“Being There”: The Enduring Value of In-Person Photovoice Health Research With Equity-Owed Populations

Abstract

The pragmatics of photovoice in health research have shifted since the inception of the methodology. Early photovoice centered ethnographic-like participatory and place-based methods where researchers were ever-present physically interacting with the participants, environments, and systems and structures that they studied. Photovoice has seen several modifications, however, including as researchers have moved to virtual and otherwise less immersive methods. At this juncture, there are wide-ranging perspectives on the optimal way(s) of using photovoice for health research, alongside wider debates about whether the methodology is being applied in line with its initial roots and aims, and indeed whether it needs to be. Amid these tensions and transitions, the current article contributes a discussion of in-person photovoice and its enduring value for meaningful and impactful health research with equity-owed populations. This discussion is framed within a photovoice study examining how trajectories of homelessness and substance use intersect for 2S/LGBTQ+ youth in Vancouver, Canada. Findings are shared across three themes. The first theme, Feeling place and presence, underscores the benefits of in-person and place-based photovoice methods for engaging with equity-owed communities and mitigating barriers to research participation. Old-school photography building process and product, reviews the asset-building capacity, practicality, and impact of photovoice research with disposable cameras, through facilitating community engagement and attention to social and material contexts. Powering pictures for community choice, consent, and control, chronicles how photovoice methods can be structured to promote reflexivities for community buy-in and purposefully active knowledge mobilization. Together, these findings underscore the potential of in-person photovoice methods for garnering deeper insight into the meaning, context, and affective dimensions of people’s lived experiences in community-based research. The insights shared in this article serve as a springboard for discussion about the pragmatics of actioning and modifying photovoice, whilst making a case for ‘being there’ with on-the-ground photovoice methods.

Introduction

Photography as a visual research method features in a variety of photo-elicitation approaches (Han & Oliffe, 2016), including photovoice (Wang & Burris, 1997), photo-essay (Corwin, 1985), and auto-photography (Noland, 2006). These approaches seek to solicit information within participant interviews and focus groups by inserting photographs, whether existing, researcher-sourced, or participant-produced (Han & Oliffe, 2016; Harper, 2002). Among photo-elicitation approaches, photovoice is differentiated by its exclusive use of participant-produced photography (Harper, 2002). The methodology involves people using participatory photography to represent their community, with the intention of promoting critical dialogue and knowledge to stimulate social action and change (Wang & Burris, 1994, 1997). In ‘giving the lens to participants,’ photovoice as participatory action research draws on principles of health promotion, empowerment education, feminist theory, and critical constructivism to offer an inclusive and grassroots means for people to record and reflect their community strengths and priorities (Wang, 1999). Recognizing this potential, researchers have mobilized photovoice for community- and place-based inquiry across a range of issues and contexts.

Photovoice was developed at a time and place characterized by significant increases in the visibility and popularity of participatory action research, as well a burgeoning appreciation for visual research methods (Boydell et al., 2012; Wang, 1999; Wang & Burris, 1997). Traditional photovoice, as advanced by Wang and Burris (1994, 1997), is presented as a relatively fixed method with a series of procedures including posing an initial theme to guide the photography, distributing cameras to participants and reviewing how to use them, providing time for participants to take pictures, meeting collectively to discuss the photographs, and planning avenues for sharing the photographs. While these procedures offer a robust foundation for the methodology, photovoice has seen some shifts over the years and attracted modifications and renaming, as well as accompanying scholarly debate about whether photovoice is being used in line with its initial roots and aims, and indeed whether it needs to be (Gubrium & Harper, 2016; Liebenberg, 2018; Strack et al., 2022). As one substantive example, in Castleden and team's (2008) study of Indigenous perspectives on health and environment issues in Western Canada, the authors make a compelling case for building trust through prolonged immersion in the field and ongoing community contact with photovoice, contrasting what they described as the more short-term, intensive approach to data collection used in previous photovoice studies. The authors present additional photovoice adaptations in the interests of promoting feasibility and capturing a fuller range of perspectives, suggesting that researchers can hold individual interviews soon after participants’ photographs are taken (rather than undertaking a single group dialogue process) and invite participants to comment on all their photographs, not only the ‘best’ photographs or others selected by group consensus (Castleden et al., 2008). Elsewhere, researchers have modified photovoice by conducting cross-community or even cross-national projects (Gaboardi et al., 2022), using mobile phones and social media for participatory photography (Yi-Frazier et al., 2015), and pairing participants with professional photographers (Kattari & Beltrán, 2022). Pushed by the COVID-19 pandemic, many researchers have also moved their photovoice projects online (Chen, 2023). Virtual and other modified photovoice approaches can carry many advantages (e.g., increased recruitment reach, sourcing of archived photographs) yet also pose challenges, such as with managing multi-site projects and engaging research participants in community-embedded participatory action processes remotely (Call-Cummings & Hauber-Özer, 2021; Chen, 2023; Oliffe et al., 2023, 2024).

