The impact of structural violence and its lasting social and economic costs far exceed what we can measure in dollars and cents. A well-documented public health issue, structural violence occurs when social institutions impose ideologies and policies causing maldevelopment within a given group while favoring another (Wendel et al., 2021). One of the most conspicuous forms of structural violence in the United States involves policies designed to establish and preserve historical racial inequality (Farmer, 2004). Such structural violence is embedded within all levels of the social ecology—individual, relational, communal, organizational, institutional, and societal (Dahlberg & Krug, 2006). Instances of structural violence include redlining, concentrated poverty, food apartheid, over-policing of Black communities, unequal enforcement of drug prohibition laws, disproportionate incarceration rates among people of color, educational achievement gaps, the school-to-prison pipeline, and a lack of access to adequate resources and healthcare services (Bluthenthal, 2021; Merolla & Jackson, 2019; Phelan & Link, 2015). Such structural inequities come at the detriment of physical, mental, and social health of Black youth. There is a growing body of literature aimed at addressing the various mechanisms through which the structural violence of racism contributes to the social determinants of health in Black communities (Alvarez et al., 2021; Bailey et al., 2017; Bath, 2021; Bluthenthal, 2021; Burrell et al., 2020; Cunningham et al., 2017; Darity et al., 2018; Farmer, 2004; Merolla & Jackson, 2019; Nuriddin et al., 2020; Paradies, 2006; Phelan & Link, 2015; Price et al., 2021; Rakatansky, 2017; Roberts & Mahtani, 2010; Wendel et al., 2021; Williams et al., 2019; W. Wilson, 2019).
In our previous studies with Black youth who have experienced community violence, youth participants identified addressing racism as a priority for promoting the health and well-being of themselves and their communities (Woods-Jaeger et al., 2019). These findings, accompanied with the national reckoning of the structural violence of racism and the disproportionate burden of COVID-19 in Black communities, reinforced the need to support Black youth with tools to cope with compounding racial trauma. Indeed, research suggests that accumulated experiences of structural violence in the form of racial discrimination may foster negative effects on self-esteem and behavioral risk-taking among youth, resulting in increased risk of injuries, health-harming behaviors, and mental health morbidities (Cave et al., 2020; Yang et al., 2019). Therefore, as Black youth continue to navigate contexts of structural violence, it is critical to foster spaces for healing and resistance. Research demonstrates that a critical analysis of what it means to be Black within a system of racial oppression can lead to social action and mitigate racism-related stress, promote healing from racial trauma, and foster overall psychological well-being (Cross & Strauss, 1998; Hope et al., 2018, 2020; Mosley et al., 2021; Sellers et al., 2003, 2006; Zimmerman et al., 2000). In our project, this critical analysis and action arises from the critical consciousness framework of photovoice, through which “the oppressed must confront reality critically, simultaneously objectifying and acting upon that reality” (Freire, 1970).
Photovoice is a process wherein youth can take photographs or create artwork to document the reality of their experiences. The images are then used to share their perspectives and engage in critical dialogue about the issue at hand (Wang, 2006). A number of in-person photovoice projects have been previously conducted to address racial identity and racism, both within the United States and abroad (Fisher-Borne & Brown, 2018; Fonseka et al., 2021; Goessling, 2018; Ornelas et al., 2009; Pérez et al., 2016; Roxas et al., 2017; Roxas & Vélez, 2019; Sethi, 2016; Wendel et al., 2019). These projects demonstrate how the photovoice process can empower youth to understand their personal experiences within a wider context of societal issues and pursue social action through policy advocacy (N. Wilson et al., 2007). These objectives are captured within the critical consciousness framework that underlies photovoice. According to this framework, photovoice aims to 1) engage participants in active listening and critical dialogue; 2) create a safe environment for introspection, critical reflection, and co-learning; and 3) propel youth towards social action (Freire, 1970). In addition to serving as an intervention that fosters critical reflection, agency, and advocacy through photo-elicited discussions, photovoice can also function as a research tool for generating knowledge and data to understand complex social inequities (Wang, 2006). Achieving these goals through a virtual adaptation of photovoice, however, can involve its own unique challenges. To avoid pitfalls to engagement, relationship-building, authentic dialogue, and advocacy efforts in an online space, participatory researchers must consider innovative strategies to maintain the critical consciousness framework throughout the process.
