Sarah A. Misyak, PhD1*, Meredith Ledlie, MSW1, Mary M. McFerren, EdD1, Kim L. Niewolny, PhD2, Kathryn W. Hosig, PhD, MPH, RD3 & Elena Serrano, PhD.4
Photo elicitation is a qualitative research tool in which photographs are used to facilitate dialogue during interviews and focus group discussions. Photo elicitation as a research method is especially suited for the complex nature of food systems work. Food systems researchers and practitioners promote community health, a broad term in this context, which encompasses the nutritional and physical health of community members as well as the environmental, economic and social health of communities. In addition to food systems work, photo elicitation is a useful tool for meaningful evaluation, which is important for both justifying and improving Extension programming. Photo elicitation provides a way for those served by Extension to provide input and feedback on programs. The participatory nature of photo elicitation also increases the capacity of Extension research and evaluation to be empowering to community stakeholders, particularly those from limited resource or underserved populations. In this article, we present an example of the practical application of photo elicitation in community and local food systems research. Our case study explores the perceptions of barriers to using farmers markets as access points to fresh and healthy local foods by the Supplemental Nutrition Assistance Program-Education (SNAP-ED) and the Expanded Food and Nutrition Education Program (EFNEP) target population of mothers with young children.
In this article, we present an example of the practical application of photo elicitation in community and local food systems research. Our case study explores the perceptions of barriers to using farmers markets as access points to fresh and healthy local foods by mothers with young children eligible to participate in the Supplemental Nutrition Assistance Program (SNAP); the target population of the Virginia Cooperative Extension’s Family Nutrition Program’s target population. We provide a review of photo elicitation as a method in community food systems work, a description of the way this photo elicitation method was used in this farmers market context, and how other community food systems practitioners might utilize this approach for similar projects. Suggestions to use photo elicitation as a means for meaningful and participatory evaluation of Extension-based programs in food systems are given.
Community food systems is an expansive term that encompasses the production, processing, distribution and consumption of food to improve community (which can be defined as a small, distinct area up to the regional level) health (Cornell University, 2014). The definition of community health is also broad, including not only the nutritional or physical health of community members but also the environmental, economic and social health of a community (Cornell University, 2014). Cooperative Extension is uniquely poised for community food systems work based on our program areas (Family and Consumer Sciences, Agriculture and Natural Resources, Community Viability and 4-H), which are active in communities around the country. Given the complex nature of this work, creative qualitative methods, in addition to quantitatively determining reach of programs, are needed to adequately research and evaluate Extension efforts to promote community health through food systems work. Photo elicitation is one such method that may be useful.
Photo elicitation is a qualitative method in which participants use photographs as a reference point or a way to frame responses during interviews and focus group discussions (Harper, 1986; 2002); this method is currently under-utilized by Extension for research and evaluation purposes. Photo elicitation is especially useful for populations in which other methods are not appropriate and is effective in gathering information and views from participants regarding their lives, which may not surface when using other qualitative methods (Ali-Khana & Siryb, 2014; Clark-Ibáñez, 2004; Mandelco, 2013; Snyder & Kane, 1990). For instance, photo elicitation is useful for children and adolescents who may not express themselves in ways similar to adults (Bessell & Burke, 2005; Mandleco, 2013). Photo elicitation also encourages participation more than traditional research methods, helping participants to more fully express themselves (White, Sasser, Borgen & Morgan, 2009). Interactive participation can lead to increased understanding, social cohesion and empowerment of limited-resource individuals while providing more transparency and accountability from researchers (Pretty, 1995; Eksvard & Rydberg, 2010).
