Photovoice as a methodology in obesity research: A scoping review

Photovoice as a methodology in obesity research: A scoping review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Photovoice as a methodology in obesity research: A scoping review Olumuyiwa Omonaiye, Jaithri Ananthapavan, Martin Hensher, Thi Thu Ngan Dinh, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6736900/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction Photovoice is a community-based participatory research methodology that empowers participants to document and reflect on their lived experiences through photography. This scoping review examines the use of Photovoice in obesity research to explore the contexts in which it has been used, its application, and key themes in the literature to date. Methods Following Joanna Briggs Institute guidelines, a systematic search was conducted in six databases, yielding 229 records, with 27 studies meeting the inclusion criteria. Key data, including study location, participant demographics, Photovoice methodology, and findings, were extracted and synthesized. Results Most studies were conducted in North America within community settings, predominantly with minority populations. Four key themes emerged: environmental influences, facilitators and barriers to healthy living, mental health and wellbeing, and perceptions of obesity. Although findings align with other research methodologies, Photovoice uniquely highlights participant voices and fosters critical community engagement. Conclusion Photovoice is a valuable tool for obesity research, amplifying participant perspectives and contextual insights in ways more traditional methods may overlook. Future research should expand geographic and demographic diversity, adapt Photovoice for virtual formats to broaden its accessibility and explore its impact on participants and policy or practice change. Health Policy Photovoice obesity obesity research health inequities Figures Figure 1 Figure 2 1 INTRODUCTION Photovoice was first conceptualised in the mid-1990s as a community based, participatory action research methodology 1 . It is centred around photographs taken by participants 1 while also incorporating narrative elements 1 , 2 . In their seminal article introducing photovoice, Wang and Burris outlined three primary goals: (1) enabling people to document and reflect their community’s strengths and concerns, (2) fostering critical dialogue and knowledge sharing about significant community issues through group discussions of the photographs, and (3) reaching policymakers to advocate for change” 1(pp. 370) . This method was originally designed for use with marginalized and underrepresented groups. It is believed that using visual artefacts, Photovoice can reveal emotional and metaphoric insights that are not easily accessible through other qualitative methods 2 , 3 . Photovoice may also produce more nuanced and richer data than traditional interviews 4 , because it does not rely solely on verbal and written data 5 . The visual images become symbolic representations of participants’ lived experience, prompting them to critically reflect on the barriers they face, both individually and within their broader community, in ways that transcend the limitations of narrative alone 1 , 6 , 7 . Photovoice aims to enable critical conversations about the challenges or barriers faced by marginalised and underrepresented communities, service as a foundation for active change. Its participatory approach involves participants at every stage of the research process, reflecting a democratic approach that seeks to capture both individual priorities and broader community dynamics 8 , 9 . Photovoice empowers participants to play a key role in raising awareness, enabling communities to influence decision makers and shape policies that genuinely reflect their needs 1 , 10 . Obesity has emerged as a critical public health concern, with substantial evidence highlighting its widespread impact on individuals and societies. Recent studies point to the global rise in obesity rates, emphasising its link to increased risk of chronic diseases such as type 2 diabetes, cardiovascular disorders, and certain cancers 11 , 12 . The economic consequences of obesity are also significant, with rising healthcare costs driven by obesity-related illnesses and a corresponding decline in productivity 13 , 14 . The perceptions and preferences of people with obesity are underrepresented in global literature 15 , 16 . For example, although research demonstrates variations in how interventions affect people with obesity compared to those with a normal BMI 17 , 18 , clinical trials continue to lack adequate representation of individuals with obesity 19 , resulting in limited inclusivity. This exclusionary trend restricts the generalisability of findings and hampers the development of evidence-based interventions tailored to the diverse needs of those with obesity. Stigmatisation and discrimination linked to obesity often discourage individuals from participating in studies due to fear of judgment or biased treatment 20 , 21 . This social stigma is further reinforced by pervasive stereotypes and negative attitudes within society and healthcare settings 21 , 22 . Additionally, research infrastructure and recruitment methods may inadvertently contribute to the underrepresentation of individuals with obesity. Obesity stigma and discrimination are prevalent in many areas of life, including healthcare, employment, education and social relationships 23 , 24 . Photovoice is therefore an appropriate and relevant research methodology for people with obesity, due to their status as a marginalized group. However, there have been no comprehensive reviews of its use with this group to understand its implementation and identify opportunities for further development. A deeper understanding of how Photovoice is applied in obesity research is needed to optimise its potential in this field. Photovoice studies do not typically address questions of effectiveness, causality or prevalence, which are the focus of systemic reviews. However, scoping reviews are well suited to synthesising diverse research, mapping existing evidence, clarifying concepts and identifying knowledge gaps 25 . This scoping review aims to comprehensively examine the existing literature on the use of Photovoice methodology in studies involving people with obesity. Its objective is to describe the available studies, the contexts in which Photovoice is used, and the key findings for these studies. 2 METHODS This scoping review followed the Joanna Briggs Institute (JBI) guidelines for scoping reviews 26 and the Preferred Reporting Items for Systematic Reviews (PRISMA) Scoping Reviews extension (PRISMA-ScR) 27 to ensure a systematic and replicable process 26 . The five stages outlined by Arksey and O'Malley 28 guided the methodological approach for this review. This scoping review protocol was registered at Open Science Framework on April 19th, 2024: https://doi.org/10.17605/OSF.IO/P4RXM 2.1 Stage 1: Identification of the research question and the objectives The primary question guiding this inquiry, analysis, and evidence consolidation was: ‘What are the characteristics of Photovoice studies involving people with obesity, and what key themes emerge from their findings?’ The objective of this review was to guide future use of this research methodology in obesity research. 2.2 Stage 2: Identifying relevant studies. 2.2.1 Data sources We developed a search strategy in conjunction with a university librarian specialising in health research, to ensure its quality and rigour. Our search terms included keywords such as photovoice, photojournalism, photonarrative, photo elicitation, obes*, “weight loss", "weight gain", overweight, "over weight." From these keywords, we identified MeSH terms for database searches. The following databases was searched: Medline Complete, CINAHL, Global Health, Psycinfo, Social Work Abstracts, SocINDEX and Web of Science. Bibliographic software (EndNote) was used to store, organise, and manage all references. A draft search strategy for MEDLINE is available in Appendix 1 to demonstrate its application to this database 2.2.2Inclusion criteria 1) Primary research using Photovoice as a research method. 2) Studies providing description of the Photovoice process, including all phases of data collection and analysis. 3) Obesity is the focus of the study aim or research question. 4) Data is collected from people with lived experience of obesity 5) English, French or Portuguese language publication (languages spoken by the research team). 6) Peer reviewed publications. 7) Reports qualitative and/or quantitative empirical evidence 8) Published after 1st January 1997 (the year in which Photovoice first emerged). 2.2.3 Exclusion Criteria Documents were excluded based on the following criteria: 1) reporting secondary research only (i.e. reviews). 2) Studies in which Photovoice is used for pedagogical or health-promotion purposes rather than data collection. 3) Studies including people with obesity, but not directly addressing obesity in their aims or research questions. 4) Data not collected from people with lived experience of obesity 5) Languages other than English, French or Portuguese. 6) Non peer reviewed publications. 7) Non empirical forms of evidence such as review studies, theoretical articles and editorials. 8) Published before 1st January 1997. 2.3 Stage 3: Study selection Two independent reviewers assessed all articles using the Covidence platform 29 according to the specified inclusion and exclusion criteria. Covidence automatically removed all duplicates upon upload. Before formal screening, the reviewers screened a small set of studies together to ensure consistency. Articles were first screened based on titles and abstracts, before progressed to full text review. The reasons for excluding full text articles were recorded. Any conflicts were discussed and resolved by the reviewers with notes justifying their decision. As no unresolved disagreements arose, a third reviewer was not required. The reference lists of all studies included after the full text review were screened for additional studies, but no further references were identified through the Connected Papers platform 30 . A PRISMA diagram illustrating the article selection process is presented in Fig. 1 . 2.4 Stage 4: Data extraction and charting Data from articles meeting the inclusion criteria were extracted through Covidence based upon the Joanna Briggs Institute manual for data extraction 29 , 31 . The initial version of the form was created by the first author and then shared with the broader research team for consultation and revision. The form systematically captures essential information from the included studies, such as authors, study year, objectives, geographic location, study population characteristics, sample size, study design, results, and key findings relevant to the review question and objectives. The extraction form can be found in Appendix II. 2.5 Stage 5: Collating, summarizing, and reporting The characteristics of included articles were summarized using descriptive statistics, primarily frequencies. Key themes from the findings were synthesized using descriptive qualitative analysis, identifying themes and comparing them across studies. All findings are illustrated and discussed in the results section below. 3 RESULTS 3.1 Search results The reviewers found 229 records from database searches. Following the elimination of duplicates and screening of titles, abstracts, and full texts, 27 records were included in this scoping review. Detailed information regarding the selection process and reasons for excluding articles are outlined in Fig. 1 . 3.2 Characteristics of Photovoice Studies 3.2.1 Geographical Location All included studies were conducted in the Global North, with the majority completed in the United States of America (n = 22) (see Table 1). The remaining studies were conducted in Canada (n = 2), Ireland (n = 1), and England (n = 1). Table 1: Study Characteristics First Author Year Study Location Setting Study Aims & /or Objectives Sample Size Majority Gender Sample Characteristics * 1 Findings Balvanz 2 2016 USA Rural community To assess contextual determinants of childhood obesity, create a community action plan, and report actions taken with a community-based organisation and a university. n=7 Female 100% Adolescents (specific age n/r) African American (n=7) · Three themes: access to healthy food, social support, and community disorder. · Youth were effective collaborators in identifying obesity factors and significantly contributed to developing and implementing obesity strategies with adult community stakeholders. Banik 3 2023 Poland Rural and urban communities To investigate adolescents' critical awareness of local community policies for obesity prevention. n=41 Female 90% 16 to 18 years ( M 17, SD 0.8). Polish (n=41) · Obesity prevention policies focused on food environments and healthy diets. Adolescents were three times more likely to perceive a lack of such policies than notice existing, active policies. Bateman 4 2019 USA Urban community To explore social determinants of obesity as perceived by residents in two segregated, low-income communities. To understand residents' views on obesity-contributing factors and effective interventions in their communities. n=59 Female 73% 21 years to 90 years old ( M 53, SD 16) Location A: African American (n=3), American (n=3) Location B: African American (n=3), American (n=1) · Root determinants: Equity and social justice, linked to racial segregation and unmet market needs. · Underlying determinants: Neighbourhood conditions, community development, employment, social cohesion. · Proximal determinants: Convenience, cost, time, cooking skills and cultural norms. Breland 5 2024 USA Community (unspecified location) To understand the factors influencing variable weight loss outcomes for veterans. n=9 Male 78% 42 to 69 years ( M 58) Nine veterans who self-identified as Black or African American · Three key themes: Food in our lives and health care, body image, and healthcare bias and discrimination. Corty 6 2022 USA Urban community To explore community factors that influence healthy childhood weight and understand participant insights on the photovoice process. n=8 Female 88% Aged ³ 16 years Hispanic North American (n=8). · Community barriers and facilitators to healthy weight: Including family habits, cultural influences on food, built environment and food marketing · Participant motivations for Photovoice: Including desire to learn about health, personal growth from group sharing, pride in representing their community and empowerment as role models Cueva 7 2020 USA Urban community To explore youth perspectives on community-based obesity prevention, emphasizing cultural connectedness and traditional foods revival. n=44 Male 52% 9 to 11 years old Native North American Indian (n=44) · Traditional foods are cultivated through farming or gardening and are · perceived as healthy. · Stores offering less nutrient dense food are considered unhealthy. · The theme "Feast for the Future" fosters positive cultural connections and a hope for increased farming and gardening for future generations. Farrell 8 2022 Ireland Community (unspecified location) To examine the impact of the COVID-19 pandemic and associated stay-at-home orders on adults with obesity. n=15 Female 53% Age n/r Irish (n=15) · The pandemic and stay-at-home orders had varying health and wellbeing effects, which changed over time. Some experienced positive outcomes while others faced negative consequences. · Felt stigmatised and isolated after being labeled 'at risk’ and marginalised by social attitudes from public health messaging about obesity. Findholt 9 2010 USA Rural community To gathering insights on community assets and barriers impacting rural youths’ physical activity and dietary habits. n=6 Female 67% 15 to 18 years American (n=6) · Environmental influences on activity and diet included structural features, natural surroundings, economic conditions, community norms, and obesity related policies. · These factors acted as either barriers or enablers. Hackett 10 2015 USA Urban community To explore assets and barriers to nutrition and physical activity in an underserved, majority-minority suburban community. n=9 Female 56% 15 to 17 years African American (n=8), Hispanic North American (n=1). · Key challenges: Limited access to fresh, nutritious food and safe spaces for physical activity. · Recognised need for policy reform and active civic involvement in change. Homer 11 2016 UK Urban community To explore experiences of individuals seeking bariatric surgery and identify implications for behavioural and self-management interventions. n=18 Female 78% 30 to 61 years Ethnicity n/r · Three themes: Negative experiences of obesity, Experience of weight management services, and expectations of normality. Jennings 12 2020 USA Urban community To explore cultural health perspectives of food-insecure, transitionally housed Indigenous children n=18 (n=10 completed project) Male 60% (completed project) 8 to 12 years old n=6 boys, 4 girls Native North American Indian n=10) · Healthy themes: Nutrition, gardening, relationships, food sovereignty, water quality, natural and built environments. · Unhealthy themes: Cumulative stress, food insecurity, access and cost issues, screen time, smoking, violence. Johnson 13 2018 USA Hospital (unspecified location) To explore explore bariatric patients' journeys, from pre-surgery to post-surgery experiences n=15 Female 73% 37 to 65 years Hispanic or Latino (n=5) Not Hispanic or Latino (n=10) · Key themes: perceptions of beauty based on race/ethnicity; adherence to gender norms; dealing with comorbidities; depression / disordered eating; discrimination due to obesity; and financial challenges to adherence. Maley 14 2010 USA Rural Community To understand rural community perspectives on how built, natural, and social environments influence food choices and physical activity behaviours. n=27 Gender % n/r 20 to 80 years n=2 female, 3 male (others unreported) African American (n=2), American (n=3), Other participants were American women (n=25) · Obesity is both an individual and collective issue · Participants observed conflicts between desired behaviours and community values/environmental conditions. · Existing models don’t address the relationship between social, built, and natural environments. McFatrich 15 2013 USA Urban Community To use photovoice, a community-based participatory research tool to gain insights into the perspectives of African American faith leaders regarding the factors influencing childhood obesity within their communities. n=5 Female 100% African American · Faith leaders focused on modelling positive behaviours and meeting family needs. However, parenting demands often led to a cycle of stress, which in turn contributed to unhealthy behaviours. · External opinions on parenting created pressure to meet ideal standards, and their fear of appearing vulnerable led faith leaders hesitant to seek help. Nabors 16 2020 USA Community (unspecified location) This study aimed to evaluate the effectiveness of a healthy eating intervention in after-school programs and document observed changes in eating behaviour. n=42 Study 1 (n=30) Male 63% Study 2 (n=12) Female 50% Study 1: 8 years to 11 years ( M 9, SD 0.8) African American (n=4), American (n=22), Asian American (n=1), Native North American Indian (n=2), Hispanic North American (n=1). Study 2 8 years to 10 years old ( M 9, SD 0.8) African American (n=1), American (n=11) · Two key themes: Changing or improving diet for healthy eating and helping my family to eat more healthy foods. Necheles 17 2007 USA Urban community To identifying factors influencing youth health behaviours and support the development of health advocacy projects. n=13 Female 85% 13 to 17 years African American (n=9), Asian American (n=1), Mexican (n=3) · Key themes: unhealthy eating, stress, friendships, emotions, environment, health, positive family dynamics. · Advocacy targeted unhealthy eating and stress through social marketing. · Obesity focus initiated a new community based participatory research project within the local school district. Nichols 18 2016 USA Community (unspecified location) To identify social ecological barriers and supports for healthy weight management in an underserved community of the parents of adolescents with obesity in a weight management program n=24 Female 54% Adolescent / parent dyads (n=12) Adolescents: 12 to 16 years ( M 13.5) African American (n=11) American (n-1) Parental age and ethnicity n/r · Individual: Influenced by knowledge, beliefs, values, genetics, race, ethnicity, SES. Personal temptation and food or activity choices were barriers. · Interpersonal: Parents (positive and negative influence), time with grandparents, and dynamics in divorced or single parent homes. · Community: Neighbourhood safety levels (including urban decay, gangs and crime) · Organisational: Limited free public programs, private programs are costly. Nieuwendyk 19 2016 Canada Rural and urban communities To explore perceptions of how micro- and macro-level community environmental factors impact physical activity and healthy eating, identifying key elements of obesogenic environments and suitable local interventions. n=35 Female 74% Majority aged ³ 35 years Ethnicity n/r · Participants viewed health in a broad context, including "community social health." · Microenvironment influences were frequently discussed, but macroenvironment was mentioned less · Photovoice visually