In making a deliberate effort to uphold the critical consciousness framework, a virtual adaptation of photovoice can also overcome many of the challenges associated with in-person implementation. Photovoice can prove resource-intensive as researchers may be required to find space for its implementation, coordinate facilitators, transport participants, distribute cameras, and compile and print images ahead of time—all of which may require a substantial financial investment. Additionally, in-person implementation of photovoice may be geographically constrained, enabling only certain community members and stakeholders to engage in particular projects. Adopting an online approach to photovoice can mitigate these barriers by increasing the engagement of diverse communities and allowing for partnerships with stakeholders across state lines. Thus, virtual photovoice can serve as an effective means of increasing accessibility for participants while minimizing barriers, especially for disadvantaged groups. Given the promising potential of virtual photovoice, there has been a growing interest in online platforms for implementation. While photovoice remains a popular participatory research method during the COVID-19 pandemic (Adu et al., 2021; Andrada-Poa et al., 2021; Badanta et al., 2021; Malka, 2021; Rania et al., 2021; Walsh & Kaushik, 2021), there is a lack of literature addressing how photovoice can be adapted to a virtual environment with the intent to retain its original participatory principles (Heberle et al., 2020). To date, research on virtual photovoice methods have focused on asynchronous activities, involving uploading photos onto a blog (Licthy et al., 2019) and web-based software to incorporate additional resources, such as learning modules, to complement regular photovoice sessions (Strack et al., 2015). Asynchronous photovoice activities may yield several benefits such as greater reach and increased participant flexibility. However, synchronous engagement may be required for researchers to maintain the essential tenets of photovoice, such as critical dialogue, real-time co-learning, and community-building.
To this end, we created shared spaces within a virtual setting to empower Black youth. Our process involved facilitating a youth-focused healing process, informing community efforts, and addressing racism as a public health issue. To accomplish these goals online, we implemented several strategies to maintain the integrity of the critical consciousness framework fundamental to the photovoice method.
Context
This project is the latest implementation in an ongoing partnership between our research team and Youth Ambassadors (YA). YA is a community-based organization that supports more than 250 underserved youth (ages 14–18) in the Kansas City, Missouri, metropolitan area annually. YA utilizes a strengths-based Social Emotional Learning approach to develop job and life skills, build supportive interpersonal relationships, promote resilience, and, in turn, mitigate the negative consequences of racial trauma and concentrated poverty. From 2017 to 2020, our research team partnered with YA to engage in a community-based participatory research (CBPR) project to achieve the following: 1) understand barriers and facilitators to resilience after community violence exposure; and 2) develop and test a community-level intervention to promote resilience among Black youth exposed to community violence (Woods-Jaeger et al., manuscript under review). In a series of five focus groups with Black youth, racism was consistently identified as a key factor hindering the ability of Black youth to heal from community violence, acting as a barrier to health equity (Woods-Jaeger et al., 2019). Despite the increasing recognition of racism as a public health issue, there are a limited number of interventions directly informed by Black youth that specifically address this critical health problem. To begin filling this gap, we virtually implemented an eight-session adaptation of the Youth Empowered Advocating for Health (YEAH) curriculum (Woods-Jaeger et al., 2013) to equip Black youth from YA with the tools to serve as advocates by educating policymakers and community members about racism as a public health issue. A key component of this curriculum is four photovoice sessions, which precede the social action planning phase (Woods-Jaeger et al., 2013).
Sessions were facilitated by a team of five graduate assistants and one YA staff member. Each member of the team was drawn to the project by a shared belief that community is an important foundation for promoting healing amongst Black and other marginalized youth. Members of the research team also shared a personal connection with the work based on their own identities and experiences with racism and community violence. This project offered the opportunity to build community, promote healing, and address the harms of structural racism. We collaborated with nine Black high school students from YA who have been impacted by community violence in Kansas City. Youth participants dedicated their time to these photovoice sessions—outside of standard YA programming—to learn more about their community, connect with other youth, and make an impact. After completing the photovoice sessions, three youth members continued to partner with the research team in the development of their youth-led social action. Two also contributed to the writing of this manuscript (authors 6 and 7).