The qualitative research literature details wide-ranging perspectives on the optimal way(s) of conducting a photovoice study for health research. Here, existing reviews of photovoice provide overarching guidance on the methodology (Catalani & Minkler, 2010; Golden, 2020; Han & Oliffe, 2016; Hergenrather, 2009; Lal et al., 2012; Nykiforuk et al., 2011), emphasizing its many strengths while detailing opportunities to enhance participant engagement, advance study design, and address emergent ethical considerations. A review of reviews about photovoice (Seitz & Orsini, 2022) indicated that researchers inconsistently adhere to the original photovoice methodology, noting that many studies do not engage participants in the research design, conduct individual interviews rather than group discussions, and waive participants in data analysis and knowledge mobilization. Clear from this review are the diverse and sometime conflicting perspectives and pragmatics on photovoice, as well as the tension between the need for methodological flexibility on the one hand, and consistency and coherence on the other, in line with broader conversations about methodological precision and fluidity (Cutcliffe & Harder, 2012; Holloway & Todres, 2003). Amid such tensions, many health researchers have strategically adapted conventional photovoice traditions to fit disciplinary and pragmatic needs, leading to several methodological innovations. For example, health researchers have detailed distinct approaches to photovoice analysis (Oliffe et al., 2008; Switzer & Flicker, 2021; Tsang, 2020) and taken up important paradigmatic and axiological questions, including about issues of social justice intent (Sanon et al., 2014), participant voice (Evans-Agnew & Rosemberg, 2016), and theoretical framing in photovoice (Higgins, 2016). Oftentimes generating more questions than answers, this literature has opened new lines of inquiry about the demands and possibilities of photovoice health research, which are ripe for continued methodological deliberation.

Much photovoice health research has been with equity-owed populations, comprising people who experience poorer access to social and structural determinants of good health coupled with marginalization along intersecting axes of identity (Armstrong & Ritchie, 2022; Ng et al., 2024). The use of photovoice for equity-focused research reflects the methodology’s origins and original intent, whereby early photovoice projects utilized highly participatory and place-based methods that required the researcher to be physically present and collaboratively interact with the participants, environments, and systems and structures they studied (Wang, 1999; Wang & Burris, 1997; Wang et al., 2000). By emphasizing the importance of ‘being there' for community-based research and knowledge co-construction, photovoice researchers traditionally relied on in-person fieldwork and interviews or focus groups (Oliffe et al., 2023; Wang, 1999). Data collection methods along this anthropological or modernist ethnographic tilt centred on bringing participants into the research process, in ways that are decidedly hands-on involving the researcher being ever-present to facilitate the participatory and liberating intentions (and promises) of photovoice (Oliffe et al., 2023; Wang, 1999). This embedded approach to research is not without its ethical challenges, especially in work with equity-owed populations and engaging stigmatized and/or criminalized topics (Holtby et al., 2015; Joanou, 2009; Smith et al., 2024), though it has been invaluable for generating deeply contextualized and participant-driven understandings of complex societal issues. Emergent from this literature is acknowledgement of the nimble and adaptive potential of photovoice, alongside recognition of concessions that are often claimed with modified photovoice approaches, particularly those that turn away from place- and community-based methods characterized by being there with physical presence, materiality, and relationality. The current article builds on this literature to contribute a project-informed discussion of in-person photovoice data collection methods and their enduring value for meaningful and impactful qualitative research with equity-owed populations.

Situating the Current Photovoice Study

The methodological insights offered in this article build on a recent photovoice study, titled “Out on the Street,” completed as part of the lead author’s (TG’s) doctoral research (Goodyear, 2024), with the support of author JLO, who was a dissertation committee member. The study examined how trajectories of homelessness and substance use intersect for Two-Spirit, lesbian, gay, bisexual, transgender, queer, and other sexual minority (2S/LGBTQ+) youth, aged 17–29 years. The study aims, procedures, and findings are detailed in three data-driven publications documenting how (i) substance use features in pathways to homelessness for 2S/LGBTQ+ youth (Goodyear, Jenkins, Oliffe, et al., 2024), (ii) drugs shape their practices and contexts of homemaking (Goodyear, Jenkins, Fast, et al., 2024), and (iii) youth navigate and negotiate “outness” in the context of homelessness (Goodyear, Knight, et al., 2024). There is an additional study publication focused on participatory knowledge mobilization (Goodyear et al., 2025), detailing TG’s engagement with a youth advisory committee with whom he planned and hosted a community photovoice exhibit for Vancouver’s Queer Arts Festival in June 2024, and subsequently developed an accompanying photo catalogue (Goodyear, Barborini, et al., 2024).