showed community partners and decision-makers how macroenvironmental forces can limit healthy choices. Oates 20 2018 USA Urban community To explore community perspectives on obesity in two urban areas and investigating grassroots solutions to address obesity. n=59 Location A: African American Female 70.6% While Female 66.7% Location B: African American Female 76.5% White Female 71.4% Age Location A: African American ( M 49, SD 12), American ( M 53, SD 18). Location B: African American ( M 55, SD 11), American ( M 57, SD 25) African American (n=34), American (n=25) · Main barriers to healthy weight were restaurants, physical activity limitations and food store access. · Recommended solutions included individual efforts, peer support, education for children and adults and community advocacy. Rosado 21 2020 USA Rural community To explore environmental and social determinants of childhood obesity as perceived by rural migrant farm workers. n=13 Female 85% M 40 years. Hispanic North American (n=13). Parents of 30 children ( M 10 years) · Themes addressed the impact of built and social environments on diet, physical activity, and consequently, health and weight status. Sackett 22 2016 USA Urban community To explore adolescent girls' views on environmental factors in childhood obesity and outline implications for counsellor advocacy n=7 Female 100% 14 to 17 years American (n=7) Divided into two groups based on location · Shared Themes: ease and convenience, money and SES, freedom and pride. · Two groups also had unique themes suggesting influence of local context - Ignorance, addiction, will and motivation, time (Location A); advertisement (Location B) Torres 23 2013 USA Urban community To identify barriers and opportunities influencing physical activity for Latino children and propose policy changes, from the perspective of mothers. n=12 Female 100% 25 to 30 years Guatemalan (n=1) Mexican (n=11) 7 years USA residency (mean) · Generally positive perceptions of neighbourhoods · Barriers to physical activity: transportation limitations, language barriers, lack of awareness of school programs, and anti-immigration discrimination. · Suggested improvements: healthier family diets, better public park equipment, community sidewalks, and increased police presence. Van Oss 24 2014 USA Urban community To raise adolescent awareness of positive and negative influences on dietary and physical activity behaviours and explore perceptions of physicians' roles in shaping these behaviours. n=7 Female 86% 13 to 19 years ( M 16) African American (n=4), Asian American (n=1), Hispanic North American (n=2). · Barriers to healthy eating: Family influences on food choices and high cost of healthy foods · Barriers to physical activity: Academic pressures and unsafe neighbourhoods · Healthy eating strategies: Portion control and moderation · Physical activity strategies: Enjoyable activities and social supports · Other influences: Role of physicians and physical education teachers, along with a desire for more personalised and culturally aware healthcare · Study participation increased their awareness of health behaviours, with some making positive behaviour changes. Watts 25 2015 Canada Urban community To explore factors perceived to hinder or support healthy eating in the home environment among overweight/obese adolescents. n=22 Female 77% M 14 years ( SD 1.9) Parental ethnicity: White (n=12) Nonwhite (n=10) · Six themes in order of frequency: home cooking; availability and accessibility of foods/beverages; parenting practices; family modelling, celebrations; and screen use and studying Weinstein 26 2019 USA Urban community To investigate social and structural factors influencing weight loss in collaboration with people with serious mental illness and overweight/obesity involved in a lifestyle program in supported housing. n=8 Male 75% M 56 years ( SD 6.8) African American (n=5), American (n=3) · Structural barriers included prevalence of low-quality food, costly transportation, financial limitations, food pantry constraints, easy availability of tobacco and alcohol products, and limited exercise opportunities. Woolford 27 2012 USA Community (unspecified location) To explore images that adolescents with obesity find supportive for their weight loss efforts n=23 Female 78% 13 to 19 years ( M 14) Arab American (n=3), African American (n=7), American (n=10), Hispanic North American (n=2), Native North American Indian (n=1) · Participants rated Photovoice highly, noting that selecting pictures encouraged reflection on their weight loss journey. · They believed a mobile intervention with personal images would enhance adherence. · Photos often featured family and friends, highlighting their essential role in motivation and support. Xiao 28 2021 USA Community (unspecified location) To explore perceptions of obesity and overweight conditions among African American women and identify influencing factors. n=18 Female 100% M 35 years ( SD 7) African American (n=18) · "The Weight of a Black Neighbourhood" referred to challenges in maintaining healthy habits in their neighbourhoods. · "Cultural Ties" described preferences for high-carbohydrate, salty, and fatty foods and difficulties changing cultural dietary habits. · "Weight is Just a Number” referred to their personal views on the significance of weight. Note: * = Based upon the Australian Standard Classification of Cultural and Ethnic Groups (ASCCEG) 1 as per reported ethnicity. M = mean, n/r = not reported, SD = standard deviation, SES = Socio-Economic Status. UK = United Kingdom. USA = United States of America. 1. Australian Bureau of Statistics. Australian Standard Classification of Cultural and Ethnic Groups (ASCCEG). 2019; https://www.abs.gov.au/statistics/classifications/australian-standard-classification-cultural-and-ethnic-groups-ascceg/latest-release#data-downloads. 2. Balvanz P, Dodgen L, Quinn J, Holloway T, Hudspeth S, Eng E. From Voice to Choice: African American Youth Examine Childhood Obesity in Rural North Carolina. Progress in community health partnerships : research, education, and action. 2016;10(2):293-303. 3. Banik A, Knai C, Klepp K-I, et al. What policies are there and what policies are missing? A Photovoice study of adolescents' perspectives on obesity-prevention policies in their local environment. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2023;24 Suppl 2:e13617. 4. Bateman LB, Simoni ZR, Oates GR, Hansen B, Fouad MN. Using photovoice to explore social determinants of obesity in two underserved communities in the southeast. Sociological spectrum : the official journal of the Mid-South Sociological Association. 2019;39(6):405-423. 5. Breland JY, Tanksley L, Sr., Borowitz MA, et al. Black Veterans Experiences with and Recommendations for Improving Weight-Related Health Care: A Photovoice Study. Journal of general internal medicine. 2024. 6. Corty EW, Charite JL, Ugochukwu A, et al. "The First Step to Changing Something": Addressing Latinx Childhood Obesity through Photovoice. Progress in community health partnerships : research, education, and action. 2022;16(3):307-320. 7. Cueva K, Speakman K, Neault N, et al. Cultural connectedness as obesity prevention: Indigenous youth perspectives on geast for the guture. Journal of Nutrition, Education and Behaviour. 2020;52(6):632-639. 8. Farrell E, Hollmann E, Roux CL, Nadglowski J, McGillicuddy D. At home and at risk: The experiences of Irish adults living with obesity during the COVID-19 pandemic. EClinicalMedicine. 2022;51:101568. 9. Findholt NE, Michael YL, Davis MM. Photovoice engages rural youth in childhood obesity prevention. Public health nursing (Boston, Mass). 2011;28(2):186-192. 10. Hackett M, Gillens- Eromosele C, Dixon J. Examining childhood obesity and the environment of a segregated, lower-income US suburb. International Journal of Human Rights in Healthcare. 2015;8(4):247-259. 11. Homer CV, Tod AM, Thompson AR, Allmark P, Goyder E. Expectations and patients' experiences of obesity prior to bariatric surgery: a qualitative study. BMJ open. 2016;6(2):e009389. 12. Jennings DR, Paul K, Little MM, Olson D, Johnson-Jennings MD. Identifying Perspectives About Health to Orient Obesity Intervention Among Urban, Transitionally Housed Indigenous Children. Qualitative health research. 2020;30(6):894-905. 13. Johnson LP, Asigbee FM, Crowell R, Negrini A. Pre-surgical, surgical and post-surgical experiences of weight loss surgery patients: a closer look at social determinants of health. Clinical obesity. 2018;8(4):265-274. 14. Maley M, Warren BS, Devine CM. Perceptions of the environment for eating and exercise in a rural community. Journal of nutrition education and behavior. 2010;42(3):185-191. 15. McFatrich M, Weinhold A, Riggins L, et al. Faithful five: exploring African American faith leaders' perspectives on factors affecting childhood obesity. Family & community health. 2013;36(4):338-349. 16. Nabors L, Murphy MJ, Lusky C, Young C-J, Sanger K. Using Photovoice to Improve Healthy Eating for Children Participating in an Obesity Prevention Program. Global pediatric health. 2020;7:2333794X20954673. 17. Necheles JW, Chung EQ, Hawes-Dawson J, et al. The Teen Photovoice Project: a pilot study to promote health through advocacy. Progress in community health partnerships : research, education, and action. 2007;1(3):221-229. 18. Nichols M, Nemeth LS, Magwood G, Odulana A, Newman S. Exploring the Contextual Factors of Adolescent Obesity in an Underserved Population Through Photovoice. Family & community health. 2016;39(4):301-309. 19. Nieuwendyk LM, Belon AP, Vallianatos H, et al. How perceptions of community environment influence health behaviours: using the Analysis Grid for Environments Linked to Obesity Framework as a mechanism for exploration. Health promotion and chronic disease prevention in Canada : research, policy and practice. 2016;36(9):175-184. 20. Oates GR, Phillips JM, Bateman LB, Baskin ML, Fouad MN, Scarinci IC. Determinants of Obesity in Two Urban Communities: Perceptions and Community-Driven Solutions. Ethnicity & disease. 2018;28(1):33-42. 21. Rosado JI, Rivera A, Fernandez T. Perceived Role of Built and Social Environments on Childhood Obesity: A PhotoVoice Approach With Latino Migrant Farmworking Families. Family & community health. 2020;43(3):221-228. 22. Sackett CR, Granberg EM, Jenkins AM. An Exploration of Adolescent Girls' Perspectives of Childhood Obesity Through Photovoice: A Call for Counselor Advocacy. The Journal of Humanistic Counseling. 2016;55(3):215-233. 23. Torres ME, Meetze EG, Smithwick-Leone J. Latina voices in childhood obesity: a pilot study using Photovoice in South Carolina. American journal of preventive medicine. 2013;44(3 Suppl 3):S225-S231. 24. Van Oss K, Leung MM, Sharkey Buckley J, Wilson-Taylor M. Voices through cameras: Learning about the experiences and challenges of minority government-insured overweight and obese New York City adolescents using photovoice. Journal of Communication in Healthcare. 2014;7(4):262-271. 25. Watts AW, Lovato CY, Barr SI, Hanning RM, Mâsse LC. Experiences of overweight/obese adolescents in navigating their home food environment. Public health nutrition. 2015;18(18):3278-3286. 26. Weinstein LC, Chilton M, Turchi R, et al. Reaching for a Healthier Lifestyle: A Photovoice Investigation of Healthy Living in People with Serious Mental Illness. Progress in community health partnerships : research, education, and action. 2019;13(4):371-383. 27. Woolford SJ, Khan S, Barr KLC, Clark SJ, Strecher VJ, Resnicow K. A picture may be worth a thousand texts: obese adolescents' perspectives on a modified photovoice activity to aid weight loss. Childhood obesity (Print). 2012;8(3):230-236. 28. Xiao Z, Brown R. Using photovoice to understand perceptions of obesity among African-American women. Journal of Human Behavior in the Social Environment. 2021;31(6):751-770. All but one of the studies were carried out in community settings, while one took place in a hospital 32 (see Table 2). Community studies were conducted in urban 33 – 44 , rural 45 – 49 , and suburban areas 50 . Two spanned both rural and urban settings 51 , 52 , however six studies 53 – 58 did not describe their geographical location. Table 2: Photovoice Methodologies of Included Studies First Author Year Method Session Number & Duration Per Session SHOWeD Utilised Equipment* Number of Photos (Instructed, Taken & Analysed) Photos Published Balvanz 1 2016 Standalone Photovoice method 4 sessions. 90 mins. Yes Camera (type of camera n/r) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) Yes Banik 2 2023 Standalone Photovoice method 4 sessions. Duration n/r. No Smartphone or camera (type of camera n/r) · Instructions: Up to 6 photos showing either the presence (n=3) or absence (n=3) of healthy eating or physical activity initiatives. · Photos taken (n=222) · Photos analysed (n=213) Yes Bateman 3 2019 Standalone Photovoice method 10 sessions. 90 mins. Yes Camera (disposable) · Instructions: 3–4 pictures per day for 7 days. · Photos taken (n/r) · Photos analysed (n=96) Yes Breland 4 2024 Standalone Photovoice method 6 sessions. 85 mins. No n/r · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) Yes Corty 5 2022 Standalone Photovoice method 7 sessions. 90 mins. Yes Smartphones · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) Yes Cueva 6 2020 Standalone Photovoice method 8-9 sessions per group. Duration n/r. Yes (adapted) Cameras (disposable) · Instructions: At least 3 photos for each of 14 guiding questions · Photos taken (n/r) · Photos analysed (n/r) Yes Farrell 7 2022 Photovoice used alongside phenomenological interviews 1 session. Up to 120 mins. No Cameras (disposable) · Instructions: 3–4 pictures per day for 7 days. · Photos taken (n/r) · Photos analysed (n=5 per participant) Yes Findholt 8 2010 Photovoice used alongside other unspecified research methods. 4 sessions. 180 mins. (Sessions 1-3) and 60 mins. (Session 4) Yes (adapted) Cameras (disposable) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) No Hackett 9 2015 Standalone Photovoice method 10 sessions. 60-120 mins. No Smartphones or flip video cameras · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n=78) Yes Homer 10 2016 Photovoice used alongside descriptive qualitative interviews 2 sessions. Duration n/r. No n/r · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) No Jennings 11 2020 Standalone Photovoice method 2 sessions (1 interview, 1 group discussion. Duration n/r. No Camera (type of camera n/r) · Instructions (n/r) · Photos taken (n=400) · Photos analysed (n=100) No Johnson 12 2018 Standalone Photovoice method 2 sessions. Duration n/r. No Camera (digital) · Instructions (n/r) · Photos taken (n=150 approx.) · Photos analysed (n/r) Yes Maley 13 2010 Photovoice used alongside qualitative interviews and focus groups 1 interview. 60 mins. 1 focus group. 30 mins. Yes (adapted) Cameras (disposable) · Instructions (n/r) · Photos taken (n=113) · Photos analysed (n=17-34 approx.) No McFatrich 14 2013 Standalone Photovoice method 3 sessions. 90 mins. Yes Cameras (disposable) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) No Nabors 15 2020 Photovoice used alongside surveys. 8 sessions. Duration n/r. Yes (adapted) Cameras (disposable) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) No Necheles 16 2007 Photovoice used alongside a skills building program. 9 sessions. 120 mins. Yes Cameras (digital), plus memory card, photo-editing software, USB cable and photo album · Instructions (n/r) · Photos taken (n=3,500) · Photos analysed (n=130) Yes Nichols 17 2016 Standalone Photovoice method 1 session per participant. Duration n/r. Yes Camera (digital) · Instructions (n/r) · Photos taken (n=590) · Photos analysed (n=72-120 approx.) Yes Nieuwendyk 18 2016 Standalone Photovoice method 2 sessions. 60-90 mins. No Camera (digital) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n=average 13 per participant) Yes Oates 19 2018 Standalone Photovoice method 4 sessions. 90 mins. Yes Camera (disposable) · Instructions: 3 to 4 pictures per day for 7 days · Photos taken (n=1,600) · Photos analysed (n=174 discussion, n=96 focus group) Yes Rosado 20 2020 Standalone Photovoice method 3 sessions Duration n/r Yes Camera (disposable) · Instructions (n/r) · Photos taken (n=182) · Photos analysed (n=49) Yes Sackett 21 2016 Standalone Photovoice method 4 sessions. Duration n/r. Yes (adapted) Camera (disposable) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n=15-25 approx.) No Torres 22 2013 Standalone Photovoice method 3 sessions. 90 mins. Yes Camera (type of camera n/r) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n=24-36 approx.) No Van Oss 23 2014 Standalone Photovoice method 3 sessions. Duration n/r. No Smartphone or camera (digital) · Instructions: Minimum of 5 photos to be taken. · Photos taken (n/r) · Photos analysed (n/r) Yes Watts 24 2015 Standalone Photovoice method 1 session. 15 mins. No Camera (digital) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n=105) Yes Weinstein 25 2019 Standalone Photovoice method 4-7 sessions. Duration n/r. Yes Camera (digital) · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n=33) Yes Woolford 26 2012 Standalone Photovoice method. 1 session. 15-25 mins. No Smartphone · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) No Xiao 27 2021 Standalone Photovoice method 2 sessions. 60 mins. Yes n/r · Instructions (n/r) · Photos taken (n/r) · Photos analysed (n/r) No Note: * Smartphones were participant provided, while cameras were researcher provided. approx. = approximately. n/r = not reported. mins. = minutes. 1. Balvanz P, Dodgen L, Quinn J, Holloway T, Hudspeth S, Eng E. From Voice to Choice: African American Youth Examine Childhood Obesity in Rural North Carolina. Progress in community health partnerships : research, education, and action. 2016;10(2):293-303. 2. Banik A, Knai C, Klepp K-I, et al. What policies are there and what policies are missing? A Photovoice study of adolescents' perspectives on obesity-prevention policies in their local environment. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2023;24 Suppl 2:e13617. 3. Bateman LB, Simoni ZR, Oates GR, Hansen B, Fouad MN. Using photovoice to explore social determinants of obesity in two underserved communities in the southeast. Sociological spectrum : the official journal of the Mid-South Sociological Association. 2019;39(6):405-423. 4. Breland JY, Tanksley L, Sr., Borowitz MA, et al. Black Veterans Experiences with and Recommendations for Improving Weight-Related Health Care: A Photovoice Study. Journal of general internal medicine. 2024. 5. Corty EW, Charite JL, Ugochukwu A, et al. "The First Step to Changing Something": Addressing Latinx Childhood Obesity through Photovoice. Progress in community health partnerships : research, education, and action. 2022;16(3):307-320. 6. Cueva K, Speakman K, Neault N, et al. Cultural connectedness as obesity prevention: Indigenous youth perspectives on geast for the guture. Journal of Nutrition, Education and Behaviour. 2020;52(6):632-639. 7. Farrell E, Hollmann E, Roux CL, Nadglowski J, McGillicuddy D. At home and at risk: The experiences of Irish adults living with obesity during the COVID-19 pandemic. EClinicalMedicine. 2022;51:101568. 8. Findholt NE, Michael YL, Davis MM. Photovoice engages rural youth in childhood obesity prevention. Public health nursing (Boston, Mass). 2011;28(2):186-192. 9. Hackett M, Gillens- Eromosele C, Dixon J. Examining childhood obesity and the environment of a segregated, lower-income US suburb. International Journal of Human Rights in Healthcare. 2015;8(4):247-259. 10. Homer CV, Tod AM, Thompson AR, Allmark P, Goyder E. Expectations and patients' experiences of obesity prior to bariatric surgery: a qualitative study. BMJ open. 2016;6(2):e009389. 11. Jennings DR, Paul K, Little MM, Olson D, Johnson-Jennings MD. Identifying Perspectives About Health to Orient Obesity Intervention Among Urban, Transitionally Housed Indigenous Children. Qualitative health research. 2020;30(6):894-905. 12. Johnson LP, Asigbee FM, Crowell R, Negrini A. Pre-surgical, surgical and post-surgical experiences of weight loss surgery patients: a closer look at social determinants of health. Clinical obesity. 2018;8(4):265-274. 13. Maley M, Warren BS, Devine CM. Perceptions of the environment for eating and exercise in a rural community. Journal of nutrition education and behavior. 2010;42(3):185-191. 14. McFatrich M, Weinhold A, Riggins L, et al. Faithful five: exploring African American faith leaders' perspectives on factors affecting childhood obesity. Family & community health. 2013;36(4):338-349. 15. Nabors L, Murphy MJ, Lusky C, Young C-J, Sanger K. Using Photovoice to Improve Healthy Eating for Children Participating in an Obesity Prevention Program. Global pediatric health. 2020;7:2333794X20954673. 16. Necheles JW, Chung EQ, Hawes-Dawson J, et al. The Teen Photovoice Project: a pilot study to promote health through advocacy. Progress in community health partnerships : research, education, and action. 2007;1(3):221-229. 17. Nichols M, Nemeth LS, Magwood G, Odulana A, Newman S. Exploring the Contextual Factors of Adolescent Obesity in an Underserved Population Through Photovoice. Family & community health. 2016;39(4):301-309. 18. Nieuwendyk LM, Belon AP, Vallianatos H, et al. How perceptions of community environment influence health behaviours: using the Analysis Grid for Environments Linked to Obesity Framework as a mechanism for exploration. Health promotion and chronic disease prevention in Canada : research, policy and practice. 2016;36(9):175-184. 19. Oates GR, Phillips JM, Bateman LB, Baskin ML, Fouad MN, Scarinci IC. Determinants of Obesity in Two Urban Communities: Perceptions and Community-Driven Solutions. Ethnicity & disease. 