Abstract
Background
Calls for More Age-Friendly Research
Rapid population aging is a global phenomenon (Gu et al., 2021). People are living longer worldwide, leading to a growth in the number and proportion of older adults (World Health Organization, 2023). In Canada, approximately 18.9% of the population is 65 years and older (Statistics Canada, 2024), outnumbering children for the first time in 2016 (Statistics Canada, 2019). Older adults continue to contribute to the social and economic fabric of society. As many as 21% remain in the workforce past age 65, engage in volunteerism, offering more hours than any other age cohort, and provide essential caregiving to grandchildren, spouses and other family members (Morissette & Hou, 2024; Statistics Canada, 2017, 2020). They are also likely to suffer from chronic diseases and have multiple health needs that require informal support along with health and social care services (McGilton et al., 2018). More than 90% of older Canadians report that they plan on supporting themselves to live safely and independently in their own home as long as possible (Canadian Institute for Health Information, 2024). Therefore, older adults are no longer seen as passive care recipients; instead, they are increasingly recognized as active partners in care (Menichetti & Graffigna, 2016), which calls for more responsive and inclusive health and social services and polices. As such, an area of growth and interest is in co-production and co-research with older people, including participatory and age-friendly research (Buffel, 2018).
Research as an Opportunity to Support Research Engagement
Yet, historically, older adults’ participation in health and community-based research has been limited, which may contribute to ongoing inadequate support and unaddressed care needs (Boutilier et al., 2025). Compounding this issue is that much of the existing evidence on problems faced by older people comes from formal institutional care settings, such as acute or rehabilitation centres and long-term care homes (Tate et al., 2022). Relatedly, those recruited into clinical trials frequently do not represent the broader aging population (Goodwin et al., 2023). To gain a more comprehensive understanding of the aging experience of older adults, it is imperative to collect data in different ways and from diverse settings. Qualitative approaches in research provide a means of exploring the lived experience of and generating knowledge from traditionally under-researched groups (Najib Balbale et al., 2014), including older adults (Goodwin et al., 2023). One particular method, photovoice, uses photographs taken by participants to facilitate dialogue, and is seen as endorsing inclusiveness, giving voice to participants and stimulating empowerment (Mysyuk & Huisman, 2020).
Photovoice Method with Older People
Photovoice, developed by Wang and Burris (1997), was conceived to accomplish three main goals: (1) supporting people to record and reflect on their community’s assets and concerns, (2) promoting critical dialogue about these concerns through group discussion of the photographs, and (3) reaching policymakers (Wang & Burris, 1997). More recently, photovoice has been used in different populations and ages, for example, with people living with diabetes (Duhn et al., 2025; Tang et al., 2025), the LGBTQIA + community (Natafgi et al., 2024), and with Indigenous young people (Anderson et al., 2023). The approach has been adapted for virtual use (Call-Cummings & Hauber-Özer, 2021; Oliffe et al., 2023) and continues to explore contemporary issues, like climate change (Bagge-Petersen et al., 2025) and long Covid (Natafgi et al., 2024). Photovoice has also been used extensively with older adults, examining topics such as chronic pain experience, age-friendly living environments, and living with mental illness (Baker & Wang, 2006; Dulek & Stein, 2024; Novek & Menec, 2014). Despite the varied ways the photovoice method has been used, it remains a well-established participatory research approach since it can benefit both the individual and the collective needs of the participant group (Anderson et al., 2023; Wang & Burris, 1997). In this context, participatory action research (PAR) is considered core to photovoice, seen as a way to promote community-driven social change (Liebenberg, 2018). Older adult participants in photovoice research have also realized these benefits. For example, learnings from photovoice involvement have informed cultural continuity and solutions supporting low-resourced communities (Gabel et al., 2016; Jackson & Ronzi, 2021; Stephenseon, 2012).
Potential to Inform Action-Oriented Research
According to one scoping review from 2020 examining the use of photovoice in older adults, photovoice provided an opportunity to raise awareness, engagement, and empowerment (Mysyuk & Huisman, 2020). However, this review paper failed to report the country of origin, making it difficult for readers to contextualize the study findings locally. For example, many studies involving older participants have been published in Canada (Karmann et al., 2023; Novek & Menec, 2014), demonstrating an opportunity for understanding how this approach has contributed to participatory action among older adults within the Canadian context.
Review Objectives
This scoping review aims to identify and synthesize the available literature on older adults in photovoice research in Canada. In this context, we will address the following objectives: (1) To identify the available research on older adults’ involvement in the photovoice method research within the Canadian context. (2) To identify the impacts of this research approach at the individual and community level. (3) To evaluate the quality of published studies utilizing the JBI critical appraisal instrument for qualitative research.
Methods
The proposed scoping review will be conducted in accordance with the 2020 Joanna Briggs Institute (JBI) methodology for scoping reviews (Peters et al., 2020). The review protocol has been pre-registered on the Open Science Framework platform (https://osf.io/fevmh/). It is being reported against the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) (Tricco et al., 2018).
Eligibility Criteria
Populations
This review’s population of interest is older adults. Older people will be considered ‘older’ if they are defined as such by the study itself, regardless of the age range of the included participants. Studies conducted with adults under 65 will not be included, but with the exception that at least 50% of the sample comprises older adults defined as 65 and older.