The Out on the Street study was set in Vancouver, Canada, in 2023, and was purposely designed to be 100% in person. Recruitment involved posting study advertisements and regularly visiting (with ethics and staff approval) youth shelters and drop-ins in downtown Vancouver, to identify prospective study participants: 2S/LGBTQ+ youth experiencing current or past-year substance use and homelessness. Data collection was led entirely by TG and involved a three-stage photovoice activity with 26 youth. Participants first completed a baseline interview to review photovoice instructions and safety guidelines. Then, participants spent one to two weeks taking photographs depicting how their substance use related to their experiences of homelessness and housing, as well as their social identities, after which they returned their disposable cameras to the researcher for photo development. A few days later, participants completed a follow-up interview to review their photographs. Interviews took place at the youth drop-ins and shelters, and at a nearby downtown research field office. The study was approved by the University of British Columbia Behavioural Research Ethics Board (#H22-02910). Participants provided informed verbal consent and received a $150 CAD honorarium.

In this article, we focus on key methodological learnings gained throughout the course of the study, particularly as we identified various benefits, and at times challenges with doing in-person photovoice research. These learnings were derived through researcher field notes with each interview, reflections from monthly research team meetings to debrief the study procedures and progress, and participant interviews. These interviews welcomed discussion of the photovoice process and included guiding questions and prompts, including: How did you find the overall experience of taking your pictures? What did you find came easily? What was more difficult? And, What surprised you or stood out during the activity? Participant responses to these questions and other insightful comments were collated during coding for the empirical articles detailing the study findings. These data were captured with an umbrella code, “Photovoice Methodology,” which was distinct from codes capturing empirical insights about 2S/LGBTQ+ youths’ substance use and homelessness trajectories.

Data analysis followed a reflexive thematic approach (Braun & Clarke, 2006, 2019). Although we employed a participatory approach to analysis and knowledge mobilization for the data-driven components of this study, including discussing study findings during monthly youth advisory committee meetings and involving youth as co-authors, analysis for the current article was conducted by co-authors TG and JLO. Data immersion was facilitated through TG conducting all interviews and leading analyses for the empirical articles stemming from this study. Photovoice processes and insights from this study were discussed in research team and youth advisory committee meetings, providing embedded opportunities for reflection on the methodology and triangulation of key learnings derived over the course of this research. After the empirical analyses and end-of-study knowledge mobilization for this study were completed, TG returned to the dataset and reflexive memos he had taken throughout data collection and analysis to undertake the present investigation. TG and JLO further developed the interview data that had been coded to “Photovoice Methodology” by inductively writing to and (re)labelling these data. We narrowed broad content categories to more refined themes, which we assigned descriptive titles to pre-empt salient methodological findings about the enduring value of in-person photovoice methods for meaningful and impactful qualitative research with equity-owed populations. Below, we present these three themes and provide illustrative quotes and photographs to contextualize key points. All participant names provided are pseudonyms.

Findings

Feeling Place and Presence

The ‘on-the-ground’ and in-person methods used in this photovoice study were instrumental to feeling place and presence. Being physically present and available was essential for mitigating barriers to research participation for this population of youth experiencing substance use, unstable housing, and intersecting forms of inequity and oppression. As a research team, we decided early on that TG would work from a downtown research field office affiliated with the At-Risk Youth Study. This is a longitudinal cohort study for which street-involved youth who use(d) drugs take part in semi-annual surveys and can also be connected to active qualitative research studies (Fast, 2024; Wood et al., 2006). The field office is a lively hub for youth to participate in research, access harm reduction supplies and information about local health and social services, and otherwise step inside to escape the weather and have a snack and/or drink. Youth inhabit this space in diverse ways, often quite routinely but sometimes on a more sporadic or respite-driven basis, particularly as crises and transitions (e.g., with housing changes and hospital stays) draw them away from research participation then back again. In working here, we were positioned such that we could inform youth who were coming into the office about the study, screen for eligibility, and schedule interviews, many of which were held on the same day or later that week. This strategic placement was a boon for gathering momentum with study recruitment, which we bolstered through targeted and place-based recruitment outreach efforts.

As our research team began the study, we leveraged established relationships with nearby youth services – including two drop-ins/shelters and one clinic – and began supplementing recruitment through frequent (at least weekly) visits to these services. These visits were scheduled to overlap with key service delivery times (e.g., drop-in clinic and hot breakfast hours) to enhance potential for youth engagement and streamline coordination of the visits with the service providers and institutions. The visits allowed opportunity for the researcher to speak with youth who were present in the spaces about the study, as well as other active studies being led by members of the research team, and to screen for eligibility and arrange interviews. Many of these interviews were held in private areas of the drop-ins, when requested by the youth and approved by staff. The researcher having a friendly, approachable, and enthusiastic presence in these spaces over the course of the study supported youth and service providers to become familiar with – and interested in – the research, with TG’s day-to-day conversations with youth helping to establish rapport, and the research project quickly becoming known as “the camera study.” The degree of community buy-in garnered through the researcher consistently being present could not have been achieved with less immersive photovoice methods, including virtual projects, and reflects the benefits of engaging community partners from a very early point in the research process and throughout the conduct of a study (Hergenrather, 2009; Suarez-Balcazar, 2020). Evident here was the temporal dimensions of being there consistently and weaving a researcher presence into the fabric and materiality of place. In essence, TG was part of the milieu, and the photovoice work known and named by people inhabiting that arena.