2018;28(1):33-42. 20. Rosado JI, Rivera A, Fernandez T. Perceived Role of Built and Social Environments on Childhood Obesity: A PhotoVoice Approach With Latino Migrant Farmworking Families. Family & community health. 2020;43(3):221-228. 21. Sackett CR, Granberg EM, Jenkins AM. An Exploration of Adolescent Girls' Perspectives of Childhood Obesity Through Photovoice: A Call for Counselor Advocacy. The Journal of Humanistic Counseling. 2016;55(3):215-233. 22. Torres ME, Meetze EG, Smithwick-Leone J. Latina voices in childhood obesity: a pilot study using Photovoice in South Carolina. American journal of preventive medicine. 2013;44(3 Suppl 3):S225-S231. 23. Van Oss K, Leung MM, Sharkey Buckley J, Wilson-Taylor M. Voices through cameras: Learning about the experiences and challenges of minority government-insured overweight and obese New York City adolescents using photovoice. Journal of Communication in Healthcare. 2014;7(4):262-271. 24. Watts AW, Lovato CY, Barr SI, Hanning RM, Mâsse LC. Experiences of overweight/obese adolescents in navigating their home food environment. Public health nutrition. 2015;18(18):3278-3286. 25. Weinstein LC, Chilton M, Turchi R, et al. Reaching for a Healthier Lifestyle: A Photovoice Investigation of Healthy Living in People with Serious Mental Illness. Progress in community health partnerships : research, education, and action. 2019;13(4):371-383. 26. Woolford SJ, Khan S, Barr KLC, Clark SJ, Strecher VJ, Resnicow K. A picture may be worth a thousand texts: obese adolescents' perspectives on a modified photovoice activity to aid weight loss. Childhood obesity (Print). 2012;8(3):230-236. 27. Xiao Z, Brown R. Using photovoice to understand perceptions of obesity among African-American women. Journal of Human Behavior in the Social Environment. 2021;31(6):751-770. In one study 46 , the gender of participants was not fully reported. However, for the remaining studies, all except four 43 , 49 , 55 , 58 had a female majority sample, and around half were completed with children or adolescents. Included studies were primarily conducted among ethnically minority groups, however two 39 , 51 provided no information about the ethnicity profile of their sample (see Table 2). Four studies 34 , 47 , 56 , 58 focused solely on Black or African Americans, three studies 35 , 44 , 48 , two studies on Indigenous population in America 43 , 49 . Few studies 33 , 34 , 36 , 46 , 55 recruited participants from two or more ethnic groups. Participant ages ranged from 9 to 90 years across the included studies, with twelve studies 36 , 38 , 40 – 42 , 48 , 53 – 56 , 58 , 59 reporting mean ages (from 9 to 58 years). The majority of studies (n = 11, 58%) that reported age were with young people aged between 8 and 19 years. 3.3 Photovoice Methodology Digital 32 , 38 , 41 , 51 , 54 , 60 and disposable cameras 34 , 37 , 40 , 42 , 45 , 46 , 48 , 49 , 55 , 57 were most commonly utilised, and 13 studies 32 , 33 , 38 , 40 – 43 , 46 , 48 , 50 , 51 , 57 , 59 specified the number of photographs collected and analysed. Smartphone cameras were used relatively infrequently 36 , 44 , 50 , 53 , 59 and three studies gave no information about cameras in their photovoice research 39 , 56 , 58 . The number of data collections sessions in these sessions, both photography and interviews, ranged from 2 to 8. However, ten studies did not describe the duration of these sessions 32 , 36 , 37 , 39 , 41 , 48 , 49 , 54 , 55 , 59 , but when reported ranged from 15 to 120 minutes. To facilitate photo discussions, eleven studies 33–35,40−42,44,47,48,54,56 employed the SHOWeD framework. This framework asks five questions: What do you S ee here? What is really H appening? How does this relate to O ur lives? W hy does this situation exist? What can we D o about it? Five other studies 37 , 45 , 46 , 49 , 55 adapted the SHOWeD framework. Most (n = 17, 63%) of the studies included participant photographs in their subsequent publications 32 , 33 , 36 , 38 , 40 – 42 , 44 , 47 – 51 , 54 , 57 – 59 . 3.3.1 Photovoice Studies Over Time Few Photovoice studies involving people with obesity were published prior to 2016, as shown in Fig. 2 . 3.3.2 Study Aims and Objectives The aims and or objectives of included studies (Table 1) covered a wide range of topics related to obesity research. Youth and adolescent engagement were a common focus, which involved identifying factors influencing health behaviors, promoting health advocacy, and exploring adolescents' perceptions and experiences with obesity 33 , 36 , 37 , 45 , 53 , 59 , 61 . Community perspectives were also investigated, relating to assets, barriers, and environmental factors affecting health behaviours, along with community-specific aspects related to obesity 40 , 42 , 44 , 46 , 48 , 50 , 51 , 62 – 65 . Cultural, social, and economic determinants of obesity 42 , 48 , 56 , 58 , the development and evaluation health interventions and policy 39 , 41 , 44 , 55 , 57 and the use of photovoice as a methodology was also the focus of multiple studies 33 , 34 , 43 , 44 , 47 , 50 , 53 , 55 . 3.3.3 Key Themes in Existing Studies Four key themes were identified in the findings of included studies; environmental influences; facilitators and barriers to healthy living and eating; mental health and wellbeing; and perceptions of obesity. Findings related to multiple themes were evident in many studies, indicating their close and interconnected relationships. The impact of features in built, natural and economic environments were explored across studies with children, adolescents and adults 37,45,46,48,51,60–62,64−69 . Built and natural environments were described as having the potential to both help or hinder physical activity, depending on factors such as available green spaces, transportation limitations, perceived safety and the presence of fast-food outlets. However, economic environments were consistently considered a barrier to healthy eating, with some disadvantaged communities living in ‘food deserts’ with limited access to affordable nutritious food. Their presence in Photovoice studies suggests that obesogenic (and health promoting) environments are perceived as an important issue by marginalized communities but may also reflect the visual nature of the research methodology. Several studies explored other facilitators and barriers to health eating and physical activity, including social, cultural and political influences. Relationships with parents, family, friends and peers were all identified as potential facilitators through the modelling of good habits and opportunities for communal activity 36 , 38 , 60 , 63 – 65 . However, these social influences (or social isolation) could also lead people to unhealthy eating and sedentary habits and therefore contribute to obesity. More broadly, experiencing a sense of community and access to community-based programs provided structured opportunities for guidance, physical activities, and shared experiences. These communal aspects of the study findings are also closely related to the build and natural environmental theme. Cultural identity and the challenges of changing related dietary habits were also examined 36 , 63 – 65 , 70 , 71 . Some cultural preferences were for foods high in carbohydrates, salt, or fats, which are at odds with dietary recommendations related to obesity prevention. Social gatherings and celebrations also often centre around unhealthy eating, such as large family meals or festive ‘treats’. Changing these habits may therefore challenge a persons cherished cultural identity and meet with resistance from their family or social circles. Cultural expectations related to physical activity were also identified, which may be inhibited by community values or be encouraged to express identity. Language barriers and discrimination may prevent culturally diverse people with obesity from accessing health programs and community infrastructure which could help them manage their obesity. However, traditional food cultivation practices through farming or gardening can support healthy lifestyles while also maintaining connection to culture 61 . Several changes and improvements were recommended by participants to address the barriers they identified in their communities 67 , 69 – 72 . Many of the recommendations addressed common themes and structural issues identified in the literature, for example eliminating ‘food deserts’, enhancing community recreational infrastructure, improving food and exercise affordability and increasing green spaces. A collaborative approach using participatory methods such as community action plans was preferred in underserved communities, along with the tailoring of interventions to local cultural and socioeconomic contexts. However, participants acknowledge and desired structural and sustained transformation to tackle the issues they identified. 3.3.4 Mental Health and Wellbeing A small number of studies explicitly addressed the influence of mental health and wellbeing but strongly emphasized the importance of these factors to the experiences of people with obesity. Two studies explored the link between stress, family responsibilities, unhealthy eating and low levels of physical activity. People with obesity experiencing social and familial described the challenges these factors posed to maintaining healthy lifestyles. McFatrich et al. 63 found that stress from parenting responsibilities and societal expectations around this role contributed to unhealthy behaviours for African Americans. Similarly, Nichols et al. 64 reported that adolescents and their parents experienced stressful family dynamics and economic challenges, both of which had a negative influence on dietary choices and activity levels. As such, multiple psychosocial factors were perceived to be a higher priority or demand by people with obesity than prioritising their personal health. Two further studies explored the connection between obesity and clinical comorbidities like depression and disordered eating. Structural barriers (such as limited access to healthy food and opportunities to exercise), play a role in exacerbating mental health problems for people with serious psychiatric conditions, consequently increasing their risk of obesity 67 . For people receiving bariatric surgery, Johnson et al. 32 (2018) report that depression, disordered eating, and weight stigma also create a cyclical relationship between poor mental health and sustained obesity. 3.3.5 Perceptions and Experiences At both the individual and community level, negative perceptions of obesity interact with (and potentially amplify) other perceptions of disadvantage in the lived experiences of marginalised people with obesity. In a study by Van Oss et al. 36 adolescents described weight as “just a number” but were also aware of societal expectations around being a healthy weight. African American women also perceived community influences and expectations as a key driver of their problems with body image and weight management 56 . People undergoing bariatric surgery also described their experiences of discrimination and societal disapproval, which had a significant impact on their self-perception and efforts to manage their obesity 32 . Finally, two studies specifically commented on the empowering effects of the Photovoice process when collecting lived experience data. Corty et al. 44 found their participants valued Photovoice as a tool for personal growth, community representation, and motivation for health advocacy. Similarly, Necheles et al. 60 reported their participants appreciated the platform provided by Photovoice for self-reflection and advocacy, and its ability to foster both individual and collective awareness. In both cases, Photovoice was perceived as a way for marginalized participants to share their experience and actively contribute to positive change in their community. 4 DISCUSSION This scoping review synthesised the findings of 27 Photovoice studies conducted with individuals experiencing obesity, predominantly in Western countries, with a notable concentration in North America. This geographical concentration is consistent with previous research that highlights the prevalence of obesity-related studies in these regions due to higher obesity rates and greater research funding availability 73 – 75 . Key themes reported in the findings of these studies included the impact of environmental influences, facilitators and barriers to healthy living, mental health and well-being, and perceptions of obesity. These themes reflect the complex interplay of social, cultural, and environmental factors on the lived experiences of people with obesity, particularly in community settings. By highlighting these themes, this scoping review synthesizes the evidence for applying Photovoice methodology to obesity research. It also highlights its potential for capturing complex and nuanced influences on lived experience and promoting a participatory approach to meaningful collaboration with marginalized communities. This community focus aligns with the participatory nature of Photovoice, which aims to engage and empower communities in addressing health issues 1 . Urban settings dominated the community studies, reflecting the urban-centric nature of public health research, where urban populations often face unique health challenges and have greater access to research initiatives 76 , 77 . The limited number of studies in rural settings indicates a need for more research in these areas, where obesity rates can be high, but resources and interventions are often lacking 78 . Notably, most studies were conducted in community settings, with only one taking place in a clinical setting. This emphasis on community settings complements the participatory nature of Photovoice, which aims to engage and empower communities in addressing health-related challenges 1 . However, the limited focus on regional, rural and remote community’s points to a significant gap in the research. Rural populations often face distinct health challenges, including higher obesity rates and limited access to resources and interventions 78 . Greater use of Photovoice methodology in these underserved regions could support the development of more inclusive and context sensitive obesity interventions. The reviewed studies primarily focused on minority groups, with African Americans and Indigenous populations prominently represented. This emphasis on minority groups is important, given these populations often face higher obesity rates and greater health disparities 79 . However, the limited range of ethnic groups represented in the current literature limits understanding of lived experience for people with obesity across the broader demographic spectrum, particularly for cultures outside of North America and Europe. In addition, two studies provide limited demographic data about participants; a reporting problem that reduces the transferability of findings and evaluations of inclusivity in Photovoice studies within obesity research. A recent systematic review 15 of 131 obesity clinical trials reports 40% do not report race or ethnicity, and 80% do not report socioeconomic status. Diversifying samples and improving reporting for future research would provide a more comprehensive picture of how obesity is experienced across diverse cultural backgrounds. Photovoice methodology is intended to be flexible to meet the needs of diverse communities, but the diverse approached identified in this review also have consequences for quality reporting. The majority of studies in this review used the SHOWeD framework to guide the application of the Photovoice technique, which is a higher proportion than reported in a qualitative review by Hergenrather et al 80 of studies focused on disability and community health soon after the emergence of this methodology. This aligns with Wang’s 1 recommendations, to use the process to support participatory analysis and social action. However, some researchers used other approaches to data collection, and so it is possible the framework is inappropriate in some circumstances 81 . The number and duration of data collection sessions varied widely between the studies, ranging from 2 to 8 sessions of 15 to 120 minutes long. While a lack of detail in methodological description was an exclusion criteria for this study, the variability within included studies is a barrier to comparison and synthesis. Methodological transparency is particularly important for evaluating participatory integrity in Photovoice studies. As a participatory research method, it emphasizes active participant involvement in documenting and representing their own lived experience. While journal word counts are a limitation 82 , detailed reporting is fundamental to evaluating the extent of participant engagement and agency practices within each study and therefore its credibility. For example; community-based participatory research affirms the importance of actively involving and acknowledging participants in the publication process 83 , and their images are often included in research publications. A lack of participant involvement in photograph selection raises ethical concerns which may not be explicitly acknowledged 84 . Reporting guidelines for community based participatory research have been available for over a decade 85 but appear to have limit effect on publication quality 86 . Given its distinctive characteristics, the co-production of guidelines specific to the Photovoice methodology with marginalized communities could improve both relevance and uptake. Beyond these issues, the findings of this review indicate Photovoice is a relevant and appropriate research methodology in obesity research. Some of the identified themes are reflect findings in existing research, such as the impacts of obesogenic environments 87 , 88 , stress and family responsibilities 89 , mental health and wellbeing 90 , weight stigma 91 – 93 and the built environment 94 – 96 on the lived experience of people with obesity. The themes within this review also build on previous findings about the role of culture 97 and socioeconomic status 98 . As such, they provide a new perspective on known issue and consolidate evidence about the importance of these issues to people with obesity. However, Photovoice still offers a unique and important contribution to obesity research, because it centres and amplifies the voices and lived experiences of people with obesity in a way that is deeply participatory and empowering. It addresses some important limitations of traditional research methods and provides visual context that enables a deeper understanding of contextual factors than words alone. The use of visual artefacts also provides more inclusive opportunities to participation, particularly in communities with low literacy rates or language diversity. Photovoice enables participants to shift from a position of ‘passive participant’ to ‘active advocate’, by providing opportunities for personal transformation and the sorts of informal communication pathways and resource exchanges that build trust and sustainable change 99 . Actively involvement of people with obesity in data generation and interpretation ensures findings are locally relevant and fosters collaborative (and preferably community led) problem solving 100 . Policy and environmental interventions tend to be more sustainable than program interventions 101 , and Photovoice is particularly well suited to their design. Therefore, the value of Photovoice to obesity research is not so much what it finds, but what it can do with the knowledge it generates. 4.1 Limitations and Future Directions While this review highlights the value of Photovoice to obesity research, identified gaps in the literature are limitations to its use. The scarcity of Photovoice studies involving people with obesity published since 2020 likely reflects the impact of COVID-19, which posed significant barriers to participatory research designs that typically rely on face-to-face interaction. Future research should explore virtual or hybrid format adaptations which enable meaningful engagement while maintaining methodological rigor. The currently limited geographical focus of this research limits its generalisability to diverse cultural and environmental settings, and Photovoice methodologies should be applied more broadly to currently underrepresented communities. Methodological variability in Photovoice studies, such as differences in camera equipment, session structures, and frameworks used, also limits cross-study comparability and synthesis. While flexibility is an advantage of Photovoice, standardised reporting guidelines could help improve methodological transparency and ensure rigorous documentation of participant agency and engagement. These steps will solidify Photovoice’s role in obesity research, maximizing its potential to capture lived experiences and drive impactful, community-informed solutions. Future studies could also explore the impact of Photovoice on participants themselves, by investigating how the process influences their sense of self-perception, community identity, and empowerment around managing obesity. This would provide evidence about the role of Photovoice as a transformative tool, beyond its data collection function, and guide its use as an intervention strategy in and of itself. Implementation and evaluative research on the policy and practice changes resulting from Photovoice research is also needed, to understand how actionable and sustainable their recommendations are, and describe the process of moving from participant to advocate. 