform their program planning efforts. The client had high praises for the report I wrote summarizing the findings from the additional focus groups.

How would input from your customers re-shape your offerings and make them even more appealing?

GIS: Map to Your Organization's Success

Shakti Rising provides holistic physical and mental health services to women ages 15-30 dealing with issues such as substance abuse, interpersonal violence and depression. I was invited to join the Board in 2007 after Shakti Rising’s 2-year-long leadership development program.

Currently, I am mapping data in GIS (which stands for "Geographic Information Systems") to strengthen Shakti Rising’s marketing efforts. Maps like the ones shown here will direct the organization's limited resources to areas where its programs are most likely to succeed.

Maps are an excellent way to enhance your organization's written products. Readers connect with information in different ways. Some like tables of numbers, others like text, and some engage most readily with colorful charts, graphs and maps. If you want to engage your readers, it is smart to present information in different ways. I can do that for you.

Furthermore, a map goes beyond what a chart can illustrate. GIS mapping is a data analysis tool. By looking at data in its geographic context, we can learn how space and distance affect your organization and the people with whom it works.

How could mapping benefit you?

Creating a Targeted Oureach Campaign

"It's easier to find a Domino's Pizza than to find out where to get Food Stamps."
–Food Stamp Applicant

As part of a course at San Diego State University’s Graduate School of Public Health, I worked on a group project with the San Diego County Health and Human Service Agency. The goal was to increase enrollment in the Food Stamp Program by designing outreach materials (posters and flyers) tailored to appeal to specific target audiences, and by drafting a news release for dissemination to print and electronic media. In a few short weeks, our group completed the following:

• Researched and identified two audience segments for the campaign,
• Designed draft outreach materials tailored to each audience segment,
• Piloted draft materials with Family Resource Center patrons from each audience segment via in-person interviews,
• Revised drafts based interview findings to increase their appeal,
• Determined strategic, audience-specific locations and media outlets in which the County could place/run the materials, and
• Presented the County with a ready-to-use media kit.

After presenting our project to our class and the three County employees with whom we worked, we were invited to present at a large, regional convening of the County's health promotion staff.

Holistic Health

“The art of medicine consists of amusing the patient while nature cures the disease.”
– Voltaire

Holistic health is a medical philosophy that considers physical, mental and spiritual well-being to be interconnected and equally important to health promotion and the treatment of disease. Its popularity is growing in the U.S., and it is increasingly used in mainstream U.S. medical practices.

The medical “mainstream” is a river that is constantly shifting course. It is very likely that some of the holistic health practices that are currently on the periphery will eventually enter the mainstream, which underscores the importance of hiring professionals who understand holistic health today.

Furthermore, as the healthcare system seeks to meet the needs of consumers from diverse backgrounds, and who have varied belief systems, an understanding of multiple medical philosophies is essential.

I have completed over 300 classroom hours studying holistic health topics including nutrition, herbal medicine and stress management though the education department at Shakti Rising, a community organization that provides holistic health services to women. Additionally, I have as many or more classroom hours teaching these topics. My personal experience with body-work modalities including acupuncture, massage, energy psychology, yoga, meditation and Reiki.

My research-based, capstone project for my Masters in Public Health degree was on the topic “Towards Promoting a Wider Range of Self-Management Skills among Patients with Asthma: A Review of the Literature on Complementary and Alternative Medicine for the Treatment of Asthma”.

“The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”
– Thomas Edison

Health Education via Carrots and Karaoke

I am trained in the theory of health promotion. Lessons based on theory alone, however, do not always capture a learner's interest. I enjoy creating innovative learning environments that appeal to the audience, thereby instilling not only knowledge but the desire to put learning into practice. Here are some examples:

At Shakti Rising, I teach an early intervention class to equip women with skills to manage stress and decrease tendencies to engage in unhealthy behaviors. Participants set behavior change goals each week. Most weeks I I challenge them to refine their goals, and think smaller. Setting a small, achievable goal every week sets participants up for success.

As an Agricultural Education Program Leader at U.C. Davis’ Children’s Garden, I encouraged children to play with plants. Rather than fight the children's desire to run and wiggle, I harnessed it in educational activities. Harvesting carrots - a delightfully messy endeavour - opened the window to talking about the science of why carrots are orange and why people benefit from eating orange vegetables.

As a Bilingual Tutor at Dingle Elementary School, one of my students was behind in his reading skills. He had no interest in reading. All he wanted to do was tinker with machines. I brought him a copy of the book "The Way Things Work", an illustrated guide to the mechanics of everyday objects. We read about a different machine each time we met and he quickly caught up with his classmates.

As a Lead Mentor with the Town of Danville Youth Services, I needed to motivate a moody and sometimes disinterested group of sixth grade girls to exercise. One of the most successful activities played on these diva-like qualities: karaoke dance party.

Who are you trying to reach? How can I energize your message?