Easing coordination of the photovoice interviews was another advantage of being present in the local youth homelessness service delivery and research context. The participants often had limited access to mobile phones and other means of remote communication (e.g., email, instant messaging apps) and were actively navigating the demands and structural pressures associated with unstable housing and substance use, making it difficult to schedule research interviews. Young people’s priorities and everyday emergencies could lead to them arriving very late (or very early) on days they had agreed to meet with the researcher. Sometimes, there was lost contact between the researcher and youth for days, weeks, or months at a time. These challenges are understandable and were mitigated through the researcher having an active presence, keeping an open schedule (as much as was possible), and taking a flexible and low-barrier approach to hosting interviews. This involved meeting youth ‘where they were at,’ conducting interviews at short notice and on the spot. There were some limitations, as the researcher could not always be available due to conflicting commitments (e.g., meetings, interviews with other youth) and the research office operating on a schedule that was essentially business hours. Still, ‘being there’ was impactful for facilitating data collection, and for following up with youth as they moved through the photovoice project stages, including the initial interview, participant-directed photography activity, and follow-up interview.

The research team’s grounding and presence in the community yielded ethnographic insights that were highly beneficial to informing and contextualizing our investigation. There were many instances of participants vising the research field office or approaching TG during outreach to update him about their living situations. On some occasions, these conversations pivoted to additional one-on-one interviews to speak in more depth about changes in participants’ housing and substance use trajectories. More often, these were relatively brief and informal conversations that nonetheless supported the researcher to gain insight into participants’ shifting life circumstances and material realities. These conversations could also be validating and beneficial to the youth. One research participant, Edgar, a 21-year-old man, visited our research field office on numerous occasions between April and July 2023, during which time he was using crystal methamphetamine intensively and cycling between living with a parent, staying at shelters, and sleeping outdoors. The initial and prolonged engagement with Edgar helped to develop a strong rapport, with Edgar seemingly anchoring himself to the research(er) as he repeatedly came by the office to talk through developments in his living situation, substance use, and mental health. In this way, the research team’s place and presence was both ordering and disordering to the participatory action research methodology, as it made space for ad-hoc, less regimented but very ‘real’ interactions with community. These interactions were messy, uncertain, and flowing through time rather than working to the researcher’s schedule, especially as much of the communication with participants – particularly those without access to phones or computers – was in person based entirely on them dropping into the office. Yet, these interactions and side conversations could also make space for more structured opportunities to gain deep insights into participants’ lives. Indeed, after some time, Edgar asked to do a second round of the photovoice activity, using another disposable camera, and his new photographs captured his reflections about the evolving role of drugs in his life. He took one photograph of local graffiti (Figure 1), titled with the response “Nobody,” to represent the family conflict and accompanying housing precarity he was experiencing in connection with his crystal methamphetamine use and queer sexuality. The longitudinal insights from follow-up activities such as this and our quasi-ethnographic interactions with Edgar and other participants provided critical contexts for how trajectories of substance use and homelessness intersect for equity-owed 2S/LGBTQ+ youth. Importantly, our research team would have been poorly equipped to capture these insights, had we not been using an ‘on-the-ground’ and in-person research approach.

Who benefits? I think about it... Yeah, it is a great question. Who?

Figure 1.

“Nobody,” by Edgar

Edgar rhetorically asked and answered the question of who benefits? featured in his photograph, asserting that nobody wins an argument or conflict. Graffiti-like, the black on white reached out to centre the caricature of a man whose place, presence, and purpose were in question and questioning. Asked about the photograph, Edgar explained the wall was adjacent to the research office, in a secluded area frequented by people in circumstances similar to himself. Edgar’s place and presence within that hardship was positioned as a wider community challenge and indeed an issue of importance to the research study (and other studies). Plus, there were tinges of Edgar belonging to a powerfully grounding place yet simultaneously craving inclusion, or at least to be seen, by ecosystems that he felt had abandoned him. Feelings of place and young people’s presence within it were consistently depicted in their narratives and photographs. These feelings were further enhanced through the researcher being in that locale, and able to understand and offer nuance to locate and elaborate visuals that otherwise may have been unfamiliar.