5 CONCLUSIONS This scoping review affirms that Photovoice is a valuable methodology in obesity research, due to its capacity to provide unique insights into the lived experiences of people with obesity and fully engage with complex environmental, social, and cultural factors within context. 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Lachance LL, Quinn M, Kowalski-Dobson T. The Food & Fitness Community Partnerships: Results From 9 Years of Local Systems and Policy Changes to Increase Equitable Opportunities for Health. Health Promotion Practice . 2018;19:114S - 92S. Ochtera RD, Siemer CJ, Levine LT. Supporting Community-based Healthy Eating and Active Living Efforts in Sustaining Beyond the Funding Cycle. American journal of preventive medicine . 2018;54 5S2:S133-S138. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Process\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6736900/v1/934924a069ace50a991f195e.jpg"},{"id":83596515,"identity":"8a804f07-2a6a-490b-95e5-899ec4830339","added_by":"auto","created_at":"2025-05-29 08:02:14","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":171693,"visible":true,"origin":"","legend":"\u003cp\u003eNumber of Photovoice studies involving people with obesity\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-6736900/v1/c6b119c0ff4c087619d218ed.png"},{"id":83597284,"identity":"3278b07d-5178-4410-8b1f-7b581b3d5fcf","added_by":"auto","created_at":"2025-05-29 08:10:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1799239,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6736900/v1/030a60c3-7a50-4a4c-8248-6a3ac28267b4.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003ePhotovoice as a methodology in obesity research: A scoping review\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"1 INTRODUCTION","content":"\u003cp\u003ePhotovoice was first conceptualised in the mid-1990s as a community based, participatory action research methodology\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. It is centred around photographs taken by participants \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e while also incorporating narrative elements \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. In their seminal article introducing photovoice, Wang and Burris outlined three primary goals: (1) enabling people to document and reflect their community\u0026rsquo;s strengths and concerns, (2) fostering critical dialogue and knowledge sharing about significant community issues through group discussions of the photographs, and (3) reaching policymakers to advocate for change\u0026rdquo;\u003csup\u003e1(pp. 370)\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThis method was originally designed for use with marginalized and underrepresented groups. It is believed that using visual artefacts, Photovoice can reveal emotional and metaphoric insights that are not easily accessible through other qualitative methods\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. Photovoice may also produce more nuanced and richer data than traditional interviews\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e, because it does not rely solely on verbal and written data\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The visual images become symbolic representations of participants\u0026rsquo; lived experience, prompting them to critically reflect on the barriers they face, both individually and within their broader community, in ways that transcend the limitations of narrative alone\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e,\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003ePhotovoice aims to enable critical conversations about the challenges or barriers faced by marginalised and underrepresented communities, service as a foundation for active change. Its participatory approach involves participants at every stage of the research process, reflecting a democratic approach that seeks to capture both individual priorities and broader community dynamics\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e. Photovoice empowers participants to play a key role in raising awareness, enabling communities to influence decision makers and shape policies that genuinely reflect their needs\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eObesity has emerged as a critical public health concern, with substantial evidence highlighting its widespread impact on individuals and societies. Recent studies point to the global rise in obesity rates, emphasising its link to increased risk of chronic diseases such as type 2 diabetes, cardiovascular disorders, and certain cancers\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. The economic consequences of obesity are also significant, with rising healthcare costs driven by obesity-related illnesses and a corresponding decline in productivity\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe perceptions and preferences of people with obesity are underrepresented in global literature\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. For example, although research demonstrates variations in how interventions affect people with obesity compared to those with a normal BMI\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e, clinical trials continue to lack adequate representation of individuals with obesity\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e, resulting in limited inclusivity. This exclusionary trend restricts the generalisability of findings and hampers the development of evidence-based interventions tailored to the diverse needs of those with obesity. Stigmatisation and discrimination linked to obesity often discourage individuals from participating in studies due to fear of judgment or biased treatment\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. This social stigma is further reinforced by pervasive stereotypes and negative attitudes within society and healthcare settings\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Additionally, research infrastructure and recruitment methods may inadvertently contribute to the underrepresentation of individuals with obesity.\u003c/p\u003e \u003cp\u003eObesity stigma and discrimination are prevalent in many areas of life, including healthcare, employment, education and social relationships\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. Photovoice is therefore an appropriate and relevant research methodology for people with obesity, due to their status as a marginalized group. However, there have been no comprehensive reviews of its use with this group to understand its implementation and identify opportunities for further development. A deeper understanding of how Photovoice is applied in obesity research is needed to optimise its potential in this field.\u003c/p\u003e \u003cp\u003ePhotovoice studies do not typically address questions of effectiveness, causality or prevalence, which are the focus of systemic reviews. However, scoping reviews are well suited to synthesising diverse research, mapping existing evidence, clarifying concepts and identifying knowledge gaps\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. This scoping review aims to comprehensively examine the existing literature on the use of Photovoice methodology in studies involving people with obesity. Its objective is to describe the available studies, the contexts in which Photovoice is used, and the key findings for these studies.\u003c/p\u003e"},{"header":"2 METHODS","content":"\u003cp\u003eThis scoping review followed the Joanna Briggs Institute (JBI) guidelines for scoping reviews \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e and the Preferred Reporting Items for Systematic Reviews (PRISMA) Scoping Reviews extension (PRISMA-ScR)\u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e to ensure a systematic and replicable process\u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. The five stages outlined by Arksey and O'Malley \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e guided the methodological approach for this review. This scoping review protocol was registered at Open Science Framework on April 19th, 2024: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.17605/OSF.IO/P4RXM\u003c/span\u003e\u003cspan address=\"10.17605/OSF.IO/P4RXM\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Stage 1: Identification of the research question and the objectives\u003c/h2\u003e \u003cp\u003eThe primary question guiding this inquiry, analysis, and evidence consolidation was: \u0026lsquo;What are the characteristics of Photovoice studies involving people with obesity, and what key themes emerge from their findings?\u0026rsquo; The objective of this review was to guide future use of this research methodology in obesity research.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Stage 2: Identifying relevant studies.\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Data sources\u003c/h2\u003e \u003cp\u003eWe developed a search strategy in conjunction with a university librarian specialising in health research, to ensure its quality and rigour. Our search terms included keywords such as photovoice, photojournalism, photonarrative, photo elicitation, obes*, \u0026ldquo;weight loss\", \"weight gain\", overweight, \"over weight.\" From these keywords, we identified MeSH terms for database searches. The following databases was searched: Medline Complete, CINAHL, Global Health, Psycinfo, Social Work Abstracts, SocINDEX and Web of Science. Bibliographic software (EndNote) was used to store, organise, and manage all references. A draft search strategy for MEDLINE is available in Appendix 1 to demonstrate its application to this database\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2Inclusion criteria\u003c/h2\u003e \u003cp\u003e1) Primary research using Photovoice as a research method. 2) Studies providing description of the Photovoice process, including all phases of data collection and analysis. 3) Obesity is the focus of the study aim or research question. 4) Data is collected from people with lived experience of obesity 5) English, French or Portuguese language publication (languages spoken by the research team). 6) Peer reviewed publications. 7) Reports qualitative and/or quantitative empirical evidence 8) Published after 1st January 1997 (the year in which Photovoice first emerged).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.2.3 Exclusion Criteria\u003c/h2\u003e \u003cp\u003eDocuments were excluded based on the following criteria: 1) reporting secondary research only (i.e. reviews). 2) Studies in which Photovoice is used for pedagogical or health-promotion purposes rather than data collection. 3) Studies including people with obesity, but not directly addressing obesity in their aims or research questions. 4) Data not collected from people with lived experience of obesity 5) Languages other than English, French or Portuguese. 6) Non peer reviewed publications. 7) Non empirical forms of evidence such as review studies, theoretical articles and editorials. 8) Published before 1st January 1997.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Stage 3: Study selection\u003c/h2\u003e \u003cp\u003eTwo independent reviewers assessed all articles using the Covidence platform\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e according to the specified inclusion and exclusion criteria. Covidence automatically removed all duplicates upon upload. Before formal screening, the reviewers screened a small set of studies together to ensure consistency. Articles were first screened based on titles and abstracts, before progressed to full text review. The reasons for excluding full text articles were recorded. Any conflicts were discussed and resolved by the reviewers with notes justifying their decision. As no unresolved disagreements arose, a third reviewer was not required. The reference lists of all studies included after the full text review were screened for additional studies, but no further references were identified through the Connected Papers platform\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. A PRISMA diagram illustrating the article selection process is presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Stage 4: Data extraction and charting\u003c/h2\u003e \u003cp\u003eData from articles meeting the inclusion criteria were extracted through Covidence based upon the Joanna Briggs Institute manual for data extraction\u003csup\u003e\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e,\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e. The initial version of the form was created by the first author and then shared with the broader research team for consultation and revision. The form systematically captures essential information from the included studies, such as authors, study year, objectives, geographic location, study population characteristics, sample size, study design, results, and key findings relevant to the review question and objectives. The extraction form can be found in Appendix II.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Stage 5: Collating, summarizing, and reporting\u003c/h2\u003e \u003cp\u003eThe characteristics of included articles were summarized using descriptive statistics, primarily frequencies. Key themes from the findings were synthesized using descriptive qualitative analysis, identifying themes and comparing them across studies. All findings are illustrated and discussed in the results section below.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 RESULTS","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n \u003ch2\u003e3.1 Search results\u003c/h2\u003e\n \u003cp\u003eThe reviewers found 229 records from database searches. Following the elimination of duplicates and screening of titles, abstracts, and full texts, 27 records were included in this scoping review. Detailed information regarding the selection process and reasons for excluding articles are outlined in Fig. \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n \u003ch2\u003e3.2 Characteristics of Photovoice Studies\u003c/h2\u003e\n \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e\n \u003ch2\u003e3.2.1 Geographical Location\u003c/h2\u003e\n \u003cp\u003eAll included studies were conducted in the Global North, with the majority completed in the United States of America (n\u0026thinsp;=\u0026thinsp;22) (see Table\u0026nbsp;1). The remaining studies were conducted in Canada (n\u0026thinsp;=\u0026thinsp;2), Ireland (n\u0026thinsp;=\u0026thinsp;1), and England (n\u0026thinsp;=\u0026thinsp;1).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eTable 1: Study Characteristics\u0026nbsp;\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst Author\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy Location\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSetting\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy Aims\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026amp; /or\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample Size\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;Majority Gender\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSample\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristics\u003csup\u003e*\u003c/sup\u003e\u003c/strong\u003e\u003cstrong\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFindings\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBalvanz\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural community\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo assess contextual determinants of childhood obesity, create a community action plan, and report actions taken with a community-based organisation and a university.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAdolescents (specific age n/r)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Three themes: access to healthy food, social support, and community disorder.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Youth were effective collaborators in identifying obesity factors and significantly contributed to developing and implementing obesity strategies with adult community stakeholders.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBanik\u003csup\u003e3\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePoland\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural and urban\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ecommunities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo investigate adolescents\u0026apos; critical awareness of local community policies for obesity prevention.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=41\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 90%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 to 18 years (\u003cem\u003eM\u003c/em\u003e 17,\u003cem\u003e\u0026nbsp;SD\u003c/em\u003e 0.8).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePolish (n=41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Obesity prevention policies focused on food environments and healthy diets. Adolescents were three times more likely to perceive a lack of such policies than notice existing, active policies.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBateman\u003csup\u003e4\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore social determinants of obesity as perceived by residents in two segregated, low-income communities.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eTo understand residents\u0026apos; views on obesity-contributing factors and effective interventions in their communities.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=59\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 73%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21 years to 90 years old (\u003cem\u003eM\u003c/em\u003e 53, \u003cem\u003eSD\u003c/em\u003e 16)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLocation A: African American (n=3), American (n=3)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLocation B: African American (n=3), American (n=1)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Root determinants: Equity and social justice, linked to racial segregation and unmet market needs.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Underlying determinants: Neighbourhood conditions, community development, employment, social cohesion.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Proximal determinants: Convenience, cost, time, cooking skills and cultural norms.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBreland\u003csup\u003e5\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCommunity (unspecified location)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo understand the factors influencing variable weight loss outcomes for veterans.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=9\u003c/p\u003e\n \u003cp\u003eMale 78%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e42 to 69 years (\u003cem\u003eM\u003c/em\u003e 58)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNine veterans who self-identified as Black or African American\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Three key themes: Food in our lives and health care, body image, and healthcare bias and discrimination.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCorty\u003csup\u003e6\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore community factors that influence healthy childhood weight and understand participant insights on the photovoice process.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=8\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 88%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAged\u0026nbsp;\u0026sup3;\u0026nbsp;16 years\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHispanic North American (n=8).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Community barriers and facilitators to healthy weight: Including family habits, cultural influences on food, built environment and food marketing\u003c/p\u003e\n \u003cp\u003e\u0026middot; Participant motivations for Photovoice: Including desire to learn about health, personal growth from group sharing, pride in representing their community and empowerment as role models\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCueva\u003csup\u003e7\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore youth perspectives on community-based obesity prevention, emphasizing cultural connectedness and traditional foods revival.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=44\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale 52%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 to 11 years old\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNative North American Indian (n=44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Traditional foods are cultivated through farming or gardening and are\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; perceived as healthy.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Stores offering less nutrient dense food are considered unhealthy.\u003c/p\u003e\n \u003cp\u003e\u0026middot; The theme \u0026quot;Feast for the Future\u0026quot; fosters positive cultural connections and a hope for increased farming and gardening for future generations.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFarrell\u003csup\u003e8\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIreland\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCommunity (unspecified location)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo examine the impact of the COVID-19 pandemic and associated stay-at-home orders on adults with obesity.