The Use of Photo Elicitation in Food Systems Work
Photo elicitation can be used as a tool to facilitate dialogue about the complex issues and problems present in community food systems work. Barnidge, Baker, Motton, Rose & Fitzgerald (2010) used photo elicitation in community-based participatory research with African American community members in rural Missouri to engage in dialogue about root factors influencing community health. The photo elicitation process helped community members to articulate economic and structural factors (in this case, segregation) that influence physical health. In this instance, the Sustainable Livelihoods Framework, a framework traditionally used in developing countries, which was developed to examine community health from an economic perspective, framed the conversation (Department of International Development, 2007).
Photo elicitation has been used in many others instances for research and evaluation related to physical or nutritional health problems and initiatives (Valera, Gallin, Schuk & Davis, 2009; Johnson, Sharkey, McIntosh & Dean, 2010; Stephenson, 2012; FitzGerald, 2013; Najib Balbale, Schwingel, Chodzko-Zajko, & Huhman, 2013), but is not limited to use in public health. Photo elicitation has been used with farmers and ranchers to determine their perceptions related to changing climates and landscapes, farming, and community (Beilin, 2005; Sherren, Fischer & Fazey, 2012; Sherren & Verstraten, 2013) while Bauseke, Fuhrman, Martinez-Espinoza & Orellana (2013) developed and used pictures as a tool to evaluate training for functionally illiterate Hispanic landscape workers.
Virginia Cooperative Extension: The Food Security Project
We used photo elicitation in our work on The Food Security Project, an initiative within the Virginia Cooperative Extension Family Nutrition Program. The objectives of the Food Security Project are to 1) teach limited-resource families and youth to make healthy food choices, 2) help families to become better managers of available food resources, and 3) eliminate food deserts in Virginia. To reach these objectives we have taken the strategy of increasing access to farmers markets for low-income populations.
There are several recognized barriers to food access through farmers markets cited in community-based reports and popular press, such as transportation issues, seasonality of food choices, lack of variety, lack of awareness and convenience (McLaughlin & Merrett, 2002; Leone et al., 2012). However, little formal research has been completed exploring barriers to farmers markets. Additionally, barriers to local food access may be rooted in social constructs, such as social class and gender issues, which influence the perception of ‘access’ more than the built environment. Photo elicitation was a logical choice as a method to help our target population; SNAP-eligible mothers with young children articulate their thoughts about these complex issues. Through this process, the mothers were able to identify themes related to social inclusion, stigma and shopping preferences. Participants also identified opportunities for including experiential-based learning activities into an optional farmers market orientation lesson for Eating Smart, Moving More (The Family Nutrition Program, 2013).
*To see representative photographs from the VCE Food Security Project study, contact Sarah Misyak at firstname.lastname@example.org.
The Photo Elicitation Process
Other Extension practitioners and researchers doing food systems work, especially when working with disparate audiences and focusing on empowerment, can incorporate photo elicitation into their projects to bridge gaps in knowledge and/or power related to age, language, culture, and socioeconomic status. Photo elicitation is useful to individual interviews and focus group discussions. Our method was loosely based on the Photovoice process as presented by Stephenson (2012). A simplified version of the photo elicitation process for focus group discussions, as we implemented it in the above study, is as follows:
- Gather participants to introduce them to the purpose of the study, orient them to the photo elicitation process (including a brief introduction to photography), and explain why photo elicitation is being used (empowerment, visual representation for policy makers, etc.).
- Distribute disposable cameras with prompts to stimulate the visual storytelling process.
- Have participants return cameras after the allotted time (this will vary based on the subject matter and study purpose) and have the pictures developed. Consider printing doubles so participants can keep a copy of their pictures.
- Bring participants back together and give them time to individually review their photographs. Remind them of the prompts and ask them to group together the photographs that represent a specific idea to begin the discussion process.
- Ask participants to explain their photographs and ideas to the group (one person at a time, if they are comfortable, or prompt-by-prompt as a group). Allow room for participants to explore emerging themes through group discussion.
- As a theme emerges, tape a photograph representative of that theme to a flip chart and take notes. This will enable the group to visualize the discussion.
