Photovoice as a tool for exploring active living from the perspectives of older adults of color and language minorities


Background and Purpose:

Photovoice is a participatory action research methodology that aims to facilitate social change through participant-initiated photography. Although photovoice has been used to assess public health needs in diverse communities worldwide, few photovoice studies have explored perceptions of physical activity among older adults who are simultaneously challenged by mobility limitations and linguistic barriers.

Objective: This research investigates the perspectives of Bhutanese, Latinx, and Black/African-American participants (ages 62-86) regarding their lived experience of aging in New Hampshire.


Each group produced photos and narratives through the photovoice process, supplemented by individual interviews, focus groups, surveys (based on the IPAQ), and logbooks. We used a mixed-methods approach to facilitate participant-driven identification of needs and potential solutions. Three coders conducted thematic analysis guided by the World Health Organization’s Healthy Aging Framework, the NH State Plan on Aging, and the Socio-Ecological Model. NVivo (v12) software was used support data analysis. Community conversations with participants and other stakeholders were used to ground-truth emergent themes.


Several themes pertinent to active living emerged across groups, including the need for: 1) access to transportation; 2) access to natural resources (e.g., parks, greenspace, gardens); and 3) connection to socially supportive groups to fulfill spiritual, physical, and mental health needs.

Differences in the intensity and type of physical activity were observed across groups. For example, 93% of Bhutanese participants reported no vigorous physical activity in the past week, compared to 50% of Black/African-American participants and 44% of Latinx participants.

However, 78% of Bhutanese participants reported walking for leisure or transportation at least three days/week, as did 80% of Black/African-American and 45% of Latinx participants. Time spent outdoors was highest among Bhutanese (43%) and Latinx participants (33%), compared to Black/African-American participants (11%). With respect to perspectives about physical activity, Black/African-American participants emphasized the importance of access to exercise facilities more strongly than participants from other groups, specifically connecting “exercise” to the concept of “dignity.” Latinx participants were more likely to emphasize the importance of access to nature, gardens, and outdoor recreational spaces, connecting these themes to notions of sanctuary and refuge. Bhutanese participants emphasized the importance of having access to places of worship and ethnic foods.


The photovoice process enabled older adults to share images and stories with others, establishing a platform to advocate for change for themselves and their communities.

Implications for Practice and Policy:

The voices of older adults of color and language minorities are often not included in conversations about opportunities for active living. Results will be used to support ongoing cross-sector, cross-cultural dialogue pertinent to the NH Healthy Aging Initiative and implementation of the NH State Plan on Aging.

Support/Funding Source:

Funding for this project was provided by the Endowment for Health. This work is also a product of a Health Promotion and Disease Prevention Research Center supported by Cooperative Agreement Number U48DP005018 from the Centers for Disease Control and Prevention. The findings and conclusions in this publication are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.


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Health Management and Policy

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Conference Proceeding


Funded by The Endowment for Health

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