Old-School Photography Building Process and Product

The application of disposable cameras proved advantageous for enhancing the research process and products, including the feasibility for meaningfully engaging participants to highlight their shifting social and material circumstances and health. We opted to go ‘old-school’ and use Fujifilm QuickSnap cameras, as they take quality photographs and were low-cost and easy to use. The cameras were offered to all study participants, including those who owned mobile phones, all but one of whom still opted for the disposable camera. The participant who used their phone emphasized that doing so was pragmatic, as he was living out of his backpack at the time and “ha[d] enough to carry around as it is” and “didn’t want to put more stuff in my bag.” Youth who used the disposable cameras praised their straightforward functionality and retro feel. The maximum number of photographs allotted by the cameras limited retakes and invoked an asynchronous adventure in which the photographs were taken but not seen until later. Indeed, participants saw their photographs for the first time at the follow-up interview wherein they had to cast their mind back to when and where the photographs were first taken. Reflexivity was often (re)summoned in this moment, as participants thought back on their initial decision to take the photographs, and the meaning and context behind the photographs.

Photography with the disposable cameras was consistently and enthusiastically described as “fun” by participants. The images often depicted the youth enjoying themselves, including as they and their peers moved through the city and Vancouver’s beautiful parks, beaches, and architecture, and as their substance use sparked possibilities for socialization, forward momentum, and homemaking. One 17-year-old genderfluid young person, Kat, described the photovoice activity as documenting a “trail of memories.” In line with this, Kyrie, a 21-year-old man, used the full roll of his 27 camera exposures to capture his movements and activities in the city. He titled Figure 2 and a series of photographs, “Energy,” symbolizing his desire to capture various affective intensities and pursuits through his photovoice project:

[My photographs are] showing the routine of somebody that wants to enjoy the city. […] There’s so much to do, and so many people to meet. And everyone’s smoking and drinking, like, everyone that’s young (emphasis in bold).

Figure 2.

“Energy,” by Kyrie

Iconic, the “A-maze-ing Laughter” sculpture by artist Yue Minjun is one with a series of characters in the city’s West End, 2S/LGBTQ+ “gaybourhood,” wherein the laughing men with their rich self-embrace and joviality are meant to convey and inspire joy and playfulness. That the photograph is imperfect – i.e., it is left of centre and has sunlight intruding in to pepper and reflect on the statue – aligns with the materiality and rawness of Kyrie’s photography and accompanying narrative. Kyrie explained that the photovoice activity had been a release for him, particularly as he took asset-building photographs that contrasted the hardships he was experiencing. Amid detailing “the city’s trouble” wherein there are few options for housing and meaningful employment for young people, Kyrie explained his initiative to take command of the photovoice process and the products stemming from it. While much of this photography occurred “in the moment” (Kyrie’s words), these efforts followed his explicit venture to use the disposable camera opportunity to curate a collection of photographs reflecting strengths and desire, not damage (Tuck, 2009). The products of this photography show Kyrie buying in to pleasures and being happy in the moment, driven by processual aims that were unmistakably affective and generational: “It’s more like a feeling for me. So, if I feel my soul fill up, I would take a picture.” Viewing and talking about the developed photographs during interviews likewise sparked introspection and emotional reflection for youth, who were often very excited about seeing their photographs and being able to keep them. Here, we note that all participants were invited to retain the physical prints of their photographs (and digital copies, if requested), and that this was well received. Many participants recounted to TG during future encounters that they had shared their photographs with loved ones, peers, and support workers, and that they had posted their photographs at home, including in shelters and social housing.

Freestyling the photovoice method resulted in youth taking many photographs that were relatively ordinary, such as photographs of them hanging out with friends, relaxing on the beach, or exploring the city. Discussing these photographs during the interviews helped to strengthen rapport and enhance understandings of the everyday contexts of youths’ substance use and homelessness. Sometimes, there were deeper meanings tied to these more ‘mundane’ photographs, wherein the temporalities of the photovoice process and product, as images snapped with the disposable cameras remained unseen for days or even weeks until the follow-up interview. This distance could beckon among participants a reinterpretation or interrogation of their motivations and overall ‘read’ behind why they took photographs in the first place, occasionally unleashing more nuanced reasoning. Axel, a 25-year-old person, took Figure 3 depicting a child’s glove on the ground that they had walked by in a downtown plaza. The original title of the photo, “Two in the Pink” (a sexual reference), reflects Axel’s playful intentions as they stumbled upon an opportunity to represent their experiences as a lesbian figuring out their sense of place and community. Axel joked with the researcher when first explaining the photograph but began reflecting on a potential deeper meaning for the symbolism of a child’s glove. They proposed a second title, “Innocence,” while recounting having grown up in a family home where their queer sexuality and gender expression were heavily scrutinized. Thus, an initially routine and lighthearted photograph turned to producing self-analysis and in-depth insight into Axel’s early-life experiences of ‘coming out’ and related family conflict, which intersected with their initial use of substances and trajectory of leaving home. Herein lies the untapped potential of ‘everyday’ photovoice images, which disposable cameras proved well suited to producing.

Figure 3.

