Goal / Mission

The goal of the study was to empower Asian American and Pacific Islander (AAPI) youth to identify and analyze environmental influences associated with tobacco initiation and use. To accomplish this, youth engaged in photography and Geographic Information Systems (GIS) mapping of ethnically diverse communities to assess community needs and to motivate community organizations and policy makers in tobacco control through regulation of commercial tobacco advertisements with licensing laws.

Description:

APPEAL, in partnership with both community-based organizations (CBOs) in Long Beach, Richmond, and Seattle, and researchers at CSU Fullerton, conducted a community-based participatory research (CBPR) study using Photovoice and Geographic Information Systems (GIS) mapping to assess the efficacy of pro-tobacco and anti-tobacco influences on AA and NH/PI communities.

The use of Photovoice and Geographic Information Systems (GIS) to assess local and environmental tobacco influences effectively engaged Asian American (AA) and Native Hawaiian/Pacific Islander (NH/PI) youth participants in research and documentation of pro-tobacco and anti-tobacco influences in their communities through the use of digital photography and data analysis. After being trained in Photovoice, a visual, participatory-action-needs-assessment methodology developed by Caroline Wang and Mary Ann Burris, images and assessments were used to illustrate community public health needs successfully and to provide visual representation of community-based research.

A Photovoice facilitator assisted youth in analyzing overarching themes of the collected photos. Six major environmental themes were identified. Three of these themes were common across all four communities assessed: (1) similar tobacco company strategies for targeting AA and PI youth, (2) pervasive tobacco company advertisement in AAPI communities, and (3) physical characteristics of the distressed communities that are targeted. GIS-mapping of pro-tobacco and anti-tobacco influences on a community map showed commercial tobacco density and allowed people to see the pervasiveness of advertisement in an area.

Following a debrief and analysis of the Photovoice project findings and persuasive advocacy by empowered youth, community-based organizations and policymakers implemented additional tobacco policies requiring licensing to support safer communities through reduction of the number of unregulated environmental tobacco influences. In particular, reduction in the visibility and proximity of tobacco retailer influences in public spaces frequented by youth, including communal spaces such as churches and schools.

Implementation Process

AA and NH/PI youth participants were trained to use digital cameras and then sent out to take photos of pro-tobacco and anti-tobacco influences in four communities. The study consisted of 37 pictures selected from 168 photographs captured. A facilitator then guided participants in analyzing overarching themes.

They used GIS to plot points representing where they observed tobacco-related influences on a community map in order to provide a visual image of pro- and anti-tobacco influence density. The Photovoice methodology was used to identify community needs, provide a debrief of the Photovoice project findings and analysis as well as a report on the experience of youth empowerment in advocating for safer communities and tobacco policies.

Photovoice information was compiled by case study staff, and the findings were presented at a meeting of tobacco control advocates in February 2007. The meeting was convened with the goals of sharing models of community involvement developed by the different projects and obtaining feedback on the relative strengths and weaknesses of various processes and outcomes. Youth coordinators described their experience with Photovoice and shared initial results from the collaborative research project on environmental influences of tobacco on AAPI youth.

Impact / Results / Accomplishments/ Outcomes

Youth coordinators influenced city council to support a law requiring licensing of all tobacco vendors—a proposal that passed and was enacted in 2008. This meeting  provided a forum to share the benefits and challenges of  community-based participatory research (CBPR), as well as opportunities and strategies for addressing tobacco disparities in AAPI communities. APPEAL has since shared project findings with other community sites for potential replication. Future research and intervention studies may use this model to build clearer policy and other (e.g., media) outcomes.

Photovoice enabled youth to capture what they perceived to be environmental influences on youth tobacco use in their communities, describe images that influence tobacco use, and recommend actions that address both individual- and community-level factors. In community sites, youth presented local policy makers with impactful photographic story-telling and mapping to support the successful passage of a tobacco vendor licensing law by requiring stricter zoning laws to reduce pro-tobacco influences. Powerful visual representation of the communities’ built environment combined with the voices and narratives of youth helped to reinforce the need for policymakers to make  licensing and zoning laws a priority. As a result, positive social norm change and policy was passed.

In response to advocacy efforts by youth coordinators, city council supported a law requiring licensing of all tobacco vendors—a proposal that passed and was enacted in 2008. This meeting  provided a forum to share the benefits and challenges of CBPR, as well as opportunities and strategies for addressing tobacco disparities in AAPI communities. This experience has been disseminated to other community sites for potential replications. Future research and intervention studies may use this model to build clearer policy and other (e.g., media) outcomes.

Lessons Learned

• Qualitative assessments can engage youth and young adult participants
• Visual methods of photos and mapping can be impactful ways to provide depth and ease of understanding
• Policymakers respond to both visual presentations and youth participation
• Comparisons with other cities allowed youth to see other communities (Long Beach visiting Pasadena for the first time)

About this Promising Practice (Contact information)

1. Organization(s): 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; also located in California), Washington Asian/Pacific Islander Families Against Substance Abuse (WAPIFASA; located in Washington), and California State University, Fullerton (CSUF); Rod Lew from APPEAL and Sora Park of Photovoice should be followed up with to learn more about opportunities for youth sharing and engagement.
2. Primary Contact(s): Rod Lew – APPEAL Staff; [email protected] and Sora Park Tanjasiri, DrPH, MPH, Professor, Department of Epidemiology and Biostatistics, Program in Public Health, University of California, Irvine, 835 Health Sciences Rd, Irvine Hall 215, Irvine, CA 92697; [email protected]
3. Authors: Sora Park Tanjasiri, DrPH, MPH,  Rod Lew, MPH, Darrah G. Kuratani, MS, Michelle Wong, MPH, and Lisa Fu, MPH
4. Topic(s): Photovoice, Tobacco vendor licensing, Tobacco advertising, Tobacco control policy, Asian Americans and Pacific Islanders, Southeast Asians, Youth
5. Source: HHS Public Access Article – Using Photovoice to Assess and Promote Environmental Approaches to Tobacco Control in AAPI Communities
6. Date of Publication: September 2011
7. Date of Implementation: 2004-2007
8. Location: California, Washington
9. More details (web address for study): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3691960/
10. Target Audience: Community Based Organizations, Researchers, Policy Advocates