An Online Photovoice Study Designed by Researchers from Art and Social Work to Better Understand the Experience of Chronic Pain by Women of Color

In 1980s British feminist artist-photographer Jo Spence used phototherapy to challenge normative and medicalized constructions of the female cancer patient by documenting her illness and was then employed as a consultant by hospitals who, through her work, recognized the need to change physicians’ practices and attitudes, which objectified patients. Photovoice, a Community Based Participatory Design method where participants take photographs and combine them with short text narratives, is similar to Spence’s artistic method. It has been used widely in health and social work settings. Healthcare professionals are aware of the power of images as catalysts for meaning making in medical encounters with people in pain; as part of multidisciplinary analysis, because images can enhance a person’s sense of agency in relation to their pain, especially in clinical contexts. Photographs can also establish a common ground for discussing meaning, therefore Photovoice can make the hidden experience of pain visible through collaborative photo-texts. These are subsequently shared with other patients and healthcare workers to aid them in specialist consultations.  However, few studies have addressed gender and race-related health disparities in treating chronic pain. This paper draws on the authors’ study with twenty women of color who created photo-text works about their experiences living with and being treated for chronic pain. In this novel online Photovoice study, participants engaged with asynchronous videos created by an artist-professor about the meanings viewers make of a photograph, including how perspective, angle, and lighting can affect the viewer’s emotional response to photographs. Participants then deployed Photovoice through six synchronous sessions led by a social work professor with extensive experience designing and facilitating Photovoice studies. The resulting image-text works by study participants address health inequity and argue for health equity as a hallmark of social justice in healthcare by focusing on exposing and reducing healthcare disparities.