“Two in the Pink; Innocence,” by Axel

Axel built a metaphor in appraising their photograph. The humor in the sexual reference gave way to their relative closeness in age to the hand that fit the glove, and reflections on a childhood stained by ‘othering’ and ostracism from their family. In the photograph amid all its ordinariness emerges a life course – offering a developmental account, as well as somewhat discordant but entirely relational reads by the taker of, and talker to the image. The nature of the old-school photographs was also one of permanence. That is, there was not the option to delete the images taken, and while they could be redacted, the photographs instead drew participants’ spontaneous commentaries, conversations, and sometimes competing narratives.

Youth did not only take spontaneous photographs. The finite number of photographs each camera could take (27 total) also precipitated introspection and advanced planning as youth endeavored to capture the moments and issues that best represented their living situations and identities. Here, it is noteworthy that the researcher advised youth to take at least one to two weeks for their photography activity. Some research participants wanted to move through the data collection activities as quickly as possible, in part so that they could receive their full honoraria (which was provided over three payments), and a minority of participants requested to drop off their cameras on the same day or day after they were provided. Perhaps youth who rushed the activity also did so due to efficiencies, including feelings that they were being paid to do something, particularly as an honorarium was ostensibly being attached to ‘paid work’ and a concrete deliverable – or contribution – in the form of their photographs. Our research team recognized that many of the youth were living in poverty and actively pursuing opportunities for paid employment, though we also understood that it was neither feasible nor appropriate to speed through photovoice data collection. Participants generally respected this, and many highlighted the experiential benefits of taking photographs over an extended period. Billy, a 20-year-old gender-questioning person, spent just over one week on their photography activity, and explained how they had enjoyed the process and been able to strike a balance with capturing premeditated and spontaneous photographs, each of which held a specific meaning:

I really like the actual functioning of the camera. Like, it was really fun! And to just sit there and kind of focus, and I would think of like meanings behind the photos before taking them, to actually sit down and think about what it means to me. Cuz a lot of it was like connection and a bit of reflecting while taking the picture. So, it was very interesting. […] [And then] some of them were a little bit spontaneous. It was a really fun experience and to just be able to think in the moment.

Overall, there was a great deal of youth buy-in and engagement in the old-school photovoice process, so much that many of the research participants inquired about opportunities to take part in similar studies, and/or to repeat the photography exercise. Notwithstanding the material gains of using disposable cameras, there were concessions including some issues with the quality of the images, and participants’ satisfaction with their photography. These issues were mitigated by the researcher giving a brief training and ‘demo’ on how to use the disposable cameras with the introduction of the photovoice activity, similar to Wang’s approach (1999), and the reality that many youth had previously used the cameras. Still, the photography did not always go as planned; occasionally, the camera lenses were obstructed by participants’ fingers, the photographs were taken in poor lighting and/or without the camera flash, and some photographs simply did not turn out during the development process. These issues were generally taken in stride by the participants and researcher, especially when they only occurred with a subset of photographs. The reality of these photography mishaps emphasizes the need for researchers to review with participants how to use the cameras, and to accept both the benefits and limitations of this old-school photography method. Indeed, these mishaps count toward understanding the participatory processes of old-school photovoice as a work in progress that sometimes does impact the photographic products, for better and worse.

Powering Pictures for Community Choice, Consent, and Control

The in-person photovoice methods and three-stage approach to data collection were intentionally structured to promote community choice, consent, and control in the research and related knowledge mobilization. The baseline interview provided opportunities for the researcher to orient participants to the focal study phenomena (e.g., homelessness//housing, substance use, identity) and introduce and contextualize the photography activity. Youth were advised: “For this study, we ask you to take 10-27 photographs that represent your experiences using drugs and how this may connect with your housing status, sexual and/or gender identity, and access to services.” This guidance allowed for flexibility in how participants could approach the photography activity, and many indicated that the general instruction was sufficient. Lucifer, a 23-year-old non-binary person, summarized, “I went on my instincts; I just took the camera and snapped the pictures.” Other participants requested more direction, for which we offered additional guiding prompts, such as, “You might want to think about taking photographs depciting how your drug use relates to your experiences of housing and homelessness.” This tailored approach to instruction provided a starting point that youth could take in the direction they wanted. It also helped to focus the complex and intersectional nature of the investigation. CJ, a 23-year-old person who described their gender as androgynous, explained the power and impacts of having (structured) choice in the photovoice project:

There was a lot of freedom with it. There wasn’t like, “You have to take photo of this, it has to mean this.” There was none of that. It was just, “Here is the camera, here are some basic rules, have fun.” And I think that kind of allows people freedom. [And freedom] is great, but freedom with structure is better. Because it gives individuals a chance. The bit of structure that was involved with the photo-taking was very, like, it got me thinking about what’s going on. Like, why do I wanna take a photo of this? What does this mean to me?