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=15\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 53%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge n/r\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eIrish (n=15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; The pandemic and stay-at-home orders had varying health and wellbeing effects, which changed over time. Some experienced positive outcomes while others faced negative consequences.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Felt stigmatised and isolated after being labeled \u0026apos;at risk\u0026rsquo; and marginalised by social attitudes from public health messaging about obesity.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFindholt\u003csup\u003e9\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003cp\u003ecommunity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo gathering insights on community assets and barriers impacting rural youths\u0026rsquo; physical activity and dietary habits.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=6\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 67%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 to 18 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAmerican (n=6)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Environmental influences on activity and diet included structural features, natural surroundings, economic conditions, community norms, and obesity related policies.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; These factors acted as either barriers or enablers.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHackett\u003csup\u003e10\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003ecommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore assets and barriers to nutrition and physical activity in an underserved, majority-minority suburban community.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=9\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 56%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 to 17 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=8), Hispanic North American (n=1).\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Key challenges: Limited access to fresh, nutritious food and safe spaces for physical activity.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Recognised need for policy reform and active civic involvement in change.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHomer\u003csup\u003e11\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUK\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003ecommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore experiences of individuals seeking bariatric surgery and identify implications for behavioural and self-management interventions.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=18\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 78%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 to 61 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eEthnicity n/r\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Three themes: Negative experiences of obesity, Experience of weight management services, and expectations of normality.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eJennings\u003csup\u003e12\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003ecommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore cultural health perspectives of food-insecure, transitionally housed Indigenous children\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=18 (n=10 completed project)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale 60% (completed project)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 to 12 years old\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003en=6 boys, 4 girls\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNative North American Indian n=10)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Healthy themes: Nutrition, gardening, relationships, food sovereignty, water quality, natural and built environments.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Unhealthy themes: Cumulative stress, food insecurity, access and cost issues, screen time, smoking, violence.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eJohnson\u003csup\u003e13\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHospital\u003c/p\u003e\n \u003cp\u003e(unspecified location)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore explore bariatric patients\u0026apos; journeys, from pre-surgery to post-surgery experiences\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=15\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 73%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e37 to 65 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHispanic or Latino (n=5)\u003c/p\u003e\n \u003cp\u003eNot Hispanic or Latino (n=10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Key themes: perceptions of beauty based on race/ethnicity; adherence to gender norms; dealing with comorbidities; depression / disordered eating; discrimination due to obesity; and financial challenges to adherence.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMaley\u003csup\u003e14\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003cp\u003eCommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo understand rural community perspectives on how built, natural, and social environments influence food choices and physical activity behaviours.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=27\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGender % n/r\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 to 80 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003en=2 female, 3 male (others unreported)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=2), American (n=3), Other participants were American women (n=25)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Obesity is both an individual and collective issue\u003c/p\u003e\n \u003cp\u003e\u0026middot; Participants observed conflicts between desired behaviours and community values/environmental conditions.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Existing models don\u0026rsquo;t address the relationship between social, built, and natural environments.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMcFatrich\u003csup\u003e15\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003eCommunity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo use photovoice, a community-based participatory research tool to gain insights into the perspectives of African American faith leaders regarding the factors influencing childhood obesity within their communities.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=5\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 100%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAfrican American\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Faith leaders focused on modelling positive behaviours and meeting family needs. However, parenting demands often led to a cycle of stress, which in turn contributed to unhealthy behaviours.\u003c/p\u003e\n \u003cp\u003e\u0026middot; External opinions on parenting created pressure to meet ideal standards, and their fear of appearing vulnerable led faith leaders hesitant to seek help.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNabors\u003csup\u003e16\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCommunity (unspecified location)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThis study aimed to evaluate the effectiveness of a healthy eating intervention in after-school programs and document observed changes in eating behaviour.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=42\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eStudy 1 (n=30)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale 63%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eStudy 2 (n=12)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 50%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStudy 1:\u003c/p\u003e\n \u003cp\u003e8 years to 11 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(\u003cem\u003eM\u003c/em\u003e 9, \u003cem\u003eSD\u003c/em\u003e 0.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=4), American (n=22), Asian American (n=1), Native North American Indian (n=2), Hispanic North American (n=1).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eStudy 2\u003c/p\u003e\n \u003cp\u003e8 years to 10 years old (\u003cem\u003eM\u003c/em\u003e 9, \u003cem\u003eSD\u003c/em\u003e 0.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=1), American (n=11)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Two key themes: Changing or improving diet for healthy eating and helping my family to eat more healthy foods.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNecheles\u003csup\u003e17\u003c/sup\u003e \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo identifying factors influencing youth health behaviours and support the development of health advocacy projects.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=13\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 85%\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13 to 17 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=9), Asian American (n=1), Mexican (n=3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Key themes: unhealthy eating, stress, friendships, emotions, environment, health, positive family dynamics.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Advocacy targeted unhealthy eating and stress through social marketing.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Obesity focus initiated a new community based participatory research project within the local school district.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNichols\u003csup\u003e18\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCommunity (unspecified location)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo identify social ecological barriers and supports for healthy weight management in an underserved community of the parents of adolescents with obesity in a weight management program\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=24\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 54%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAdolescent / parent dyads (n=12)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAdolescents: 12 to 16 years (\u003cem\u003eM\u003c/em\u003e 13.5)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=11)\u003c/p\u003e\n \u003cp\u003eAmerican (n-1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eParental age and ethnicity n/r\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Individual: Influenced by knowledge, beliefs, values, genetics, race, ethnicity, SES. Personal temptation and food or activity choices were barriers.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Interpersonal: Parents (positive and negative influence), time with grandparents, and dynamics in divorced or single parent homes.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Community: Neighbourhood safety levels (including urban decay, gangs and crime)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Organisational: Limited free public programs, private programs are costly.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNieuwendyk\u003csup\u003e19\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural and urban communities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore perceptions of how micro- and macro-level community environmental factors impact physical activity and healthy eating, identifying key elements of obesogenic environments and suitable local interventions.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=35\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 74%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMajority aged\u0026nbsp;\u0026sup3;\u0026nbsp;35 years\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eEthnicity n/r\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Participants viewed health in a broad context, including \u0026quot;community social health.\u0026quot;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Microenvironment influences were frequently discussed, but macroenvironment was mentioned less\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photovoice visually showed community partners and decision-makers how macroenvironmental forces can limit healthy choices.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOates\u003csup\u003e20\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore community perspectives on obesity in two urban areas and investigating grassroots solutions to address obesity.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=59\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLocation A: African American Female 70.6%\u003c/p\u003e\n \u003cp\u003eWhile Female 66.7%\u003c/p\u003e\n \u003cp\u003eLocation B:\u003c/p\u003e\n \u003cp\u003eAfrican American Female 76.5%\u003c/p\u003e\n \u003cp\u003eWhite Female 71.4%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003cp\u003eLocation A: African American (\u003cem\u003eM\u003c/em\u003e 49, \u003cem\u003eSD\u003c/em\u003e 12), American (\u003cem\u003eM\u003c/em\u003e 53, \u003cem\u003eSD\u003c/em\u003e 18).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eLocation B: African American (\u003cem\u003eM\u0026nbsp;\u003c/em\u003e55, \u003cem\u003eSD\u003c/em\u003e 11), American (\u003cem\u003eM\u003c/em\u003e 57, \u003cem\u003eSD\u003c/em\u003e 25)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=34), American (n=25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Main barriers to healthy weight were restaurants, physical activity limitations and food store access.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Recommended solutions included individual efforts, peer support, education for children and adults and community advocacy.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRosado\u003csup\u003e21\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRural community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore environmental and social determinants of childhood obesity as perceived by rural migrant farm workers.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=13\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 85%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e 40 years.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHispanic North American (n=13).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eParents of 30 children (\u003cem\u003eM\u003c/em\u003e 10 years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Themes addressed the impact of built and social environments on diet, physical activity, and consequently, health and weight status.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSackett\u003csup\u003e22\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore adolescent girls\u0026apos; views on environmental factors in childhood obesity and outline implications for counsellor advocacy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14 to 17 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAmerican (n=7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDivided into two groups based on location\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Shared Themes: ease and convenience, money and SES, freedom and pride.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Two groups also had unique themes suggesting influence of local context - Ignorance, addiction, will and motivation, time (Location A); advertisement (Location B)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTorres\u003csup\u003e23\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003ecommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo identify barriers and opportunities influencing physical activity for Latino children and propose policy changes, from the perspective of mothers.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=12\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 100%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e25 to 30 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eGuatemalan (n=1)\u003c/p\u003e\n \u003cp\u003eMexican (n=11)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7 years USA residency (mean)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Generally positive perceptions of neighbourhoods\u003c/p\u003e\n \u003cp\u003e\u0026middot; Barriers to physical activity: \u0026nbsp;transportation limitations, language barriers, lack of awareness of school programs, and anti-immigration discrimination.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Suggested improvements: healthier family diets, better public park equipment, community sidewalks, and increased police presence.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVan Oss\u003csup\u003e24\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo raise adolescent awareness of positive and negative influences on dietary and physical activity behaviours and explore perceptions of physicians\u0026apos; roles in shaping these behaviours.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=7\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 86%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13 to 19 years\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e(\u003cem\u003eM\u003c/em\u003e 16)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=4), Asian American (n=1), Hispanic North American (n=2).\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Barriers to healthy eating: Family influences on food choices and high cost of healthy foods\u003c/p\u003e\n \u003cp\u003e\u0026middot; Barriers to physical activity: Academic pressures and unsafe neighbourhoods\u003c/p\u003e\n \u003cp\u003e\u0026middot; Healthy eating strategies: Portion control and moderation\u003c/p\u003e\n \u003cp\u003e\u0026middot; Physical activity strategies: Enjoyable activities and social supports\u003c/p\u003e\n \u003cp\u003e\u0026middot; Other influences: Role of physicians and physical education teachers, along with a desire for more personalised and culturally aware healthcare\u003c/p\u003e\n \u003cp\u003e\u0026middot; Study participation increased their awareness of health behaviours, with some making positive behaviour changes.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWatts\u003csup\u003e25\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCanada\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore factors perceived to hinder or support healthy eating in the home environment among overweight/obese adolescents.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=22\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 77%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e 14 years (\u003cem\u003eSD\u003c/em\u003e 1.9)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eParental ethnicity:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eWhite (n=12)\u003c/p\u003e\n \u003cp\u003eNonwhite (n=10)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Six themes in order of frequency: home cooking; availability and accessibility of foods/beverages; parenting practices; family modelling, celebrations; and screen use and studying\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWeinstein\u003csup\u003e26\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eUrban community\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo investigate social and structural factors influencing weight loss in collaboration with people with serious mental illness and overweight/obesity involved in a lifestyle program in supported housing.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=8\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMale 75%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eM\u003c/em\u003e 56 years (\u003cem\u003eSD\u003c/em\u003e 6.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=5), American (n=3)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Structural barriers included prevalence of low-quality food, costly transportation, financial limitations, food pantry constraints, easy availability of tobacco and alcohol products, and limited exercise opportunities.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWoolford\u003csup\u003e27\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCommunity (unspecified location)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore images that adolescents with obesity find supportive for their weight loss efforts\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=23\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 78%\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13 to 19 years\u003c/p\u003e\n \u003cp\u003e(\u003cem\u003eM\u003c/em\u003e 14)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eArab American (n=3), African American (n=7), American (n=10), Hispanic North American (n=2), Native North American Indian (n=1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Participants rated Photovoice highly, noting that selecting pictures encouraged reflection on their weight loss journey.\u003c/p\u003e\n \u003cp\u003e\u0026middot; They believed a mobile intervention with personal images would enhance adherence.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos often featured family and friends, highlighting their essential role in motivation and support.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eXiao\u003csup\u003e28\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eUSA\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCommunity\u003c/p\u003e\n \u003cp\u003e(unspecified location)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTo explore perceptions of obesity and overweight conditions among African American women and identify influencing factors.