Photovoice and empowerment: evaluating the transformative potential of a participatory action research project.

BACKGROUND: Photovoice is a visual research methodology with the intention to foster social change. Photovoice has been used to investigate change in empowerment in vulnerable communities, However, the individual experience of participants involved in Photovoice projects is seldom scrutinized. Our aim was to explore and describe the individual experiences of the female individuals who participated in a previous Photovoice project. We analyzed a change in the women's empowerment in terms of: 1) gain in knowledge and skills, 2) change in self-perception, and 3) access to and use of resources. METHODS: This qualitative study took place in the low-income District of Villaverde (Madrid, Spain), from January-June 2016. We conducted 10 semi-structured interviews with the female residents who had participated in the previous Photovoice project. We also collected field notes. We analyzed these data through a direct qualitative content analysis. The three outlined dimensions of empowerment provided guidance for the analysis of the results. RESULTS: We found positive changes in the three dimensions of empowerment: 1) participants acquired new knowledge and developed critical awareness of their community; 2) the social recognition participants received transformed their self-perception; and 3) the project allowed them to expand their social networks and to build new links with different actors (research partners, local decision makers, media and the wider public). CONCLUSIONS: Photovoice projects entail the opportunity for empowering participants. Future research using Photovoice should assess the influence it has on participants' empowerment changes and how to sustain these individual and social changes.

Health assets for adolescents: opinions from a neighbourhood in Spain.

This study uses a health asset (HA) framework to explore current perspectives on health, wellbeing and their determinants amongst a group of 15-18-year-old adolescents living in the neighbourhood of Zaidin (Granada, Spain). The study was carried out in Summer 2011 using a qualitative approach. It included 20 semi-structured interviews, 2 focus groups with adolescents and 4 semi-structured interviews with key informants (adults who work with adolescents). Narrative data were analysed by means of content analysis methodology, considering the concept of health, HAs and how they are prioritized as dimensions for the analysis. The concept of health defined by adolescents involves physical, psychological and social dimensions. According to them, health is associated with happiness and quality of life. A range of HAs were identified and classified as internal (belonging to the adolescents) and external or contextual. Internal assets are classified into three types: personal traits (assets of 'being'), behaviour (assets of 'doing') and social resources which contribute to their feeling of health and well-being (assets of 'having'). The latter connects internal and external assets. The classification of HAs ('being', 'doing' and 'having') proposed in this study provides a useful starting framework of thinking about how these assets could be organized to support the development of health promotion programmes. The study highlights the opportunity for public policy to contribute to the improvement of the conditions and local scenarios that improve the possibilities for positive connections at the community level.

Development and evaluation of a training programme on asset-based community development aimed at general practice trainees: protocol for a mixed-method multilevel and multicentric action research study.

INTRODUCTION: Asset-based community development (ABCD) is a strategy aimed at strengthening communities of interest through the identification and enhancement of those protective resources (also called 'health assets') that contribute to improve population health. Although primary care is specially well placed to contribute to ABCD by facilitating patients' access to community health assets, the implementation of ABCD approaches is limited, in part due to training deficiencies amongst general practitioners. In this study, we will develop a training programme on ABCD aimed at general practice trainees and evaluate its implementation and scale-up in Andalusia, Spain. We will also investigate whether the programme may contribute to strengthen the community orientation of the primary care practices involved in the study. METHODS AND ANALYSIS: We will undertake a mixed methods, multilevel and multicentric action research study drawing on theoretical frameworks relevant to learning (pedagogy) and community health promotion. The intervention will be implemented and evaluated in eight different study areas over 48 months. It will comprise a classroom-based session and a practical exercise, which will involve general practice trainees producing a map of community health assets relevant to common health conditions. In each study area, we will set up a stakeholder group to guide our study. We will run the intervention sequentially across the eight study areas, and modify and refine it iteratively by incorporating the findings from the evaluation. We will employ qualitative (interviews and focus groups with general practice trainees, primary care workers, members of the teaching units and policymakers) and quantitative methods (self-administered questionnaires with an approximate sample of 157 general practice trainees and 502 primary care workers). ETHICS AND DISSEMINATION: Ethics approval from the Andalusian Regional Health Council has been granted (6/2020). It is envisaged that this research will provide relevant, evidence-based guidance on how best to incorporate learning on ABCD into the general practice training curriculum. Findings will be disseminated in an ongoing manner and will target the following audiences: (1) general practice trainees, primary care workers and members of the teaching units, (2) policymakers and strategic decision makers and (3) the academic community.

[Health promotion based on assets: how to work with this perspective in local interventions?] / Promoción de la salud basada en activos: ¿cómo trabajar con esta perspectiva en intervenciones locales?

An asset-based approach could be useful to revitalise health promotion or community health interventions combining work with multiple partnerships, positive health, community engagement, equity and orientation of health determinants. We set some recommendations about how to incorporate the assets model in programmes, projects and interventions in health promotion. Some techniques are described for assets mapping and some experiences with this methodology being developed in different regions are systematised. We propose the term "Asset-based Health Promotion/Community Health" as an operational definition to work at the local level with a community engagement and participatory approach, building alliances between different institutions at the state-regional level and trying to create a framework for action with the generation of evaluations and evidence to work on population interventions from the perspective of positive health.

Vídeos como herramientas de diseminación y transferencia de conocimiento / Videos as tools for scientific dissemination and knowledge transfer

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[Health among teenagers and young adults]. / La salud de los jóvenes.

The objective of this article is to analyse different behaviours and opinions about health and health determinants of Spanish young people by age, sex, and place of residence. They have a broad concept of their health, tending to identify health as physical activity and healthy eating behaviours. Most of them (91%) declared enjoying good or very good health. Depending upon the age, sex, and place of residence 10 to 20% could have mental health problems. Young people consider illegal drugs as their main health problem. Boys have higher prevalence of overweight and obesity than girls. However, girls reported more often than boys that they perceived themselves as obese. Practice of sporting activities is influenced by family and friends. The proportion of young people that practice sport declines after the age of 15, both in boys and girls. Young people perceive cannabis consumption as normal, but remain ambivalent towards other illegal drugs and asked for more information about drugs. We found a high proportion of young people declaring that they not would try illegal drugs. In the urban settings, smoking is more common among girls than among boys, but the contrary happens in rural areas. Most of them know that smoking is harmful for health, and among those who are smokers, 20 to 40% declared that they want to stop smoking. They consider that health care services are useless for preventing health problems. It is necessary to improve behaviours involving safety, such as use of seat belts and helmets, mainly in rural areas. Young people associated traffic accidents with driving conditions rather than with identification of risk.

[Methodology for health assets mapping in a community]. / Metodología para el mapeo de activos de salud en una comunidad.

Within the development of a regional strategy for community health engagement in Asturias (Spain), and connected to the Health Observatory, we carried out a methodology to initiate the mapping of health assets at a local level. This methodology begins with a description of the most formal resources and of the pre-existing community activities, together with a characterization of the most informal, personal and symbolic health resources. We introduce our tools, grouped for the development of mapping, and explain their connection with the theoretical models of salutogenesis, asset model and community development.