Promoting school-based learning about nutrition and physical activity using Photovoice: A systematic review

Abstract

Objective: Photovoice as a participatory research method seeks to capture and share participants’ perspectives and experiences. It has been widely used in school settings to prioritise student voice in health research. Photovoice also presents opportunities for health education. There is limited synthesis on school-based Photovoice focused on nutrition and physical activity (PA). This systematic review examined the use of school-based Photovoice in relation to nutrition and PA for 10- to 18-year-olds. The research questions explored were twofold: what Photovoice approaches and implementation processes have been used in schools with respect to nutrition and PA; and what were the student learning outcomes? Methods: Six electronic databases were searched: MedLine, PsycInfo, EMBASE, ProQuest Education Journal, Cochrane Central and ERIC. The Participant, Intervention, Comparison, Outcome and Study (PICOS) framework was used to specify inclusion/exclusion criteria. Nineteen articles were selected from the search results of 2,305 articles based on fit with the established criteria. Iterative inductive thematic analysis was used to analyse the data with a focus on (1) approaches and implementation, and (2) student learning outcomes. Results: Nineteen studies were included in the review. Themes related to approaches and implementation were the importance in introductory sessions; processes for meaning-making; student-led community engagement and health promotion; and learning from challenges and limitations. Themes related to student learning outcomes included critical awareness of nutrition and PA environmental influences; capability development; and agency and empowerment. Conclusion: School-based Photovoice benefits health research by generating data with a focus on student voice. An under-valued and under-reported benefit relates to student learning outcomes, supporting the potential for healthy behaviour change. Multisectoral education and health research should value both types of goals. Photovoice can be used as a curriculum-linked pedagogical tool to add value to the pursuit of educational goals in school.