Photovoice As a Tool for Formative Research for Communications Campaigns and Community Engagement

Background:  With a limited budget, the Hawaii Counter-Drug Support Program decided to launch a social marketing campaign to reduce underage drinking but faced significant barriers to engaging youth in formative research on multiple Hawaiian islands. People exposed to alcohol at an early age show lowered performance in memory and visual-spatial tests, and lowered verbal and non-verbal communications. The financial costs of underage drinking have risen to billions.   In spite a recent decrease in underage drinking in Hawaii, lifetime prevalence rates remain only slightly lower than mainland counterparts.

Program background:  A social marketing campaign to prevent underage drinking in late 2008.  The campaign is consistent with best practices for tobacco prevention social marketing campaigns and promising practices from the field of alcohol control.  As part of its formative research, the campaign employed Photovoice, a form of photography-based community-participatory research.  Photovoice is used to collect youth feedback on how alcohol affected them, their family, and community, and to collect ideas for themes and marketing strategies. The comments youth associated with the photographs were analyzed and grouped into themes and further analyzed to develop recommendations for the campaign. 

Evaluation Methods and Results:  The campaign engaged community youth groups across Hawaii with 80 participants submitting more than 700 photos.  Photo comments were reviewed and organized into 24 categories which were then grouped into seven themes.  The themes aided campaign staff to identify prominent ideas and extract possible suggestions for campaign directions and imagery. The project uncovered that most youth that participated were well aware of consequences of drinking and driving, but failed to identify more common consequences to underage drinking, such as lowered school/work performance.  Youth also misperceived the amount of drinking that happened with their peers, and identified adults at home and in the community as a source of exposure to alcohol. 

Conclusions:  These results, coupled with more formal methods of formative research, allowed campaign staff to create the first state-wide social marketing campaign to address commonly misperceived norms and source of alcohol for underage drinkers.  The campaign also utilized Photovoice as a way to open relationships to island communities that received small contracts to re-create their own Photovoice project addressing issues specific to their island. 

Implications for research and/or practice:  This project showed that Photovoice may be a viable source of formative research for a social marketing and health communications campaign.  This type of formative research may be especially effective in hard-to-reach populations or in projects with budget limitations prevent formal testing.  This type of formative research may also be considered as a way to “give back” to the community that researchers are tapping for information.