- Throughout the process, confirm with participants that the name of the theme adequately reflects their thoughts and feelings.
- Be sure to adequately explore each emerging theme, asking participants why this theme is important to them and what they perceive as the causes and consequences of this theme.
Budget may be a concern when purchasing disposable cameras and printing photographs, but the widespread use of smart phones (especially among youth and some low-income populations) enables participants to easily take and share photographs of their experiences. For populations without access to such technology, researcher-derived photographs, which were originally used when photo elicitation was developed in anthropological work and the cost of participant-derived photographs was prohibitively expensive, may also be used for the photo elicitation process (Collier, 1957).
The Use of Photo Elicitation for Evaluation
Evaluation of Extension programming serves the dual purposes of both justifying and improving programs. Photo elicitation can provide meaningful information from program participants when assessing program relevance, quality and cultural responsiveness, all of which are an aspect of program impact (Rennekamp & Arnold, 2009). The impact of our programs is the difference we make in people’s lives, including participants’ attitudes and behaviors (Workman & Scheer, 2012). Photo elicitation is a qualitative method that can help participants articulate those attitudes and behaviors and provide us with insight on the reasoning behind their behaviors so we can adequately tailor our programs to their needs.
Photo elicitation can give participants greater control over the evaluation process, especially when photographs are taken by the participants. This is due to the fact that information, content, and meaning is introduced by participants and not bound to what researchers and practitioners perceive as important, allowing room for creativity and differing viewpoints (Padgett, Smith, Derejko, Henwood & Tiderington, 2013). Therefore, as we move forward in Extension, and especially with the holistic view of health taken in community food systems work, tools for participatory evaluation, which empowers stakeholders and strengthens communities (Cousins & Whitemore, 1998) need to be incorporated into our research and evaluation.
Ali-Khana, C. & Siryb, C. (2014). Sharing seeing: Exploring photo-elicitation with children in two different cultural contexts. Teaching and Teacher Education, 37, 194-207.
Barnidge, E., Baker, E.A., Motton, F., Rose, F. & Fitzgerald, T. (2010). A participatory method to identify root determinants of health: The heart of the matter. Progress in Community Health Partnerships, 4(1), 55-63
Bauseke, E.M., Fuhrman, N.E., Martinez-Espinoza, A.D. & Orellana, R. (2013). Use of pictorial evaluations to measure knowledge gained by Hispanic landscape workers receiving safety training. The Journal of Extension, 51(5).
Beilin, R. (2005). Photo‐elicitation and the agricultural landscape: ‘Seeing’ and ‘telling’ about farming, community and place. Visual Studies, 20(1), 56-68.
Clark-Ibáñez, M. (2004). Framing the social world with photo-elicitation interviews. The American Behavioral Scientist, 47(12), 1507-1527.
Collier, J.J. (1957). Photography in anthropology: a report on two experiments. American Anthropologist, 59, 843–859.
Cornell University. A primer on community food systems: Linking food, nutrition and agriculture. Accessed on March 7, 2014. Available at http://www.discoverfoodsys.cornell.edu/primer.html
Cousins, J.B. & Whitmore, E. (1998). Framing Participatory Evaluation. In E. Whitmore, Ed. Understanding and Practicing Participatory Evaluation. New Directions for Evaluation (5-23). San Francisco: Jossey-Bass.
Department of International Development. (2007). Sustainable livelihoods guidance sheets. Available at http://www.livelihoods.org/info/guidance_sheets_pdfs/section2.pdf
Drew, S., Duncan, R., & Sawyer, S. (2010). Visual storytelling: A beneficial but challenging method for health research with young people. Qualitative Health Research, 20, 1677–1688. doi:10.1177/1049732310377455
Family Nutrition Program. (2013). Keeping local foods affordable. Available at http://blogs.ext.vt.edu/eatsmart-movemore/2013/08/14/keeping-local-food-affordable/
FitzGerald, E.A., Frasso, R., Dean, L.T., Johnson, T.E., Solomon, S., Bugos E., Mallya, G. & Cannuscio, C.C. (2013). Community-generated recommendations regarding the urban nutrition and tobacco environments: A photo-elicitation study in Philadelphia. Preventing Chronic Disease, 10, E98. doi: 10.5888/pcd10.120204.
