HISPANIC CAREGIVERS' PERCEPTIONS ABOUT ASTHMA MANAGEMENT: A PHOTOVOICE STUDY
Purposes/Aims: The purpose of this study is to report how photovoice was used to 1) ascertain Hispanic caregiver perspectives about asthma management, and 2) engage caregivers in disseminating their work.
Rationale/Conceptual Basis/Background: Hispanic children are 70% more likely to visit the emergency room for asthma and 40% more likely to die from asthma, as compared to Non-Hispanic whites. Although clinical practice guidelines exist for asthma management, asthma disparities result from a complex interaction of factors on multiple ecological levels. As causes of asthma are poorly understood, and there is no cure for asthma, a better understanding of asthma management among Hispanic caregivers is an important step to developing a partnership in care and diminishing health disparities associated with this chronic disease.
Methods: Photovoice is a participatory methodology through which people identify, represent, and enhance their community by taking photographs that record their everyday realities. In the Spring of 2014, eleven adult, Hispanic caregivers of children with asthma were recruited and given cameras to photograph people, places or things that helped or hindered their ability to care for their child with asthma. Through participation in four photovoice sessions, participants prioritized which images to share, discussed the images with the group, and wrote accompanying titles and captions. Sessions were facilitated in Spanish and occurred in a community setting. Titles and captions were translated into English by the facilitator. Participants presented their work to peers and community members in two photo exhibitions. Identified issues were subsequently categorized by investigators according to the four components of asthma care identified in the guidelines.
Results: Participants prioritized 32 phototexts, the majority of which (n=20, 63%) represented “Control of Environmental Factors and Comorbid Conditions.” Caregivers highlighted asthma triggers, and suggested ways to maintain indoor air quality through home cleaning. The need for policies that enforce smoking bans in shared housing and public places was identified as an important strategy to improve outdoor air quality. “Education for a Partnership in Asthma Care” was represented in six (19%) phototexts. Five phototexts (16%) represented “Assessment and Monitoring.” Only one phototext (3.13%) primarily represented “Medications.”
Implications: Evidence from this study supports the development of active partnerships between clinicians and caregivers, especially in the area of environmental control. Photographs can be used as the basis for reciprocal education between patient and provider as well as a tool to collectively advocate for healthy housing and protective public health policies.
Funding provided by the MultiCare Institute for Research and Innovation (MIRI)