Changes in perceptions of the alcohol environment among participants in a Photovoice project conducted in two districts with different socio-economic status.

Irene Molina-De La Fuente,Carmen Ramos,Paloma Conde,Andrea Pastor,Manuel Franco,Marina Bosque-Prous,María Sandín Vázquez,Xisca Sureda,Luisa N Borrell

doi:10.1371/journal.pone.0254978

Abstract

Perceptions of the alcohol environment may influence alcohol consumption patterns. The purpose of this study was to describe changes in perceptions of the urban alcohol environment as experienced by residents of two districts with different socio-economic status after taking part in a Photovoice study. The study was conducted in Madrid, Spain, in a district with a high socio-economic status (HSES) and another district with a low socio-economic status (LSES). A Photovoice project was conducted with 26 participants divided into four groups based on sex and district. Groups met over five sessions in which they discussed photographs taken by the participants themselves on the subject of alcohol in their neighbourhood. A qualitative, descriptive and thematic analysis of participants’ discourses was performed to explore changes in their perceptions of the alcohol environment over the project sessions. Changes in perceptions of the alcohol environment were observed in all groups over the project. The process of change varied by districts’ socio-economic characteristics and gender. Greater changes in perceptions of the alcohol environment were observed in HSES, especially among women, as the participants had a much more positive initial view of their alcohol environment. In LSES, participants showed a more critical perception of the alcohol environment from the beginning of the study, and this broadened and intensified over the course of the sessions. Changes in perceptions also varied by thematic categories, including some categories that were discussed from the start (e.g. socialising and alcohol consumption) and categories that only emerged in later sessions (e.g. alcohol advertising). Involvement in a Photovoice project has favoured a shift in the participant’s perceptions of their alcohol environment towards more critical positions, widening their scope of perceived elements and raising their awareness of specific problems, such as alcohol advertising and social role of alcohol consumption in relation to alcohol exposure.

Highlights

Alcohol consumption has been identified as a major risk factor for global health, causing approximately three million deaths every year [1]
Social acceptance of consumption may be influenced by the urban alcohol environment, as well as by the social and cultural context [8, 9]
Photovoice engagement favoured changes in the participants’ perceptions of their alcohol environment, widening their scope of perceived elements and intensifying their consideration as potentially relevant. This process resulted in more critical discourses on aspects of their alcohol environment that participants consider important, that means in-depth reflections and complex discourses about their alcohol environment and its negative impact on health

Summary

Introduction

Alcohol consumption has been identified as a major risk factor for global health, causing approximately three million deaths every year [1]. Normalised alcohol consumption and low risk perception are associated with higher levels of heavy drinking [4]. This association is problematic among young people, where it has been linked to binge drinking [5]. In Spain, alcohol consumption enjoys a high degree of social acceptance, as evidenced by people’s tendency to underestimate their own intake [6, 7]. Social acceptance of consumption may be influenced by the urban alcohol environment, as well as by the social and cultural context [8, 9]. Key characteristics of the urban alcohol environment include alcohol accessibility and availability [10, 11], as well as advertising in public spaces [12, 13]

Objectives

Methods

Results

Discussion

Conclusion