Framework and Preparation
Grounded within the critical consciousness framework, photovoice aims to engage participants in introspection, co-learning, and social action (Freire, 1970; Wang & Burris, 1997). Utilizing photovoice as an anti-racist praxis, we aimed to maintain the integrity of this method to cultivate 1) critical reflection; 2) critical agency; and 3) critical action within a virtual space while addressing racial trauma. Authentic partnership was a critical foundation for our project. Paramount to our implementation were community action board (CAB) meetings over three months with YA and other stakeholders where we discussed how to most effectively translate our in-person sessions to a virtual platform. During these meetings, we reviewed session activities and had YA advise on the adaptation process. We collaboratively reviewed materials to consider organizational strategies, discussed materials within the YEAH toolkit to be delivered to youth, and determined the best timing to schedule and facilitate each session. Crucial to this process was also ensuring that youth had accessibility to both technology and Wi-Fi services to ensure their ability to attend the sessions. YA was able to supply technology and brainstorm service accessibility for youth, which helped mitigate barriers to participation. The pre-planning meetings also established the value of having a YA team member trained to co-facilitate the photovoice sessions. Our partnership with YA served as a bridge to build trust, credibility, and integrity in the process, and was instrumental to our overall implementation.
Facilitating Critical Reflection
Critical reflection involves analyzing the structural causes of inequitable socio-political conditions (Hope et al., 2020). Our established history with YA enabled us to build upon a trusting partnership, allowing the critical engagement of youth to be a steadfast process. Promoting critical reflection during our photo-elicited discussions required intentional steps given our remote environment. We included an adult team member from YA with an existing relationship to create a safe space for youth. Additionally, we were proactive in centering youth expertise from an early stage. We developed an informational recruitment video to outline the background of our work, the photovoice method, our project objectives and timeline, photo-taking guidelines, recommended safety measures during the pandemic, eligibility criteria, and contact information. Most critically, we utilized this video as an opportunity to emphasize the youths’ creative and introspective capacity, along with their unique perspectives and experiences with structural violence, which were central elements to the photo discussions. We also reiterated these objectives during the consent process, where we scheduled calls with each parent and youth to have one-on-one conversations, ensure that they were familiar with the intent of our project, and address any concerns. Post-enrollment, we held an orientation meeting for the first photo assignment to allow the youth to familiarize themselves with all attendees and form a safe space for critical reflection. Orientation was also an opportunity for youth to set their own ground rules for discussion. Affirmation and validation were key strategies implemented throughout the process to promote healing among the youth as they recounted their experiences of racial discrimination. This strengthened trust and critical reflection as a group because it aided in conceptualizing their experiences within wider systems of oppression, rather than isolated encounters.
The overarching guiding question for the project asked, “How does racism impact youth who experience community violence?” As each session progressed, the group narrowed down their focus to more specific topics such as cultural appropriation, gender inequality, and preservation of Black history and culture. These topics were critically analyzed to understand the nature of the problem and brainstorm potential solutions. Based on the discussions in each session, the youth worked with facilitators to develop photo assignments for prospective sessions, which included the following:
-
“How does living in fear affect how we see the world?”
-
“What is something that shows a sense of change/hope in how racism is evolving for the better in the world?”
-
“How does cultural appropriation affect you and your community?”
We list our session questions and provide sample photo submissions in Table 1. During sessions, we allowed for multiple spaces of critical reflection and leveraged the chat function to elicit engagement, supplement discussion, re-state contributions and probe for further introspection. To sustain engagement across the sessions, we assigned each youth a point-of-contact from the research team. The points-of-contact individually followed up with their two-to-three assigned youth to check in and offer support in various ways. This support included helping youth understand the photo assignment, encouraging creativity, and discussing how to complete photo assignments safely despite COVID-19-related constraints. Individual check-ins helped build rapport between sessions, which cultivated the overall sense of trust necessary to promote an open space for honest discussions and critical reflection. We summarize these strategies for facilitating critical reflection in Figure 1.
Promoting Critical Agency
Critical agency is the perceived ability to enact social change as an individual or collective (Hope et al., 2020). To promote critical agency, we offered youth participants decision-making opportunities throughout the process, including shaping photo submission formats, mediums, and modes of virtual engagement. The majority of youth chose to use traditional methods of photo-taking and sharing by capturing pictures using a cellphone or cameras provided by the research team. However, this was not an option for some youth due to barriers such as transportation, COVID restrictions, and safety concerns. Consequently, our team used the individual check-ins between sessions to encourage youth to take ownership of the assignment and come up with creative solutions to these problems. As a result, many elected to submit original drawings that they felt represented their viewpoints.