Harper, D. (1986). Meaning and work: A study in photo elicitation. Current Sociology, 34, 24-46.
Harper, D. (2002). Talking about pictures: A case for photo elicitation. Visual Studies, 17(1), 13-26.
Johnson, C.M., Sharkey, J.R., McIntosh, A.W. & Dean, W.R. (2010). “I’m the Momma”: Using photo-elicitation to understand matrilineal influence on family food choice. BMC Womens Health, 10, 21.
Leone, L.A., Beth, D., Ickes, S.B., Macguire, K., Nelson, E., Smith, R.A., Tate, D.F. & Ammerman A.S. (2012). Attitudes toward fruit and vegetable consumption and farmers’ market usage among low-income North Carolinians. Journal of Hunger & Environmental Nutrition, 7, 64-76.
MacMillan Uribe, A.L., Winham, D.M. & Wharton, C.M. (2012). Community supported agriculture membership in Arizona. An exploratory study of food and sustainability behaviors. Appetite, 59, 431-436.
Mandelco, B. (2013). Research with children as participants: Photo elicitation. Journal for Specialists in Pediatric Nursing, 18, 78–82.
Najib Balbale, S., Schwingel, A., Chodzko-Zajko, W. & Huhman, M. (2013). Visual and participatory research methods for the development of health messages for underserved populations. Health Communication. doi: 10.1080/10410236.2013.800442.
Padgett, D.K., Smith, B.T., Derejko, K.S, Henwood, B.F. & Tiderington E. (2013). A picture is worth . . . ? Photo elicitation interviewing with formerly homeless adults. Qualitative Health Research, 23(11), 1435-1444.
Rennekamp, R.A. & Arnold, M.E. (2009). What progress, program evaluation? Reflections on a quarter-century of Extension evaluation practice. The Journal of Extension, 47(3).
Sherren, K., Fischer, J. & Fazey, J. (2012). Managing the grazing landscape: Insights for agricultural adaptation from a mid-drought photo-elicitation study in the Australian sheep-wheat belt. Agricultural Systems, 106 (1), 72-83.
Sherren, K. & Verstraten, C. (2013). What can photo-elicitation tell us about how maritime farmers perceive wetlands as climate changes? Wetlands, 33(1), 65-81.
Snyder, E.E. & Kane, M.J. (1990). Photo elicitation: A methodological technique for studying sport. Journal of Sport Management, 4, 21-30.
Stephenson. L. (2012). My community, my voice: Rural older adults speak through photography. Journal of Extension, 50(1). Retrieved from http://www.joe.org/joe/2012february/a7.php
Valera, P., Gallin, J., Schuk, D. & Davis, N. (2009). “Trying to Eat Healthy” a Photovoice study about women’s access to healthy food in New York City. Journal of Women and Social Work, 24(3), 300-314.
White, Sasser, Borgen & Morgan, 2009. Photos can inspire a thousand words: Photolanguage as a qualitative evaluation method. The Journal of Extension, 47(3). Available at http://www.joe.org/joe/2009june/iw1.php.
Workman, J.D. & Scheer, S.D. (2012). Evidence of impact: Examination of evaluation studies published in the Journal of Extension. Journal of Extension, 50(2).
1 Family Nutrition Program, Virginia Cooperative Extension, Department of Human Nutrition, Foods and Exercise, Virginia Tech.
2 Department of Agriculture and Extension Education, Virginia Tech
3 Department of Population Health Sciences, Virginia Tech
4 Department of Human Nutrition, Foods and Exercise, Virginia Tech