Participant choice was also promoted through study consent and photo-release processes. Informed consent was obtained from all participants, including youth under the age of majority, who we assessed as emancipated minors. In addition, we actioned a photo-rating system (Holtby et al., 2015; Lowik, 2021) wherein participants were asked during the follow-up interviews to rate each photograph based on their expectations for how it could later be shared. Initially, participants were asked to designate their photographs as private (i.e., usable only as a conversation starter and not shareable outside of the interview itself), semi-public (i.e., usable in controlled environments and with limited audiences, such as presentations where the audience would be asked to not re-photograph the images), or public (usable anywhere). Participants overwhelmingly designated their photographs as public, with some exceptions, such as cases where the photographs were clearly identifiable, or where participants were not satisfied with the quality of the photographs and content being depicted in them (e.g., compromising personal situations). Youth designated these photos as private, and we noted after the initial few interviews that no photographs were made semi-public. Thus, we dichotomized our photo-rating system to public or private. When it came to planning our community photovoice exhibit, we also engaged a youth advisory committee to select photographs that could most appropriately and respectfully represent the community and issues under study, such as the photographs displayed in Figure 4, representing one wall of our exhibit. For this youth engagement, TG and the co-lead of the advisory committee (Christian Barborini) first narrowed down a set of photographs that were assessed as being well suited to the exhibit, then brought these photographs to the advisory committee to review and vote on for inclusion. The youth advisory committee additionally decided on the photographs we would display at a larger size, those we would use for the exhibit promotional poster, and those we would print as take-away postcards for exhibit attendees. This community deliberation occurred over a series of monthly meetings and sought to further embed youth choice in the photovoice process, as we detail at length elsewhere (Goodyear et al., 2025).

Figure 4.

One wall at the Queer Eyes, Queer Lives community photovoice exhibit, showcasing imagery about 2S/LGBTQ+ young people’s sense of place in the city. Photo by Ben Siegl

Our research team additionally worked to ensure participants felt in control of the expectations and boundaries of the photography activity. We emphasized to youth that photographs explicitly depicting substance use and homelessness were not required, including because we did not want to pressure participants into using substances in connection with the study, and because we were aware that many such photographs would not end up featuring in our analyses and knowledge mobilization activities, as we sought to avoid unnecessary – and potentially harmful – intrusion and exploitation (Joanou, 2009). Only one participant reported being triggered by the photography (“It kind of motivated me to party more”), though he went on to explain that the activity had ultimately been beneficial for him reflecting on his substance use and desire to be sober. Reflections about substance use and mental health were common in the study, and the researcher reviewed with all participants a list of resources and services they could access for support with managing their health and social circumstances. Being in person facilitated this process and made it easier for the study lead (a registered nurse) to be aware of psychosocial distress among the participants, and to directly connect them to appropriate supports, when needed. Indeed, there were two instances of TG accompanying youth in distress to nearby health services, instead of conducting the interviews. These youth returned to take part in data collection at a later point in the study. Being in person and in Vancouver’s Downtown South, where there is a hub of youth-focused services, acted as a sort of safety net with which to control for, and intervene on, distress among the participants. This controlled approach to the study conduct and our overall risk mitigation helped to ensure beneficence in our goal of the images (and their taking) only ever doing good.

The promotion of choice, consent, and control in this research also involved thinking about community beyond the study population. We incorporated into the photography activity safety guidelines that protected both participant safety and that of their broader communities. Specifically, participants were asked to not photograph other people (especially identifiable features), to be respectful when taking photographs near or with others, and to not trespass while taking photographs. Participants accepted these guidelines, with many agreeing that they had been “watchful” and “mindful” about respecting other people’s privacy when completing their photography activities. CJ (introduced earlier), reflected on the photovoice guidelines and shared, “The little bit of rules that were added it kind of helped me protect my community, which I think was great.” There were some slips in abiding by these guidelines, however, and all photographs that deviated from these guidelines were designated private. This may seem at odds with our desire to respect participant choice over their own photography, though our intention was to strike a balance between protecting participant autonomy and the privacy of broader community members, who did not have the opportunity to consent to this study.

Discussion

This article has contributed a pragmatic account of our experiences using in-person photovoice data collection with 2S/LGBTQ+ youth, offering salient methodological insights to help guide the work of health researchers. The emphasis on being there and the benefits thereof presented in this article revisit and extend understandings about the practicalities of actioning photovoice as a form of community-based participatory action research. While our approach is but one way of doing and modifying photovoice, the project-informed insights and lessons we share can serve as a bridge for ongoing discussion about opportunities to reconsider, adapt, and refine use of the methodology to achieve meaningful community impact.