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en=18\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFemale 100%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cem\u003eM\u0026nbsp;\u003c/em\u003e35 years (\u003cem\u003eSD\u0026nbsp;\u003c/em\u003e7)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfrican American (n=18)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; \u0026quot;The Weight of a Black Neighbourhood\u0026quot; referred to challenges in maintaining healthy habits in their neighbourhoods.\u003c/p\u003e\n \u003cp\u003e\u0026middot; \u0026quot;Cultural Ties\u0026quot; described preferences for high-carbohydrate, salty, and fatty foods and difficulties changing cultural dietary habits.\u003c/p\u003e\n \u003cp\u003e\u0026middot; \u0026quot;Weight is Just a Number\u0026rdquo; referred to their personal views on the significance of weight.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003eNote: * = Based upon the Australian Standard Classification of Cultural and Ethnic Groups (ASCCEG)\u003csup\u003e1\u003c/sup\u003e as per reported ethnicity. \u003cem\u003eM\u003c/em\u003e = mean, n/r = not reported, \u003cem\u003eSD\u003c/em\u003e = standard deviation, SES = Socio-Economic Status. UK = United Kingdom. USA = United States of America.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Australian Bureau of Statistics. Australian Standard Classification of Cultural and Ethnic Groups (ASCCEG). 2019; https://www.abs.gov.au/statistics/classifications/australian-standard-classification-cultural-and-ethnic-groups-ascceg/latest-release#data-downloads.\u003c/p\u003e\n \u003cp\u003e2.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Balvanz P, Dodgen L, Quinn J, Holloway T, Hudspeth S, Eng E. From Voice to Choice: African American Youth Examine Childhood Obesity in Rural North Carolina. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2016;10(2):293-303.\u003c/p\u003e\n \u003cp\u003e3.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Banik A, Knai C, Klepp K-I, et al. What policies are there and what policies are missing? A Photovoice study of adolescents\u0026apos; perspectives on obesity-prevention policies in their local environment. \u003cem\u003eObesity reviews : an official journal of the International Association for the Study of Obesity.\u0026nbsp;\u003c/em\u003e2023;24 Suppl 2:e13617.\u003c/p\u003e\n \u003cp\u003e4.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Bateman LB, Simoni ZR, Oates GR, Hansen B, Fouad MN. Using photovoice to explore social determinants of obesity in two underserved communities in the southeast. \u003cem\u003eSociological spectrum : the official journal of the Mid-South Sociological Association.\u0026nbsp;\u003c/em\u003e2019;39(6):405-423.\u003c/p\u003e\n \u003cp\u003e5.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Breland JY, Tanksley L, Sr., Borowitz MA, et al. Black Veterans Experiences with and Recommendations for Improving Weight-Related Health Care: A Photovoice Study. \u003cem\u003eJournal of general internal medicine.\u0026nbsp;\u003c/em\u003e2024.\u003c/p\u003e\n \u003cp\u003e6.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Corty EW, Charite JL, Ugochukwu A, et al. \u0026quot;The First Step to Changing Something\u0026quot;: Addressing Latinx Childhood Obesity through Photovoice. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2022;16(3):307-320.\u003c/p\u003e\n \u003cp\u003e7.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Cueva K, Speakman K, Neault N, et al. Cultural connectedness as obesity prevention: Indigenous youth perspectives on geast for the guture. \u003cem\u003eJournal of Nutrition, Education and Behaviour.\u0026nbsp;\u003c/em\u003e2020;52(6):632-639.\u003c/p\u003e\n \u003cp\u003e8.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Farrell E, Hollmann E, Roux CL, Nadglowski J, McGillicuddy D. At home and at risk: The experiences of Irish adults living with obesity during the COVID-19 pandemic. \u003cem\u003eEClinicalMedicine.\u0026nbsp;\u003c/em\u003e2022;51:101568.\u003c/p\u003e\n \u003cp\u003e9.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Findholt NE, Michael YL, Davis MM. Photovoice engages rural youth in childhood obesity prevention. \u003cem\u003ePublic health nursing (Boston, Mass).\u0026nbsp;\u003c/em\u003e2011;28(2):186-192.\u003c/p\u003e\n \u003cp\u003e10.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Hackett M, Gillens- Eromosele C, Dixon J. Examining childhood obesity and the environment of a segregated, lower-income US suburb. \u003cem\u003eInternational Journal of Human Rights in Healthcare.\u0026nbsp;\u003c/em\u003e2015;8(4):247-259.\u003c/p\u003e\n \u003cp\u003e11.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Homer CV, Tod AM, Thompson AR, Allmark P, Goyder E. Expectations and patients\u0026apos; experiences of obesity prior to bariatric surgery: a qualitative study. \u003cem\u003eBMJ open.\u0026nbsp;\u003c/em\u003e2016;6(2):e009389.\u003c/p\u003e\n \u003cp\u003e12.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Jennings DR, Paul K, Little MM, Olson D, Johnson-Jennings MD. Identifying Perspectives About Health to Orient Obesity Intervention Among Urban, Transitionally Housed Indigenous Children. \u003cem\u003eQualitative health research.\u0026nbsp;\u003c/em\u003e2020;30(6):894-905.\u003c/p\u003e\n \u003cp\u003e13.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Johnson LP, Asigbee FM, Crowell R, Negrini A. Pre-surgical, surgical and post-surgical experiences of weight loss surgery patients: a closer look at social determinants of health. \u003cem\u003eClinical obesity.\u0026nbsp;\u003c/em\u003e2018;8(4):265-274.\u003c/p\u003e\n \u003cp\u003e14.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Maley M, Warren BS, Devine CM. Perceptions of the environment for eating and exercise in a rural community. \u003cem\u003eJournal of nutrition education and behavior.\u0026nbsp;\u003c/em\u003e2010;42(3):185-191.\u003c/p\u003e\n \u003cp\u003e15.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;McFatrich M, Weinhold A, Riggins L, et al. Faithful five: exploring African American faith leaders\u0026apos; perspectives on factors affecting childhood obesity. \u003cem\u003eFamily \u0026amp; community health.\u0026nbsp;\u003c/em\u003e2013;36(4):338-349.\u003c/p\u003e\n \u003cp\u003e16.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Nabors L, Murphy MJ, Lusky C, Young C-J, Sanger K. Using Photovoice to Improve Healthy Eating for Children Participating in an Obesity Prevention Program. \u003cem\u003eGlobal pediatric health.\u0026nbsp;\u003c/em\u003e2020;7:2333794X20954673.\u003c/p\u003e\n \u003cp\u003e17.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Necheles JW, Chung EQ, Hawes-Dawson J, et al. The Teen Photovoice Project: a pilot study to promote health through advocacy. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2007;1(3):221-229.\u003c/p\u003e\n \u003cp\u003e18.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Nichols M, Nemeth LS, Magwood G, Odulana A, Newman S. Exploring the Contextual Factors of Adolescent Obesity in an Underserved Population Through Photovoice. \u003cem\u003eFamily \u0026amp; community health.\u0026nbsp;\u003c/em\u003e2016;39(4):301-309.\u003c/p\u003e\n \u003cp\u003e19.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Nieuwendyk LM, Belon AP, Vallianatos H, et al. How perceptions of community environment influence health behaviours: using the Analysis Grid for Environments Linked to Obesity Framework as a mechanism for exploration. \u003cem\u003eHealth promotion and chronic disease prevention in Canada : research, policy and practice.\u0026nbsp;\u003c/em\u003e2016;36(9):175-184.\u003c/p\u003e\n \u003cp\u003e20.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Oates GR, Phillips JM, Bateman LB, Baskin ML, Fouad MN, Scarinci IC. Determinants of Obesity in Two Urban Communities: Perceptions and Community-Driven Solutions. \u003cem\u003eEthnicity \u0026amp; disease.\u0026nbsp;\u003c/em\u003e2018;28(1):33-42.\u003c/p\u003e\n \u003cp\u003e21.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Rosado JI, Rivera A, Fernandez T. Perceived Role of Built and Social Environments on Childhood Obesity: A PhotoVoice Approach With Latino Migrant Farmworking Families. \u003cem\u003eFamily \u0026amp; community health.\u0026nbsp;\u003c/em\u003e2020;43(3):221-228.\u003c/p\u003e\n \u003cp\u003e22.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Sackett CR, Granberg EM, Jenkins AM. An Exploration of Adolescent Girls\u0026apos; Perspectives of Childhood Obesity Through Photovoice: A Call for Counselor Advocacy. \u003cem\u003eThe Journal of Humanistic Counseling.\u0026nbsp;\u003c/em\u003e2016;55(3):215-233.\u003c/p\u003e\n \u003cp\u003e23.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Torres ME, Meetze EG, Smithwick-Leone J. Latina voices in childhood obesity: a pilot study using Photovoice in South Carolina. \u003cem\u003eAmerican journal of preventive medicine.\u0026nbsp;\u003c/em\u003e2013;44(3 Suppl 3):S225-S231.\u003c/p\u003e\n \u003cp\u003e24.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Van Oss K, Leung MM, Sharkey Buckley J, Wilson-Taylor M. Voices through cameras: Learning about the experiences and challenges of minority government-insured overweight and obese New York City adolescents using photovoice. \u003cem\u003eJournal of Communication in Healthcare.\u0026nbsp;\u003c/em\u003e2014;7(4):262-271.\u003c/p\u003e\n \u003cp\u003e25.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Watts AW, Lovato CY, Barr SI, Hanning RM, M\u0026acirc;sse LC. Experiences of overweight/obese adolescents in navigating their home food environment. \u003cem\u003ePublic health nutrition.\u0026nbsp;\u003c/em\u003e2015;18(18):3278-3286.\u003c/p\u003e\n \u003cp\u003e26.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Weinstein LC, Chilton M, Turchi R, et al. Reaching for a Healthier Lifestyle: A Photovoice Investigation of Healthy Living in People with Serious Mental Illness. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2019;13(4):371-383.\u003c/p\u003e\n \u003cp\u003e27.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Woolford SJ, Khan S, Barr KLC, Clark SJ, Strecher VJ, Resnicow K. A picture may be worth a thousand texts: obese adolescents\u0026apos; perspectives on a modified photovoice activity to aid weight loss. \u003cem\u003eChildhood obesity (Print).\u0026nbsp;\u003c/em\u003e2012;8(3):230-236.\u003c/p\u003e\n \u003cp\u003e28.\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;Xiao Z, Brown R. Using photovoice to understand perceptions of obesity among African-American women. \u003cem\u003eJournal of Human Behavior in the Social Environment.\u0026nbsp;\u003c/em\u003e2021;31(6):751-770.\u003c/p\u003e\n \u003cp\u003eAll but one of the studies were carried out in community settings, while one took place in a hospital\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e (see Table 2). Community studies were conducted in urban\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e, rural\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e, and suburban areas\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e\u003c/sup\u003e. Two spanned both rural and urban settings\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e, however six studies\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e did not describe their geographical location.\u003c/p\u003e\n \u003cp\u003eTable 2: Photovoice Methodologies of Included Studies\u0026nbsp;\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"left\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFirst Author\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eYear\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSession Number \u0026amp; Duration Per Session\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSHOWeD Utilised\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEquipment*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of Photos (Instructed, Taken \u0026amp; Analysed)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhotos Published\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBalvanz\u003csup\u003e1\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 sessions.\u003c/p\u003e\n \u003cp\u003e90 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (type of camera n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBanik\u003csup\u003e2\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDuration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmartphone or camera (type of camera n/r)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions: Up to 6 photos showing either the presence (n=3) or absence (n=3) of healthy eating or physical activity initiatives.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=222)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=213)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBateman\u003csup\u003e3\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e90 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (disposable)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions: 3\u0026ndash;4 pictures per day for 7 days.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=96)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBreland\u003csup\u003e4\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e85 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en/r\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCorty\u003csup\u003e5\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e90 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmartphones\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCueva\u003csup\u003e6\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8-9 sessions per group.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDuration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (adapted)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions: \u0026nbsp;At least 3 photos for each of 14 guiding questions\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFarrell\u003csup\u003e7\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhotovoice used alongside phenomenological interviews\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 session.\u003c/p\u003e\n \u003cp\u003eUp to 120 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions: 3\u0026ndash;4 pictures per day for 7 days.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=5 per participant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFindholt\u003csup\u003e8\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhotovoice used alongside other unspecified research methods.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e180 mins. (Sessions 1-3) and 60 mins. (Session 4)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (adapted)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHackett\u003csup\u003e9\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10 sessions.\u003c/p\u003e\n \u003cp\u003e60-120 mins.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmartphones or flip video cameras\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=78)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHomer\u003csup\u003e10\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhotovoice used alongside descriptive qualitative interviews\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eDuration n/r.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en/r\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eJennings\u003csup\u003e11\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 sessions (1 interview, 1 group discussion.\u003c/p\u003e\n \u003cp\u003eDuration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (type of camera n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=400)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eJohnson\u003csup\u003e12\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 sessions. \u0026nbsp; \u0026nbsp; Duration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (digital)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=150 approx.)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMaley\u003csup\u003e13\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhotovoice used alongside qualitative interviews and focus groups\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 interview.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60 mins.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1 focus group.\u003c/p\u003e\n \u003cp\u003e30 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (adapted)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=113)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=17-34 approx.)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMcFatrich\u003csup\u003e14\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 sessions.\u003c/p\u003e\n \u003cp\u003e90 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNabors\u003csup\u003e15\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhotovoice used alongside surveys.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 sessions. \u0026nbsp; \u0026nbsp; Duration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (adapted)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNecheles\u003csup\u003e16\u003c/sup\u003e \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePhotovoice used alongside a skills building program.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 sessions.\u003c/p\u003e\n \u003cp\u003e120 mins.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCameras (digital), plus memory card, photo-editing software, USB cable and photo album\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=3,500)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=130)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNichols\u003csup\u003e17\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 session per participant.\u003c/p\u003e\n \u003cp\u003eDuration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (digital)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=590)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=72-120 approx.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNieuwendyk\u003csup\u003e18\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 sessions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e60-90 mins.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (digital)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=average 13 per participant)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOates\u003csup\u003e19\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 sessions.\u003c/p\u003e\n \u003cp\u003e90 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions: 3 to 4 pictures per day for 7 days\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=1,600)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=174 discussion, n=96 focus group)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRosado\u003csup\u003e20\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 sessions\u003c/p\u003e\n \u003cp\u003eDuration n/r\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n=182)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=49)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSackett\u003csup\u003e21\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2016\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 sessions. Duration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes (adapted)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (disposable)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=15-25 approx.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTorres\u003csup\u003e22\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2013\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 sessions.\u003c/p\u003e\n \u003cp\u003e90 mins.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (type of camera n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=24-36 approx.)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVan Oss\u003csup\u003e23\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 sessions. Duration n/r.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmartphone or camera (digital)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions: \u0026nbsp;Minimum of 5 photos to be taken.\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWatts\u003csup\u003e24\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2015\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 session.\u003c/p\u003e\n \u003cp\u003e15 mins.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (digital)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=105)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWeinstein\u003csup\u003e25\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2019\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4-7 sessions. Duration n/r.\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eCamera (digital)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n=33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWoolford\u003csup\u003e26\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 session. 15-25 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSmartphone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eXiao\u003csup\u003e27\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e2021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStandalone Photovoice method\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 sessions. 60 mins.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en/r\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026middot; Instructions (n/r)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos taken (n/r)\u003c/p\u003e\n \u003cp\u003e\u0026middot; Photos analysed (n/r)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eNote: * Smartphones were participant provided, while cameras were researcher provided. approx. = approximately. n/r = not reported. mins. = minutes. \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e1. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Balvanz P, Dodgen L, Quinn J, Holloway T, Hudspeth S, Eng E. From Voice to Choice: African American Youth Examine Childhood Obesity in Rural North Carolina. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2016;10(2):293-303.\u003c/p\u003e\n \u003cp\u003e2. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Banik A, Knai C, Klepp K-I, et al. What policies are there and what policies are missing? A Photovoice study of adolescents\u0026apos; perspectives on obesity-prevention policies in their local environment. \u003cem\u003eObesity reviews : an official journal of the International Association for the Study of Obesity.\u0026nbsp;\u003c/em\u003e2023;24 Suppl 2:e13617.\u003c/p\u003e\n \u003cp\u003e3. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Bateman LB, Simoni ZR, Oates GR, Hansen B, Fouad MN. Using photovoice to explore social determinants of obesity in two underserved communities in the southeast. \u003cem\u003eSociological spectrum : the official journal of the Mid-South Sociological Association.\u0026nbsp;\u003c/em\u003e2019;39(6):405-423.\u003c/p\u003e\n \u003cp\u003e4. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Breland JY, Tanksley L, Sr., Borowitz MA, et al. Black Veterans Experiences with and Recommendations for Improving Weight-Related Health Care: A Photovoice Study. \u003cem\u003eJournal of general internal medicine.\u0026nbsp;\u003c/em\u003e2024.\u003c/p\u003e\n \u003cp\u003e5. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Corty EW, Charite JL, Ugochukwu A, et al. \u0026quot;The First Step to Changing Something\u0026quot;: Addressing Latinx Childhood Obesity through Photovoice. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2022;16(3):307-320.\u003c/p\u003e\n \u003cp\u003e6. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Cueva K, Speakman K, Neault N, et al. Cultural connectedness as obesity prevention: Indigenous youth perspectives on geast for the guture. \u003cem\u003eJournal of Nutrition, Education and Behaviour.\u0026nbsp;\u003c/em\u003e2020;52(6):632-639.\u003c/p\u003e\n \u003cp\u003e7. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Farrell E, Hollmann E, Roux CL, Nadglowski J, McGillicuddy D. At home and at risk: The experiences of Irish adults living with obesity during the COVID-19 pandemic. \u003cem\u003eEClinicalMedicine.\u0026nbsp;\u003c/em\u003e2022;51:101568.\u003c/p\u003e\n \u003cp\u003e8. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Findholt NE, Michael YL, Davis MM. Photovoice engages rural youth in childhood obesity prevention. \u003cem\u003ePublic health nursing (Boston, Mass).\u0026nbsp;\u003c/em\u003e2011;28(2):186-192.\u003c/p\u003e\n \u003cp\u003e9. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Hackett M, Gillens- Eromosele C, Dixon J. Examining childhood obesity and the environment of a segregated, lower-income US suburb. \u003cem\u003eInternational Journal of Human Rights in Healthcare.\u0026nbsp;\u003c/em\u003e2015;8(4):247-259.\u003c/p\u003e\n \u003cp\u003e10. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Homer CV, Tod AM, Thompson AR, Allmark P, Goyder E. Expectations and patients\u0026apos; experiences of obesity prior to bariatric surgery: a qualitative study. \u003cem\u003eBMJ open.\u0026nbsp;\u003c/em\u003e2016;6(2):e009389.\u003c/p\u003e\n \u003cp\u003e11. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Jennings DR, Paul K, Little MM, Olson D, Johnson-Jennings MD. Identifying Perspectives About Health to Orient Obesity Intervention Among Urban, Transitionally Housed Indigenous Children. \u003cem\u003eQualitative health research.\u0026nbsp;\u003c/em\u003e2020;30(6):894-905.\u003c/p\u003e\n \u003cp\u003e12. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Johnson LP, Asigbee FM, Crowell R, Negrini A. Pre-surgical, surgical and post-surgical experiences of weight loss surgery patients: a closer look at social determinants of health. \u003cem\u003eClinical obesity.\u0026nbsp;\u003c/em\u003e2018;8(4):265-274.\u003c/p\u003e\n \u003cp\u003e13. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Maley M, Warren BS, Devine CM. Perceptions of the environment for eating and exercise in a rural community. \u003cem\u003eJournal of nutrition education and behavior.\u0026nbsp;\u003c/em\u003e2010;42(3):185-191.\u003c/p\u003e\n \u003cp\u003e14. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;McFatrich M, Weinhold A, Riggins L, et al. Faithful five: exploring African American faith leaders\u0026apos; perspectives on factors affecting childhood obesity. \u003cem\u003eFamily \u0026amp; community health.\u0026nbsp;\u003c/em\u003e2013;36(4):338-349.\u003c/p\u003e\n \u003cp\u003e15. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Nabors L, Murphy MJ, Lusky C, Young C-J, Sanger K. Using Photovoice to Improve Healthy Eating for Children Participating in an Obesity Prevention Program. \u003cem\u003eGlobal pediatric health.\u0026nbsp;\u003c/em\u003e2020;7:2333794X20954673.\u003c/p\u003e\n \u003cp\u003e16. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Necheles JW, Chung EQ, Hawes-Dawson J, et al. The Teen Photovoice Project: a pilot study to promote health through advocacy. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2007;1(3):221-229.\u003c/p\u003e\n \u003cp\u003e17. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Nichols M, Nemeth LS, Magwood G, Odulana A, Newman S. Exploring the Contextual Factors of Adolescent Obesity in an Underserved Population Through Photovoice. \u003cem\u003eFamily \u0026amp; community health.\u0026nbsp;\u003c/em\u003e2016;39(4):301-309.\u003c/p\u003e\n \u003cp\u003e18. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Nieuwendyk LM, Belon AP, Vallianatos H, et al. How perceptions of community environment influence health behaviours: using the Analysis Grid for Environments Linked to Obesity Framework as a mechanism for exploration. \u003cem\u003eHealth promotion and chronic disease prevention in Canada : research, policy and practice.\u0026nbsp;\u003c/em\u003e2016;36(9):175-184.\u003c/p\u003e\n \u003cp\u003e19. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Oates GR, Phillips JM, Bateman LB, Baskin ML, Fouad MN, Scarinci IC. Determinants of Obesity in Two Urban Communities: Perceptions and Community-Driven Solutions. \u003cem\u003eEthnicity \u0026amp; disease.\u0026nbsp;\u003c/em\u003e2018;28(1):33-42.\u003c/p\u003e\n \u003cp\u003e20. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Rosado JI, Rivera A, Fernandez T. Perceived Role of Built and Social Environments on Childhood Obesity: A PhotoVoice Approach With Latino Migrant Farmworking Families. \u003cem\u003eFamily \u0026amp; community health.\u0026nbsp;\u003c/em\u003e2020;43(3):221-228.\u003c/p\u003e\n \u003cp\u003e21. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Sackett CR, Granberg EM, Jenkins AM. An Exploration of Adolescent Girls\u0026apos; Perspectives of Childhood Obesity Through Photovoice: A Call for Counselor Advocacy. \u003cem\u003eThe Journal of Humanistic Counseling.\u0026nbsp;\u003c/em\u003e2016;55(3):215-233.\u003c/p\u003e\n \u003cp\u003e22. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Torres ME, Meetze EG, Smithwick-Leone J. Latina voices in childhood obesity: a pilot study using Photovoice in South Carolina. \u003cem\u003eAmerican journal of preventive medicine.\u0026nbsp;\u003c/em\u003e2013;44(3 Suppl 3):S225-S231.\u003c/p\u003e\n \u003cp\u003e23. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Van Oss K, Leung MM, Sharkey Buckley J, Wilson-Taylor M. Voices through cameras: Learning about the experiences and challenges of minority government-insured overweight and obese New York City adolescents using photovoice. \u003cem\u003eJournal of Communication in Healthcare.\u0026nbsp;\u003c/em\u003e2014;7(4):262-271.\u003c/p\u003e\n \u003cp\u003e24. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Watts AW, Lovato CY, Barr SI, Hanning RM, M\u0026acirc;sse LC. Experiences of overweight/obese adolescents in navigating their home food environment. \u003cem\u003ePublic health nutrition.\u0026nbsp;\u003c/em\u003e2015;18(18):3278-3286.\u003c/p\u003e\n \u003cp\u003e25. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Weinstein LC, Chilton M, Turchi R, et al. Reaching for a Healthier Lifestyle: A Photovoice Investigation of Healthy Living in People with Serious Mental Illness. \u003cem\u003eProgress in community health partnerships : research, education, and action.\u0026nbsp;\u003c/em\u003e2019;13(4):371-383.\u003c/p\u003e\n \u003cp\u003e26. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Woolford SJ, Khan S, Barr KLC, Clark SJ, Strecher VJ, Resnicow K. A picture may be worth a thousand texts: obese adolescents\u0026apos; perspectives on a modified photovoice activity to aid weight loss. \u003cem\u003eChildhood obesity (Print).\u0026nbsp;\u003c/em\u003e2012;8(3):230-236.\u003c/p\u003e\n \u003cp\u003e27. \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Xiao Z, Brown R. Using photovoice to understand perceptions of obesity among African-American women. \u003cem\u003eJournal of Human Behavior in the Social Environment.\u0026nbsp;\u003c/em\u003e2021;31(6):751-770.\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003eIn one study\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e, the gender of participants was not fully reported. However, for the remaining studies, all except four \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e had a female majority sample, and around half were completed with children or adolescents. Included studies were primarily conducted among ethnically minority groups, however two\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e\u003c/sup\u003e provided no information about the ethnicity profile of their sample (see Table 2). Four studies\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e focused solely on Black or African Americans, three studies\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e35\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e, two studies on Indigenous population in America\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. Few studies \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e recruited participants from two or more ethnic groups.\u003c/p\u003e\n \u003cp\u003eParticipant ages ranged from 9 to 90 years across the included studies, with twelve studies \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e reporting mean ages (from 9 to 58 years). The majority of studies (n\u0026thinsp;=\u0026thinsp;11, 58%) that reported age were with young people aged between 8 and 19 years.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\n \u003ch2\u003e3.3 Photovoice Methodology\u003c/h2\u003e\n \u003cp\u003eDigital\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e and disposable cameras\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e were most commonly utilised, and 13 studies\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e specified the number of photographs collected and analysed. Smartphone cameras were used relatively infrequently\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e and three studies gave no information about cameras in their photovoice research\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e. The number of data collections sessions in these sessions, both photography and interviews, ranged from 2 to 8. However, ten studies did not describe the duration of these sessions\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e, but when reported ranged from 15 to 120 minutes.\u003c/p\u003e\n \u003cp\u003eTo facilitate photo discussions, eleven studies\u003csup\u003e33\u0026ndash;35,40\u0026minus;42,44,47,48,54,56\u003c/sup\u003e employed the SHOWeD framework. This framework asks five questions: What do you \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eS\u003c/span\u003eee here? What is really \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eH\u003c/span\u003eappening? How does this relate to \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eO\u003c/span\u003eur lives? \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eW\u003c/span\u003ehy does this situation exist? What can we \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003eD\u003c/span\u003eo about it? Five other studies\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e49\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e adapted the SHOWeD framework. Most (n\u0026thinsp;=\u0026thinsp;17, 63%) of the studies included participant photographs in their subsequent publications\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e54\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cdiv id=\"Sec16\" class=\"Section3\"\u003e\n \u003ch2\u003e3.3.1 Photovoice Studies Over Time\u003c/h2\u003e\n \u003cp\u003eFew Photovoice studies involving people with obesity were published prior to 2016, as shown in Fig. \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec17\" class=\"Section3\"\u003e\n \u003ch2\u003e3.3.2 Study Aims and Objectives\u003c/h2\u003e\n \u003cp\u003eThe aims and or objectives of included studies (Table\u0026nbsp;1) covered a wide range of topics related to obesity research. Youth and adolescent engagement were a common focus, which involved identifying factors influencing health behaviors, promoting health advocacy, and exploring adolescents\u0026apos; perceptions and experiences with obesity\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e45\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e59\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e. Community perspectives were also investigated, relating to assets, barriers, and environmental factors affecting health behaviours, along with community-specific aspects related to obesity\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e40\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e51\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e62\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e\u003c/sup\u003e. Cultural, social, and economic determinants of obesity \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e, the development and evaluation health interventions and policy \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e39\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003eand the use of photovoice as a methodology was also the focus of multiple studies \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e43\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e47\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e50\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e53\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e55\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec18\" class=\"Section3\"\u003e\n \u003ch2\u003e3.3.3 Key Themes in Existing Studies\u003c/h2\u003e\n \u003cp\u003eFour key themes were identified in the findings of included studies; environmental influences; facilitators and barriers to healthy living and eating; mental health and wellbeing; and perceptions of obesity. Findings related to multiple themes were evident in many studies, indicating their close and interconnected relationships.\u003c/p\u003e\n \u003cp\u003eThe impact of features in built, natural and economic environments were explored across studies with children, adolescents and adults \u003csup\u003e37,45,46,48,51,60\u0026ndash;62,64\u0026minus;69\u003c/sup\u003e. Built and natural environments were described as having the potential to both help or hinder physical activity, depending on factors such as available green spaces, transportation limitations, perceived safety and the presence of fast-food outlets. However, economic environments were consistently considered a barrier to healthy eating, with some disadvantaged communities living in \u0026lsquo;food deserts\u0026rsquo; with limited access to affordable nutritious food. Their presence in Photovoice studies suggests that obesogenic (and health promoting) environments are perceived as an important issue by marginalized communities but may also reflect the visual nature of the research methodology.\u003c/p\u003e\n \u003cp\u003eSeveral studies explored other facilitators and barriers to health eating and physical activity, including social, cultural and political influences. Relationships with parents, family, friends and peers were all identified as potential facilitators through the modelling of good habits and opportunities for communal activity \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e38\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e\u003c/sup\u003e. However, these social influences (or social isolation) could also lead people to unhealthy eating and sedentary habits and therefore contribute to obesity. More broadly, experiencing a sense of community and access to community-based programs provided structured opportunities for guidance, physical activities, and shared experiences. These communal aspects of the study findings are also closely related to the build and natural environmental theme.\u003c/p\u003e\n \u003cp\u003eCultural identity and the challenges of changing related dietary habits were also examined \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e65\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e70\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e71\u003c/span\u003e\u003c/sup\u003e. Some cultural preferences were for foods high in carbohydrates, salt, or fats, which are at odds with dietary recommendations related to obesity prevention. Social gatherings and celebrations also often centre around unhealthy eating, such as large family meals or festive \u0026lsquo;treats\u0026rsquo;. Changing these habits may therefore challenge a persons cherished cultural identity and meet with resistance from their family or social circles. Cultural expectations related to physical activity were also identified, which may be inhibited by community values or be encouraged to express identity. Language barriers and discrimination may prevent culturally diverse people with obesity from accessing health programs and community infrastructure which could help them manage their obesity. However, traditional food cultivation practices through farming or gardening can support healthy lifestyles while also maintaining connection to culture\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\n \u003cp\u003eSeveral changes and improvements were recommended by participants to address the barriers they identified in their communities \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e,\u003cspan class=\"CitationRef\"\u003e69\u003c/span\u003e\u0026ndash;\u003cspan class=\"CitationRef\"\u003e72\u003c/span\u003e\u003c/sup\u003e. Many of the recommendations addressed common themes and structural issues identified in the literature, for example eliminating \u0026lsquo;food deserts\u0026rsquo;, enhancing community recreational infrastructure, improving food and exercise affordability and increasing green spaces. A collaborative approach using participatory methods such as community action plans was preferred in underserved communities, along with the tailoring of interventions to local cultural and socioeconomic contexts. However, participants acknowledge and desired structural and sustained transformation to tackle the issues they identified.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec19\" class=\"Section3\"\u003e\n \u003ch2\u003e3.3.4 Mental Health and Wellbeing\u003c/h2\u003e\n \u003cp\u003eA small number of studies explicitly addressed the influence of mental health and wellbeing but strongly emphasized the importance of these factors to the experiences of people with obesity. Two studies explored the link between stress, family responsibilities, unhealthy eating and low levels of physical activity. People with obesity experiencing social and familial described the challenges these factors posed to maintaining healthy lifestyles. McFatrich et al.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e63\u003c/span\u003e\u003c/sup\u003e found that stress from parenting responsibilities and societal expectations around this role contributed to unhealthy behaviours for African Americans. Similarly, Nichols et al.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e64\u003c/span\u003e\u003c/sup\u003e reported that adolescents and their parents experienced stressful family dynamics and economic challenges, both of which had a negative influence on dietary choices and activity levels. As such, multiple psychosocial factors were perceived to be a higher priority or demand by people with obesity than prioritising their personal health.\u003c/p\u003e\n \u003cp\u003eTwo further studies explored the connection between obesity and clinical comorbidities like depression and disordered eating. Structural barriers (such as limited access to healthy food and opportunities to exercise), play a role in exacerbating mental health problems for people with serious psychiatric conditions, consequently increasing their risk of obesity \u003csup\u003e\u003cspan class=\"CitationRef\"\u003e67\u003c/span\u003e\u003c/sup\u003e. For people receiving bariatric surgery, Johnson et al.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e (2018) report that depression, disordered eating, and weight stigma also create a cyclical relationship between poor mental health and sustained obesity.