Using Photovoice Methods to Explore How African American Women Navigate Type-2 Diabetes

Background and Purpose: African Americans are disproportionately burdened by racialized health inequities including diabetes. Previous research fails to adequately capture the complexity of African American women’s experiences and perspectives navigating the disease. Understanding these experiences is crucial  step towards reducing health disparities impacting this community. The purpose of this patient-driven qualitative study was to address this gap in the literature by addressing the primary research question: How do African American women residing in Boston experience type-2 diabetes?

Methods: Photovoice methods were used in this qualitative study. Ten African American women between the ages of 30 and 60 were recruited from a New England area diabetes specialty clinic through provider referral. Participants attended three voice recorded group sessions facilitated by the researcher and a research assistant where they identified common diabetes concerns, and received training in research ethics and basic photography. Participants were given digital cameras and asked to take a series of photos pertaining to diabetes. Photographs were shared and discussed with group members in the final session. Facilitators used the SHOWeD pneumonic (Shaffer, 1983) to pose a series of questions to the participants. Voice recorded sessions were transcribed verbatim using a transcription service and transcripts were analyzed using thematic analysis. The researcher and research assistant engaged in memoing throughout the data collection and analysis phases, and reviewed and coded each transcript using NVivo. The researchers identified salient themes and presented a summary of the themes to participants, requesting their feedback as a member-checking strategy.

Results: African American women with type-2 diabetes shared their experiences navigating the disease and their perspectives on racialized health inequities through their visual images and accompanying narratives. Participants advocated for improved communication and collaboration with their diabetes care team. Themes focused on the need for support of medical providers, family, and other members of their social networks to manage the physical and emotional adjustment to the disease.

Conclusions and Implications: Elevating the voices and stories African American women with type-2 diabetes is a positive step towards reducing health disparities impacting this community. Using Photovoice methods empowers participants to narrate their experiences managing the challenges of the disease with medical providers and to leverage their assets to improve diabetes care. The results from this study will inform future research with diabetes providers and marginalized patient groups.