This study showcases the enduring value and wide-ranging impacts of in-person, on-the-ground methods for contemporary photovoice research. The initial photovoice work of Wang and Burris (1997) underscored the power of in-person studies for generating locale- and population-specific understandings of community health issues. This work positioned researchers as facilitators accountable to a group or community, and as openly committed to social change for, and with, that community (Wang & Burris, 1997). Insights from the current study suggest opportunities to redefine this role beyond one of facilitation, to better capture the dynamics of place, presence, and relationality. Indeed, this study has detailed how photovoice researchers can act as ethnographers (or quasi-ethnographers), producing rich observational and longitudinal data through informal, day-to-day conversations with participants at community recruitment sites and a research field office, with these data points helping to enrich insights from the photography activities and follow-up interviews. Similar to other works (Guell & Ogilvie, 2015; Mortensen & Questiaux, 2025), we found that frequent interactions with participants and their larger community and service delivery network (e.g., drop-ins and shelters) supported our research team to develop rapport, enhance collective understandings of the issues under study, and further grasp the material and affective contexts of participants’ lives. These processes are closely aligned with a community-based research approach, for which co-creation of knowledge between researchers and community members (and ‘in-betweeners’ across these two categories) is key to transformative and emancipatory work (Capous-Desyllas et al., 2019; Suarez-Balcazar, 2020). The deeper engagement produced through being there alongside community was indeed a key asset for our study, prompting new considerations about the potential for photovoice to be mixed with in-person ethnographic methods, and about its utility in more involved forms of community-based participatory research.

Findings from this study resonate with, and add new angles of vision to, works detailing the emancipatory potential of photovoice. The participatory action processes underpinning photovoice have characterized this methodology from its inception (Wang & Burris, 1997; Wang et al., 2000), yet these processes have been described somewhat linearly, focusing on the potential for photovoice to reach and influence policy makers (Oliffe et al., 2023). While a venerable aim, there is much more to photovoice. Indeed, studies have highlighted the empowerment impacts of participating in photovoice projects (Budig et al., 2018; Higgins, 2016), as well as the community-oriented social justice gains (and shortcomings) of the methodology (Sanon et al., 2014), including in recent research with people in recovery from substance use (Smith et al., 2024). To this end, while our study had emancipatory research products such as a community photovoice exhibit and policy-oriented submissions to government and youth-serving organizations (Goodyear et al., 2025), affective gains from the photovoice process are also significant. The excitement and momentum as youth participated in this study were palpable, with many participants emphasizing the fun, pride, and connection produced (and captured) through the research. The emancipatory, relational potential of photovoice in our study context was especially critical given that many of the youth were navigating personal hardships and social and material inequities, and that research with youth in similar circumstances has tended to be damage- and deficit-centered (Tuck, 2009) – a trend that is also the subject of critique in the photovoice literature (Hergenrather, 2009; Higgins, 2016). In surfacing the participant-centered, affective benefits of meaningful engagement in photovoice, our study can serve as a useful springboard to direct future work tracing the emancipatory processes, outcomes, and impacts of photovoice research and knowledge mobilization at a grassroots community level, as has been called for by other scholars (Golden, 2020; Sanon et al., 2014).

Photovoice studies are increasingly shifting from emphasizing the disenfranchised and oppressed notes of communities to acknowledging and prioritizing strengths (Hergenrather, 2009; Higgins, 2016), as we sought to achieve through leveraging community assets in the current study. Importantly, we did not take centre stage in telling and exhibiting participants’ strengths; rather, we immersed ourselves in the community while intentionally creating space and pathways for youth to showcase these strengths. A key focus here was on structuring our participatory photography methods such that they promoted reflexivities for community buy-in and direction in data collection and knowledge mobilization, including as youth decided the aspects of their lives to photograph, prioritize in interviews, and share publicly via a community photovoice exhibit and other avenues (Goodyear et al., 2025). The on-the-ground and in-person methods used in this study greatly facilitated this work, as the researcher was better positioned to view, discuss, and grasp the community assets and strengths. Further, there were embedded opportunities for youth to control for the possibility of exploitation and intrusion – known issues in photovoice (Holtby et al., 2015; Joanou, 2009) – including as they (re)considered the photographs they wanted to take and highlight in the research. Far from treating participants as passive to whom researchers should ‘give voice,’ we engaged youth as agentic knowers attuned to the problematics and possibilities within their communities, in alignment with Higgins and colleagues' (2016) feminist approach to photovoice. There is opportunity for researchers to continue building the methodology to better attend to community strengths, possibilities, and desires, and to do so in a way that promotes community agency and choice, including as the field works to meet calls to enhance the social justice impact of photovoice (Sanon et al., 2014).

Conclusion

While many health researchers are modifying and tailoring their use of photovoice methods, this article makes a case for being there with in-person photovoice research. We have contributed a project-informed discussion of the enduring value of on-the-ground, immersive photovoice data collection in work with equity-owed populations. ‘Being there' for photovoice can enhance researcher capacity of feel place and presence; allow practical asset-building with communities who have limited access to technology (e.g., via going old-school with disposable cameras); promote community choice in the photography; and garner deep insights to the meaning, context, and affective dimensions of people’s lived experiences. Acknowledging these advantages, this article affirms and distills the value of in-person photovoice methods for research addressing the social and structural dimensions of health and health inequities.