We deferred to youth feedback at various stages of the project, including qualitative theme development, manuscript writing, and social action planning. Additionally, following each photovoice session, the research team debriefed and referred to notes taken during the sessions to develop preliminary themes from the youths’ discussions. These themes were summarized and presented to the youth at the beginning of the next session. This was an opportunity for youth to reflect on the previous session, provide feedback to the research team about the themes, and add additional points if necessary. This helped to ensure that youth perspectives were fully captured and these themes informed the initial version of our codebook used in the formal data analysis. To promote critical agency in the social action phase, youth were able to volunteer for specific roles and responsibilities (e.g., researching previous campaigns, outreach, and designing promotional materials) that they identified as best suited to their strengths, schedules, and desired areas of growth. We summarize these strategies for promoting critical agency in Figure 1. The final themes included the following: 1) acknowledging racism at multiple levels; and 2) challenging racism with anti-racist interventions of promoting Black history knowledge and nurturing mentoring relationships (Woods-Jaeger et al., manuscript under review).
Engaging in Critical Action
Critical action entails steps taken outside of traditional political structures to address inequality (Hope et al., 2020). Our ongoing advocacy campaign works to translate the themes identified by youth in the photovoice sessions into tangible social action. Youth took the lead in developing four primary deliverables in collaboration with the research team and our community partners. These deliverables included 1) a 30-second public service announcement to be broadcast on a local Kansas City radio station, where youth expressed their frustration with the erasure of Black history and presented a call to action for community members to join in their educational social media campaign; 2) a series of billboards posted around the city to build awareness and interest in the project, which included selected photos from the photovoice sessions, a brief message aimed at capturing the attention of residents, and the hashtag that will be used for the social media campaign; 3) a virtual photo gallery that highlights pictures and quotes from the photovoice sessions of the project, which youth believed best reflected their perspectives and experiences; and 4) a compilation of personal stories to be shared through social media told by various Black Kansas City residents about the positive history of their community in order to elevate the narratives and experiences of erased Black voices.
This social media campaign represents the primary deliverable of the advocacy project, as they sought to create a product that was both educational and relatable for other Black youth. To develop these deliverables, we engaged in virtual social action planning meetings. Youth met with their assigned point-of-contact weekly and as needed to begin translating photovoice discussions into action. Meetings were generally organized by the assigned research team member in order to address all of the necessary topics, but youth often called as-needed meetings when they needed extra guidance.
A key step in this ongoing social action phase has been integrating youth into paid leadership positions within our existing community action board (CAB), whose meetings are conducted virtually. The CAB consists of a range of academic partners, youth-serving adults from community-based organizations, and YA members (Woods-Jaeger et al., 2020). Three youth from the original cohort of nine have taken on a leadership role within the CAB, where they work with members from the research team to develop summaries and progress reports to present to the CAB for feedback. Having an important seat at the table gives youth a space to engage in critical dialogue about their project, develop a sense of ownership and responsibility, and ultimately leverage resources and networks essential to implementing their ideas. For example, we utilized existing connections between YA and a local radio station to secure a 30-second time slot for airing the public service announcement. Similarly, YA leadership presented the youth with an opportunity to design billboards to promote their project in the city. In both cases, youth were given both guidance and autonomy—our university and YA leadership presented examples and advice for developing the PSA and billboards, but the final products were ultimately based on youth discretion. The knowledge of community resources and opportunities, as well as years of experience provided by our community partner, have been vital in the process of building youth agency, leadership capacity, advocacy skills, and political efficacy for social action. We summarize these strategies for engaging in critical action in Figure 1.
Successes, Challenges, and Lessons Learned
We found that a virtual photovoice adaptation has many opportunities to integrate critical consciousness theory through a strong community partnership, robust research team, attention to sustained engagement through technology assets, and the individual and collective efficacies of youth participants. Through these aspects of our project, we aimed to create a space for the youth to engage in authentic dialogue that promotes growth and healing from racial trauma. We detail our takeaways below and summarize them in Table 2.
Addressing Power Dynamics, Building Rapport, and Promoting Engagement
We emphasized relationship-building and promoting youth ownership of the space. However, the creation of this space was challenged by inherent power imbalances due to age differences, professional positions, diverse racial identities of the facilitators, and the harmful legacy of research universities in Black communities. To begin addressing such power dynamics, an adult YA staff member was trained to act as a session co-facilitator. This allowed us to bridge the initial gap between the research team and the youth and build a sense of familiarity and trust within the group. As sessions progressed, facilitators made a point to model openness and transparency by sharing their own personal experiences as they related to the topics discussed. When youth were apprehensive about sharing their experiences of racism, particularly in the presence of White adults, the facilitation team validated their viewpoints and reaffirmed the value of their perspectives. This built a sense of trust between youth and facilitators and promoted further engagement.
