School of Social Work, Boston University, Boston, MA, USA.
School of Public Health, Boston University, Boston, MA, USA.
BMC Public Health. 2023 Jan 11;23(1):81. doi: 10.1186/s12889-023-14983-7.
Photovoice is a form of visual ethnography intended to engage impacted communities in research followed by action to ameliorate the injustices under study. Photovoice has increased in use, especially in collaboration with Latinx communities addressing health inequities. The Latinx population comprises nearly 18% of the overall United States population and according to the census is projected to reach just under 30% by 2060. This diverse panethnic community faces significant structural barriers in accessing services. Racism and the resulting marginalization, specifically, contributes to limited access to recovery services and treatment. Making meaningful advances in substance use disorder training, intervention and policy necessitates learning alongside the Latinx community.
We partnered with a Latinx serving integrated behavioral health and primary care setting in Boston Massachusetts to explore barriers and facilitators to recovery using photovoice. Spanish-speaking Latinx adults with a substance use disorder participated. The group met for three photovoice sessions over a six-week period. Together group members critically analyzed photographs using the SHOWeD method.
Findings indicate a sense of purpose and meaning, security, faith and housing are important elements of recovery. The results illustrated the importance of sources of connection in maintaining sobriety. Through this photovoice project, Latinx Spanish speaking participants highlighted barriers and facilitators to their substance use disorder recovery which spanned individual, community, and structural levels.
The experiences and voices of the Latinx community are crucial to drive discussions that advance policy (e.g., housing stability and access), enhance providers' understanding of Latinx Spanish-speakers' substance use disorder recovery, and inform culturally and linguistically appropriate services. This study demonstrated that photovoice is highly acceptable and feasible among Latinx clients receiving substance use disorder services. Visual images related to housing, faith, etc. communicate challenges, power structures, as well as hopes to policymakers at multiple levels (e.g., institution/ agency, state).
影像叙事是一种视觉民族志形式，旨在让受影响的社区参与研究，然后采取行动改善研究中的不公正现象。影像叙事的使用有所增加，尤其是在与拉丁裔社区合作解决健康不平等问题方面。拉丁裔人口占美国总人口的近 18%，根据人口普查，到 2060 年，这一比例预计将达到近 30%。这个多元化的泛拉丁裔社区在获得服务方面面临着巨大的结构性障碍。种族主义和由此产生的边缘化，特别是导致恢复服务和治疗机会有限。要在物质使用障碍培训、干预和政策方面取得有意义的进展，就必须与拉丁裔社区一起学习。
我们与马萨诸塞州波士顿的一家为拉丁裔服务的综合性行为健康和初级保健机构合作，使用影像叙事来探索恢复的障碍和促进因素。参与的是有物质使用障碍的讲西班牙语的拉丁裔成年人。该小组在六周的时间里举行了三次影像叙事会议。小组成员共同使用 SHOWeD 方法对照片进行批判性分析。
研究结果表明，有目标感和意义感、安全感、信仰和住房是恢复的重要因素。结果说明了在保持清醒过程中建立联系的重要性。通过这个影像叙事项目，讲西班牙语的拉丁裔参与者强调了他们物质使用障碍恢复的障碍和促进因素，这些因素跨越了个人、社区和结构层面。
拉丁裔社区的经验和声音对于推动政策讨论至关重要，这些讨论可以推动政策发展（例如住房稳定和获得），增强提供者对拉丁裔西班牙语使用者物质使用障碍恢复的理解，并为他们提供文化和语言上合适的服务。这项研究表明，影像叙事在接受物质使用障碍服务的拉丁裔客户中是高度可接受和可行的。与住房、信仰等相关的视觉图像向各级决策者（例如机构/机构、州）传达了挑战、权力结构以及希望。