\u003c/p\u003e\n \u003c/div\u003e\n \u003cdiv id=\"Sec20\" class=\"Section3\"\u003e\n \u003ch2\u003e3.3.5 Perceptions and Experiences\u003c/h2\u003e\n \u003cp\u003eAt both the individual and community level, negative perceptions of obesity interact with (and potentially amplify) other perceptions of disadvantage in the lived experiences of marginalised people with obesity. In a study by Van Oss et al.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e adolescents described weight as \u0026ldquo;just a number\u0026rdquo; but were also aware of societal expectations around being a healthy weight. African American women also perceived community influences and expectations as a key driver of their problems with body image and weight management\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e56\u003c/span\u003e\u003c/sup\u003e. People undergoing bariatric surgery also described their experiences of discrimination and societal disapproval, which had a significant impact on their self-perception and efforts to manage their obesity\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\n \u003cp\u003eFinally, two studies specifically commented on the empowering effects of the Photovoice process when collecting lived experience data. Corty et al.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e found their participants valued Photovoice as a tool for personal growth, community representation, and motivation for health advocacy. Similarly, Necheles et al.\u003csup\u003e\u003cspan class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e reported their participants appreciated the platform provided by Photovoice for self-reflection and advocacy, and its ability to foster both individual and collective awareness. In both cases, Photovoice was perceived as a way for marginalized participants to share their experience and actively contribute to positive change in their community.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e"},{"header":"4 DISCUSSION","content":"\u003cp\u003eThis scoping review synthesised the findings of 27 Photovoice studies conducted with individuals experiencing obesity, predominantly in Western countries, with a notable concentration in North America. This geographical concentration is consistent with previous research that highlights the prevalence of obesity-related studies in these regions due to higher obesity rates and greater research funding availability\u003csup\u003e\u003cspan additionalcitationids=\"CR74\" citationid=\"CR73\" class=\"CitationRef\"\u003e73\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR75\" class=\"CitationRef\"\u003e75\u003c/span\u003e\u003c/sup\u003e. Key themes reported in the findings of these studies included the impact of environmental influences, facilitators and barriers to healthy living, mental health and well-being, and perceptions of obesity. These themes reflect the complex interplay of social, cultural, and environmental factors on the lived experiences of people with obesity, particularly in community settings. By highlighting these themes, this scoping review synthesizes the evidence for applying Photovoice methodology to obesity research. It also highlights its potential for capturing complex and nuanced influences on lived experience and promoting a participatory approach to meaningful collaboration with marginalized communities.\u003c/p\u003e \u003cp\u003eThis community focus aligns with the participatory nature of Photovoice, which aims to engage and empower communities in addressing health issues\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. Urban settings dominated the community studies, reflecting the urban-centric nature of public health research, where urban populations often face unique health challenges and have greater access to research initiatives\u003csup\u003e\u003cspan citationid=\"CR76\" class=\"CitationRef\"\u003e76\u003c/span\u003e,\u003cspan citationid=\"CR77\" class=\"CitationRef\"\u003e77\u003c/span\u003e\u003c/sup\u003e. The limited number of studies in rural settings indicates a need for more research in these areas, where obesity rates can be high, but resources and interventions are often lacking\u003csup\u003e\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eNotably, most studies were conducted in community settings, with only one taking place in a clinical setting. This emphasis on community settings complements the participatory nature of Photovoice, which aims to engage and empower communities in addressing health-related challenges\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. However, the limited focus on regional, rural and remote community\u0026rsquo;s points to a significant gap in the research. Rural populations often face distinct health challenges, including higher obesity rates and limited access to resources and interventions\u003csup\u003e\u003cspan citationid=\"CR78\" class=\"CitationRef\"\u003e78\u003c/span\u003e\u003c/sup\u003e. Greater use of Photovoice methodology in these underserved regions could support the development of more inclusive and context sensitive obesity interventions.\u003c/p\u003e \u003cp\u003eThe reviewed studies primarily focused on minority groups, with African Americans and Indigenous populations prominently represented. This emphasis on minority groups is important, given these populations often face higher obesity rates and greater health disparities\u003csup\u003e\u003cspan citationid=\"CR79\" class=\"CitationRef\"\u003e79\u003c/span\u003e\u003c/sup\u003e. However, the limited range of ethnic groups represented in the current literature limits understanding of lived experience for people with obesity across the broader demographic spectrum, particularly for cultures outside of North America and Europe. In addition, two studies provide limited demographic data about participants; a reporting problem that reduces the transferability of findings and evaluations of inclusivity in Photovoice studies within obesity research. A recent systematic review\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e of 131 obesity clinical trials reports 40% do not report race or ethnicity, and 80% do not report socioeconomic status. Diversifying samples and improving reporting for future research would provide a more comprehensive picture of how obesity is experienced across diverse cultural backgrounds.\u003c/p\u003e \u003cp\u003ePhotovoice methodology is intended to be flexible to meet the needs of diverse communities, but the diverse approached identified in this review also have consequences for quality reporting. The majority of studies in this review used the SHOWeD framework to guide the application of the Photovoice technique, which is a higher proportion than reported in a qualitative review by Hergenrather et al\u003csup\u003e\u003cspan citationid=\"CR80\" class=\"CitationRef\"\u003e80\u003c/span\u003e\u003c/sup\u003e of studies focused on disability and community health soon after the emergence of this methodology. This aligns with Wang\u0026rsquo;s\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e recommendations, to use the process to support participatory analysis and social action. However, some researchers used other approaches to data collection, and so it is possible the framework is inappropriate in some circumstances\u003csup\u003e\u003cspan citationid=\"CR81\" class=\"CitationRef\"\u003e81\u003c/span\u003e\u003c/sup\u003e. The number and duration of data collection sessions varied widely between the studies, ranging from 2 to 8 sessions of 15 to 120 minutes long. While a lack of detail in methodological description was an exclusion criteria for this study, the variability within included studies is a barrier to comparison and synthesis.\u003c/p\u003e \u003cp\u003eMethodological transparency is particularly important for evaluating participatory integrity in Photovoice studies. As a participatory research method, it emphasizes active participant involvement in documenting and representing their own lived experience. While journal word counts are a limitation\u003csup\u003e\u003cspan citationid=\"CR82\" class=\"CitationRef\"\u003e82\u003c/span\u003e\u003c/sup\u003e, detailed reporting is fundamental to evaluating the extent of participant engagement and agency practices within each study and therefore its credibility. For example; community-based participatory research affirms the importance of actively involving and acknowledging participants in the publication process\u003csup\u003e\u003cspan citationid=\"CR83\" class=\"CitationRef\"\u003e83\u003c/span\u003e\u003c/sup\u003e, and their images are often included in research publications. A lack of participant involvement in photograph selection raises ethical concerns which may not be explicitly acknowledged\u003csup\u003e\u003cspan citationid=\"CR84\" class=\"CitationRef\"\u003e84\u003c/span\u003e\u003c/sup\u003e. Reporting guidelines for community based participatory research have been available for over a decade\u003csup\u003e\u003cspan citationid=\"CR85\" class=\"CitationRef\"\u003e85\u003c/span\u003e\u003c/sup\u003e but appear to have limit effect on publication quality\u003csup\u003e\u003cspan citationid=\"CR86\" class=\"CitationRef\"\u003e86\u003c/span\u003e\u003c/sup\u003e. Given its distinctive characteristics, the co-production of guidelines specific to the Photovoice methodology with marginalized communities could improve both relevance and uptake.\u003c/p\u003e \u003cp\u003eBeyond these issues, the findings of this review indicate Photovoice is a relevant and appropriate research methodology in obesity research. Some of the identified themes are reflect findings in existing research, such as the impacts of obesogenic environments\u003csup\u003e\u003cspan citationid=\"CR87\" class=\"CitationRef\"\u003e87\u003c/span\u003e,\u003cspan citationid=\"CR88\" class=\"CitationRef\"\u003e88\u003c/span\u003e\u003c/sup\u003e, stress and family responsibilities\u003csup\u003e\u003cspan citationid=\"CR89\" class=\"CitationRef\"\u003e89\u003c/span\u003e\u003c/sup\u003e, mental health and wellbeing\u003csup\u003e\u003cspan citationid=\"CR90\" class=\"CitationRef\"\u003e90\u003c/span\u003e\u003c/sup\u003e, weight stigma\u003csup\u003e\u003cspan additionalcitationids=\"CR92\" citationid=\"CR91\" class=\"CitationRef\"\u003e91\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR93\" class=\"CitationRef\"\u003e93\u003c/span\u003e\u003c/sup\u003e and the built environment\u003csup\u003e\u003cspan additionalcitationids=\"CR95\" citationid=\"CR94\" class=\"CitationRef\"\u003e94\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR96\" class=\"CitationRef\"\u003e96\u003c/span\u003e\u003c/sup\u003e on the lived experience of people with obesity. The themes within this review also build on previous findings about the role of culture\u003csup\u003e\u003cspan citationid=\"CR97\" class=\"CitationRef\"\u003e97\u003c/span\u003e\u003c/sup\u003e and socioeconomic status\u003csup\u003e\u003cspan citationid=\"CR98\" class=\"CitationRef\"\u003e98\u003c/span\u003e\u003c/sup\u003e. As such, they provide a new perspective on known issue and consolidate evidence about the importance of these issues to people with obesity.\u003c/p\u003e \u003cp\u003eHowever, Photovoice still offers a unique and important contribution to obesity research, because it centres and amplifies the voices and lived experiences of people with obesity in a way that is deeply participatory and empowering. It addresses some important limitations of traditional research methods and provides visual context that enables a deeper understanding of contextual factors than words alone. The use of visual artefacts also provides more inclusive opportunities to participation, particularly in communities with low literacy rates or language diversity. Photovoice enables participants to shift from a position of \u0026lsquo;passive participant\u0026rsquo; to \u0026lsquo;active advocate\u0026rsquo;, by providing opportunities for personal transformation and the sorts of informal communication pathways and resource exchanges that build trust and sustainable change\u003csup\u003e\u003cspan citationid=\"CR99\" class=\"CitationRef\"\u003e99\u003c/span\u003e\u003c/sup\u003e. Actively involvement of people with obesity in data generation and interpretation ensures findings are locally relevant and fosters collaborative (and preferably community led) problem solving\u003csup\u003e\u003cspan citationid=\"CR100\" class=\"CitationRef\"\u003e100\u003c/span\u003e\u003c/sup\u003e. Policy and environmental interventions tend to be more sustainable than program interventions\u003csup\u003e\u003cspan citationid=\"CR101\" class=\"CitationRef\"\u003e101\u003c/span\u003e\u003c/sup\u003e, and Photovoice is particularly well suited to their design. Therefore, the value of Photovoice to obesity research is not so much what it finds, but what it can do with the knowledge it generates.\u003c/p\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e4.1 Limitations and Future Directions\u003c/h2\u003e \u003cp\u003eWhile this review highlights the value of Photovoice to obesity research, identified gaps in the literature are limitations to its use. The scarcity of Photovoice studies involving people with obesity published since 2020 likely reflects the impact of COVID-19, which posed significant barriers to participatory research designs that typically rely on face-to-face interaction. Future research should explore virtual or hybrid format adaptations which enable meaningful engagement while maintaining methodological rigor. The currently limited geographical focus of this research limits its generalisability to diverse cultural and environmental settings, and Photovoice methodologies should be applied more broadly to currently underrepresented communities.\u003c/p\u003e \u003cp\u003eMethodological variability in Photovoice studies, such as differences in camera equipment, session structures, and frameworks used, also limits cross-study comparability and synthesis. While flexibility is an advantage of Photovoice, standardised reporting guidelines could help improve methodological transparency and ensure rigorous documentation of participant agency and engagement. These steps will solidify Photovoice\u0026rsquo;s role in obesity research, maximizing its potential to capture lived experiences and drive impactful, community-informed solutions.\u003c/p\u003e \u003cp\u003eFuture studies could also explore the impact of Photovoice on participants themselves, by investigating how the process influences their sense of self-perception, community identity, and empowerment around managing obesity. This would provide evidence about the role of Photovoice as a transformative tool, beyond its data collection function, and guide its use as an intervention strategy in and of itself. Implementation and evaluative research on the policy and practice changes resulting from Photovoice research is also needed, to understand how actionable and sustainable their recommendations are, and describe the process of moving from participant to advocate.\u003c/p\u003e \u003c/div\u003e"},{"header":"5 CONCLUSIONS","content":"\u003cp\u003eThis scoping review affirms that Photovoice is a valuable methodology in obesity research, due to its capacity to provide unique insights into the lived experiences of people with obesity and fully engage with complex environmental, social, and cultural factors within context. Its participatory nature encourages a shift toward more inclusive, community-driven research, capable of informing policy and intervention strategies that are relevant, culturally sensitive, and sustainable. Future research leveraging Photovoice\u0026rsquo;s strengths will be critical for advancing equity-focused approaches to address obesity and empower those most affected by it.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e \u003cp\u003e This review of part of a larger project funded by Impact Obesity (ABN 65649953891)\u003c/p\u003e \u003cp\u003eKeywords: Photovoice, Obesity, obesity research, health inequities\u003c/p\u003e\u003ch2\u003eAcknowledgements:\u003c/h2\u003e \u003cp\u003ePotential conflicts of interest: There is no conflict of interest in this project\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWang C, Burris MA. Photovoice: Concept, Methodology, and Use for Participatory Needs Assessment. \u003cem\u003eHealth Education \u0026amp; Behavior\u003c/em\u003e. 1997/06/01 1997;24(3):369-387. doi:10.1177/109019819702400309\u003c/li\u003e\n\u003cli\u003eMcLaughlin J, Coleman-Fountain E. 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Rural\u0026ndash;Urban Differences in Overweight and Obesity, Physical Activity, and Food Security Among Children and Adolescents. \u003cem\u003ePrev Chronic Dis\u003c/em\u003e. 2023;20:230136. doi:http://dx.doi.org/10.5888/pcd20.230136.\u003c/li\u003e\n\u003cli\u003ePetersen R PL, Blanck HM. Racial and Ethnic Disparities in Adult Obesity in the United States: CDC\u0026rsquo;s Tracking to Inform State and Local Action. CDC. Accessed 18 June, 2024.\u003c/li\u003e\n\u003cli\u003eHergenrather KC, Rhodes SD, Cowan CA, Bardhoshi G, Pula S. Photovoice as community-based participatory research: a qualitative review. \u003cem\u003eAm J Health Behav\u003c/em\u003e. Nov-Dec 2009;33(6):686-98. doi:10.5993/ajhb.33.6.6\u003c/li\u003e\n\u003cli\u003eAbma TA, Schrijver J. \u0026lsquo;Are we famous or something?\u0026rsquo; Participatory Health Research with children using photovoice. \u003cem\u003eEducational Action Research\u003c/em\u003e. 2020/05/26 2020;28(3):405-426. doi:10.1080/09650792.2019.1627229\u003c/li\u003e\n\u003cli\u003eRoss PT, Bibler Zaidi NL. Limited by our limitations. \u003cem\u003ePerspect Med Educ\u003c/em\u003e. Aug 2019;8(4):261-264. doi:10.1007/s40037-019-00530-x\u003c/li\u003e\n\u003cli\u003eIsrael BA, Eng, E., Schulz, A. J., \u0026amp; Parker, E. A., . \u003cem\u003eMethods in community-based participatory research for health.\u003c/em\u003e First edition ed. John Wiley \u0026amp; Sons.; 2005.\u003c/li\u003e\n\u003cli\u003eEvans-Agnew RA, Rosemberg M-AS. 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Sep 2012;18(5):1172-87. doi:10.1016/j.healthplace.2012.05.006\u003c/li\u003e\n\u003cli\u003eLedbetter L, Neelis A. Beyond Policy: What Plants and Communities Can Teach us About Sustainable Changemaking. \u003cem\u003eCommunication Design Quarterly Review\u003c/em\u003e. 2023;11:21 - 27.\u003c/li\u003e\n\u003cli\u003eLachance LL, Quinn M, Kowalski-Dobson T. The Food \u0026amp; Fitness Community Partnerships: Results From 9 Years of Local Systems and Policy Changes to Increase Equitable Opportunities for Health. \u003cem\u003eHealth Promotion Practice\u003c/em\u003e. 2018;19:114S - 92S.\u003c/li\u003e\n\u003cli\u003eOchtera RD, Siemer CJ, Levine LT. Supporting Community-based Healthy Eating and Active Living Efforts in Sustaining Beyond the Funding Cycle. \u003cem\u003eAmerican journal of preventive medicine\u003c/em\u003e. 2018;54 5S2:S133-S138.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Deakin University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Photovoice, obesity, obesity research, health inequities","lastPublishedDoi":"10.21203/rs.3.rs-6736900/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6736900/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cb\u003eIntroduction\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePhotovoice is a community-based participatory research methodology that empowers participants to document and reflect on their lived experiences through photography. This scoping review examines the use of Photovoice in obesity research to explore the contexts in which it has been used, its application, and key themes in the literature to date.\u003c/p\u003e\u003cp\u003e\u003cb\u003eMethods\u003c/b\u003e\u003c/p\u003e \u003cp\u003e Following Joanna Briggs Institute guidelines, a systematic search was conducted in six databases, yielding 229 records, with 27 studies meeting the inclusion criteria. Key data, including study location, participant demographics, Photovoice methodology, and findings, were extracted and synthesized.\u003c/p\u003e\u003cp\u003e\u003cb\u003eResults\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMost studies were conducted in North America within community settings, predominantly with minority populations. Four key themes emerged: environmental influences, facilitators and barriers to healthy living, mental health and wellbeing, and perceptions of obesity. Although findings align with other research methodologies, Photovoice uniquely highlights participant voices and fosters critical community engagement.\u003c/p\u003e\u003cp\u003e\u003cb\u003eConclusion\u003c/b\u003e\u003c/p\u003e \u003cp\u003ePhotovoice is a valuable tool for obesity research, amplifying participant perspectives and contextual insights in ways more traditional methods may overlook. Future research should expand geographic and demographic diversity, adapt Photovoice for virtual formats to broaden its accessibility and explore its impact on participants and policy or practice change.\u003c/p\u003e","manuscriptTitle":"Photovoice as a methodology in obesity research: A scoping review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-29 08:02:09","doi":"10.21203/rs.3.rs-6736900/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ec72755a-ca48-4b1e-956a-3e7bbfcce5a0","owner":[],"postedDate":"May 29th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":48991725,"name":"Health Policy"}],"tags":[],"updatedAt":"2025-05-29T08:02:10+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-29 08:02:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6736900","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6736900","identity":"rs-6736900","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}