Concept
This review will consider studies that utilize the photovoice method as the data collection approach. Given the diverse ways in which photovoice is described referring to the same method, this review will use a variety of combinations of this concept, such as the photovoice method or approach, photo-elicitation, photovoice methodology, and participant-generated photographs. Studies that use photovoice in addition to other data collection methods will be considered; however, studies that utilize photovoice without presenting relevant results from the use of the method will not be considered.
Context
This review will consider studies from Canada.
Types of Studies
This review will consider all study types that include a photovoice component, including mixed-method study designs. Only peer-reviewed studies available in English will be included. Literature reviews (e.g., systematic and scoping reviews), conference abstracts, commentaries, and book chapters will not be included. A hand-search of all included articles’ reference lists will be performed to identify additional relevant articles.
Search Strategy
Ovid Medline Search Strategy
Database(s):
Study Selection
All references will be uploaded into Covidence following the search, and duplicates will be automatically removed (Covidence, 2025). Covidence is a web-based collaboration software platform that helps streamline the production of a literature review. Two independent reviewers will screen the titles and abstracts based on the inclusion criteria. All three reviewers will initially review 25 articles for inclusion against the inclusion criteria for inter-rater reliability (IRR). An IRR of 80% or higher is acceptable and will indicate strong reliability among reviews (Tricco et al., 2016). If less than 80% is achieved, reviewers will discuss the discrepancies and reconduct another round of reviewing 25 articles until 80% or higher is achieved. A third reviewer will review all differences. Following the first screening level, articles screened for inclusion will be retrieved for the full-text review. Two independent reviewers will double-screen full-text articles at this stage, with discrepancies handled by a third reviewer. The scoping review will document and report the reasons for excluding full-text articles. The search and screening process results will be reported in full in the final review paper and presented in the PRISMA flow diagram.
Assessment of Methodological Quality
All studies included in the review will be critically assessed for methodological quality using the JBI critical assessment appraisal instrument for qualitative research (Lockwood et al., 2015). Two independent reviewers will blindly conduct the critical appraisal of the eligible papers, comparing their findings after the initial appraisal is completed for each paper. In case of discrepancies, a third reviewer will be consulted to reach a consensus on the paper’s assessment. The latest version of the JBI Manual for Evidence Synthesis provides additional details on evaluating methodological quality (BI Manual for Evidence Synthesis, 2924).
Data Extraction
The lead author (MS) will develop an extraction within the Covidence platform. Data will be extracted on details about the participants, setting, purpose, photovoice application, impact of the method on the intrapersonal-, interpersonal-, community-, and sociopolitical levels (Cubero et al., 2024), and key findings related to the overarching review questions. The extraction form and the first five articles will be pilot tested independently by the lead author and two reviewers to assess compatibility with the research questions. Given the iterative nature of data extraction, the form may be adapted. Such modifications will be documented and reported in the final review.
Data Analysis and Presentation
We will extract data to synthesize based on the research objectives of summarizing the state of photovoice with older adults in Canada and identifying how this research has impacted individual participants, including at the broader community level. We will summarize the data relevant to a core PAR principle of social change, identifying ways that photovoice was used to promote this. Finally, the findings will be summarized narratively, with tables and charts. The results will be reported using the PRISMA-Scr (Tricco et al., 2018).
Discussion
This scoping review will provide an in-depth overview of English-language, peer-reviewed publications on studies that used photovoice with older adults in Canada, including a description of the use of participatory research approaches in this context. We intentionally want to consider these papers, which frame photovoice as a participatory approach to address broader system change while centring the voices of understudied populations on knowledge production and power imbalances (Wang & Burris, 1997). To date, a comprehensive scoping review examining the use of photovoice in older adults in Canada has not been conducted, despite the use of photovoice in this context (Karmann et al., 2023; Novek & Menec, 2014). Using multiple terminologies to identify the photovoice method, this scoping review will find and summarize the published research that has applied photovoice methods in this population. It will describe how participatory research has been conceptualized and operationalized in the research process.
This review will offer a comprehensive overview and understanding of how older adults in the Canadian context have been involved in this method. Considering the redefinition of aging and empowering older adults to participate in value-aligned decision-making, the findings have the potential to inform and drive change at community and/or societal levels. The findings could inform researchers, service providers, and policy-makers on the process, values, and best practices for involving older adults in PAR using photovoice. We expect that gaps will also emerge and will support informing future research. The results will inform future research development, including broad dissemination in community-based presentations and peer-reviewed journal publication.
Footnotes
Ethical Considerations
All information was sourced from published literature, and no human or animal participants were involved; therefore, no ethical committee approval was required.
Author Contributions
Saragosa M: Conceptualization, Methodology, Funding acquisition, Supervision, Writing-original draft. Singh H: Conceptualization, Writing – review & editing. Kamenitz L: Writing – review & editing. Fujita H: Methodology, Writing – review & editing. Nekolaichuk E: Methodology, Writing – review & editing. Gyansa E: Writing – review & editing. Howells A: Writing – review & editing.
Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by an SSHRC Institutional Research Grant.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.