Abstract
Background: Photovoice is a qualitative research method that uses photography to effect social change and give voice to vulnerable populations.The purpose of this study was to use Photovoice as a Community-Based Participatory Research method to partner with rural adolescents with a clinical diagnosis of depression in gathering data about their perceptions of risk and protective factors for depression. A preliminary evaluation of the relationship between participation in Photovoice and empowerment was also conducted. Methods: Using a Community-Based Participatory Research approach and a Social Ecological Framework, Photovoice was used as a method with rural adolescent participants in the southeast United States. Recorded semi-structured guided interviews between the Primary Investigator and participants were conducted using participant photographs as triggers for dialogue. Perceived risk and protective factors were identified through thematic content analysis of interview data using NVivo9. Identified factors were categorized by theme and social ecological level. Empowerment was evaluated by the Brief Perceived Opportunity for Empowerment Scale. Results: A greater number of protective factors were identified than risk factors. The majority of protective and risk factors occurred at intrapersonal and interpersonal social ecological levels. Results of a pre- and post- empowerment scale indicated positive movement toward empowerment as a result of participation. Conclusion: Photovoice is a viable Community-Based Participatory Research method to use when partnering with rural adolescents who live with depression. Mental health promotion interventions designed to address perceived risk and protective factors for depression at multiple social ecological levels may be more acceptable to youth and result in improved individual and community mental health outcomes.
Highlights
For years depression was considered to be an adult disease but it's recognized that most major mental illnesses begin in adolescence and early onset is highly related to recurrence in adulthood [1]
Adolescent mental health has been designated by Healthy People 2020 as an important topic area with the specific objective to reduce the proportion of adolescents aged 12 to 17 years who experience major depressive episodes [2]
An example of data supporting the need for this HP2020 objective is found in the 2013 Youth Risk Behavior Survey (YRBS), which was conducted among students in grades 9-12 in the United States
Summary
For years depression was considered to be an adult disease but it's recognized that most major mental illnesses begin in adolescence and early onset is highly related to recurrence in adulthood [1]. Adolescent mental health has been designated by Healthy People 2020 as an important topic area with the specific objective to reduce the proportion of adolescents aged 12 to 17 years who experience major depressive episodes [2]. Depression is a known risk factor for suicide[1,4] and more completed suicides have been found to occur in rural areas than urban [5]. Rural adolescents who live with depression face mental health care access issues not experienced by their urban peers. It is important to consider the socio-ecological context in which adolescents live and be aware of the risks and assets of environment to their health [8]
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