Identifying barriers and facilitators to nutrition and physical activity among public housing residents using photovoice

Background: Weight management is a national health priority for health disparity-facing populations. There is a paucity of literature examining perceptions of diet and physical activity behaviors for weight management among public housing residents. Photovoice is a qualitative technique in which participants take photographs to document and discuss personal, social, and environmental factors around a particular topic. Objectives: To use photovoice to identify facilitators and barriers to weight management, including diet and physical activity behaviors, among urban public housing residents. Methods: Four 2-hour sessions were held in each of four housing developments (16 total sessions). Participants were given three photo missions to take photographs of the meaning of health, facilitators, and barriers. Participants then discussed and wrote narratives of their most meaningful photographs. Results: The majority of participants (n = 28) were obese (60%), female (82%), and African American or Black (71%) residents. Qualitative analysis of the transcripts revealed multiple facilitators and barriers that influenced weight management at the individual (e.g., self-control), interpersonal (e.g., peer influence), and community (e.g., access) levels. Additional themes that were specific to the housing development level included built environment at the development, feelings of community support, the development tenant/resident task force, and living conditions. Conclusions: Findings revealed multiple facilitators and barriers to healthy eating, physical activity, and weight management among public housing residents with additional factors influencing health within the housing development. Photovoice was a feasible method to engage community members in discussions and may be useful to inform multilevel interventions.