The various group chat functions were particularly well-received by youth and allowed for more rapport-building. The larger group chat function was consistently utilized by students who may not have felt as confident verbally sharing their thoughts with the larger group right away. This allowed them to contribute in a way that they felt comfortable, gave facilitators more opportunities to validate youth’s opinions, and built confidence in youth to share their perspectives aloud. The individual chat function enabled facilitators to reach out to youth individually (and vice versa) in order to check in, ask questions, and engage in informal conversation. This created additional individualized safe spaces to connect with youth and ensure that they benefited from the experience as much as possible.
While these steps were helpful, some youth still identified a lack of familiarity with one another as a cause for initial hesitancy and a barrier to open discussion, despite the initial orientation meeting. Indeed, youth highlighted the need to engage in more activities that build familiarity and trust between one another. Such activities should promote organic relationship-building between individual students and in a group setting in order to help build interpersonal familiarity as well as a sense of group identity and comfort. These activities should be prioritized to the same degree that we focused on building rapport and trust between youth and adults. We found that smaller group video calls of three-to-five youth outside of photovoice sessions was an effective way to build this rapport in an environment that was less formal than the official sessions. This way, youth were able to expand their relationships with one another outside the photovoice sessions, and connect about shared experiences like high school graduation, prom, and sports. This increased familiarity with one another allowed for more fruitful and productive dialogue in the official sessions, particularly as we progressed into the advocacy portion of the project. This highlights the importance of prioritizing collective efficacy and strengthening interpersonal relationships, particularly in a virtual environment.
Resource Allocation and Upscaling Social Action
While we were compelled to adapt photovoice into a virtual method due to the constraints brought by the COVID-19 pandemic, we found that the virtual format of photovoice could be a beneficial alternative to the in-person format in many circumstances. For example, the virtual implementation enabled us to engage researchers, community partners, and youth across state lines. Youth members of our community action board have been able to present and discuss their work with stakeholders from their community in Kansas City as well as other partners from around the country. Furthermore, a virtual implementation can bridge youth across different communities and allow for more large-scale social action efforts. As representatives from a separate youth photovoice group from an Atlanta-based version of this project are integrated into the CAB, the two groups will be able to utilize one another as resources in their social action campaigns.
Sustaining Social Action
Finally, this process has highlighted the importance of flexibility, planning, and long-term support from stakeholders. The landscape of potential resources is constantly shifting as we navigate partnerships and funding opportunities. This has led to pauses in the social action campaign to reassess logistical capacity. In our context, these pauses pose two particular challenges 1) maintaining interest and engagement from youth and community partners; and 2) adapting to the transient nature of both the research team’s and the youths’ roles in their respective organizations.
Despite fruitful dialogue in photovoice sessions, we have faced barriers in maintaining participation among youth for the long-term social action phase. When the project is paused due to resource constraints, it often leads to the campaign becoming less of a priority for the youth, particularly given other commitments such as work, family, and school. It is important to establish plans with community partners to help maintain engagement with the youth outside of the specific project and ensure that youth are still in a position to learn and grow.
Because YA as an organization specifically serves youths aged 14 to 18, only one of the three youth CAB members is still actively engaged in programming with YA. Similarly, almost all of the members of the research team are enrolled in a two-year graduate program. As such, time constraints make it imperative that the research team and partner organizations 1) build a sustained relationship beyond the immediate project; and 2) create a plan to transition the project in a way that allows future youth to build upon the foundations of the current work. Actively engaging the youth partners in the development of this process retains a sense of youth ownership and involvement in the project even as it transitions to another phase.
Conclusion
Despite what can be a disconnected space, we found that virtual environments can be effectively utilized to maintain and build upon the integrity of the critical consciousness framework inherent to photovoice. We found that the online participatory process of photovoice was an accessible means of problem definition and intervention to address racism as a public health problem. Specifically, participatory and pedagogical researchers can benefit from utilizing virtual resources to 1) engage youth in active listening and dialogue; 2) create safe environments for introspection and critical reflection; 3) promote healing from racial trauma; and 4) move youth towards advocacy and action aimed at facilitating community changes. Such methods are especially pertinent during this pivotal time as the nation reckons with the syndemic of COVID-19 and systemic racism. Further, this virtual format of photovoice can also be a less resource-intensive alternative in other circumstances to elicit stakeholder connections, promote well-being, and facilitate advocacy efforts.