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VA RESEARCH QUARTERLY UPDATE
This Issue: The Returning Veteran | Table of Contents: Winter 2018 | Download this issue

Noteworthy Publications

Helping homeless and marginally housed Veterans through photography


I'll refer to this as the 'track of health.' You might have some stops, some slowdowns, like a train may have to stop or slow down in certain places or certain situations. Just like your health, you may have something to slow you down … then you get healthy again. And you move on with your health.
"I'll refer to this as the 'track of health.' You might have some stops, some slowdowns, like a train may have to stop or slow down in certain places or certain situations. Just like your health, you may have something to slow you down … then you get healthy again. And you move on with your health." (Photo taken by a marginally housed, post-Vietnam era Veteran)

"I'll refer to this as the 'track of health.' You might have some stops, some slowdowns, like a train may have to stop or slow down in certain places or certain situations. Just like your health, you may have something to slow you down … then you get healthy again. And you move on with your health." (Photo taken by a marginally housed, post-Vietnam era Veteran)

A research team led by Dr. Keri L. Rodriguez with the Center for Health Equity Research and Promotion at the VA Pittsburgh Healthcare System examined the use of photography to help homeless or marginally housed Veterans express their feelings about their health. Most study participants said they felt positive about their experiences taking photographs.

There are different types of "homelessness," according to the National Health Care for the Homeless Council. A Veteran who is "marginally housed" could be sleeping temporarily on a friend's couch, with no permanent home of his own.

The researchers enrolled 20 homeless or marginally housed Veterans who were receiving health services through the Pittsburgh VA Homeless Patient Alignment Care Team (HPACT). The HPACT is a patient-centered medical home that provides both medical care and housing assistance for homeless Veterans. Study participants completed initial social and health questionnaires and were given digital cameras with photo-taking prompts. They were asked to take 15 to 20 photos on the topics of health and health-related behaviors.

After two weeks Veterans returned their photographs, which were then printed and used to facilitate 30- to 60-minute semi-structured interviews with the researchers on the subjects of health and healthy behaviors. The study participants were then instructed to take another set of photographs that illustrated health care quality and access.

Following completion of the interviews, Veterans were asked to take an exit survey that was designed to assess their overall experiences with the study and with taking photographs. Most participants agreed that taking the photographs was not difficult or time-consuming. Veterans indicated that they appreciated the opportunity to take photographs and to connect with the research staff. Many of the Veterans said the process of taking photographs prompted unexpected or intense emotions.

Visual-based research, like the method used in this study, is becoming popular among health-services researchers, according to Rodriguez and her colleagues. The combination of patient-generated photographs and interviews with researchers allows for a more intimate understanding of patient experiences. For homeless Veterans who are poor and disadvantaged, and who often have chronic pain, researchers say using photography allows them to have a voice by expressing themselves visually.

The study will be published in a future issue of the Patient Experience Journal. Previous work on the effectiveness of photo-elicitation interviewing in substance use recovery was published in the October–December 2017 issue of Substance Abuse.

*In 2015, the VA Pittsburgh Healthcare System highlighted a photo-narrative study that asked homeless Veterans to take photographs representing how they felt about their own health. To see the slideshow, view: "Photos Give 'Voice' to Homeless Veterans Health."  


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