Using Photovoice to Assess and Promote Environmental Approaches to Tobacco Control in AAPI Communities

Sora Park Tanjasiri,Darrah G. Kuratani,Michelle Wong,Lisa Fu,Rod Lew

doi:10.1177/1524839910369987

Abstract

Asian American and Pacific Islander (AAPI) communities face enormous health disparities, with tobacco use contributing to high rates of cancer and heart disease. There is growing interest nationwide on the influence of environmental factors on tobacco use. AAPI communities have been found to have higher exposures to tobacco company marketing compared to the general population. The authors describe the use of Photovoice (a qualitative needs assessment technique) to empower AAPI youth to identify and understand environmental characteristics associated with tobacco use in four AAPI communities in California and Washington. Of the six major environmental themes identified from the photos, three themes were found across all four communities. Debrief sessions with youth and community leaders underscore the relevance of Photovoice for identifying community needs and motivating community organization for change. Despite some logistical challenges, Photovoice exemplifies the power and potential of this community-based methodology to capture how the environment influences youth on tobacco use.

Highlights

Despite nearly three decades of successful tobacco prevention and control efforts, cigarette use among adolescents and young adults remains high in ethnically diverse communities (Centers for Disease Control and Prevention, 2006)
The study team consisted of representatives from one national and four local communitybased organizations (CBOs) and one university: Asian Pacific Partners for Empowerment Advocacy and Leadership (APPEAL), Guam Communications Network (GCN) and Families in Good Health (FIGH; both located in the same city in California), Asian Pacific Psychological Services (APPS; located in California), Washington Asian/Pacific Islander Families Against Substance Abuse (WAPIFASA; located in Washington), and California State University, Fullerton (CSUF)
The overall goal of this 3-year (2004–2007) study was to explore the environmental influences on tobacco use in American and Pacific Islander (AAPI) communities, and the partnership between the CBOs and the university formed as a result of preexisting relationships with ethnically and economically diverse AAPI populations, a shared vision and goals of action-oriented work, and the desire to empower AAPI youth in tobacco control efforts

Summary

Introduction

Despite nearly three decades of successful tobacco prevention and control efforts, cigarette use among adolescents and young adults remains high in ethnically diverse communities (Centers for Disease Control and Prevention, 2006). Research has exposed the potent power of influences in the physical environmental, such as advertising and nonoutdoor smoking (Cummings et al, 2009), on the initiation of smoking among youth. A recent study reported that youth who live in communities with more advertising and availability of tobacco products were more likely to have smoked (Novak, Reardon, Raudenbush, & Buka, 2006). A meta-analysis of exposure to tobacco marketing in films found a twofold increase of initiating tobacco use among youth 18 years old and younger (Wellman, Sugarman, DiFranza, & Winickoff, 2006). Media can facilitate smoking prevention; a study of pro- and antitobacco media among youth in California found that antitobacco advertisements were protective against susceptibility to adolescent smoking (Weiss et al, 2006). School-based smoking bans for outdoor smoking among staff have been associated with lower levels of youth tobacco use (Barnett et al, 2007)

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Results

Conclusion