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Authors

Michael A. Mitchell, Office of Data Analysis, Research, and Evaluation, Allegheny County Department of Human Services, USA; Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, USAFollow
Daniel O. Hedayati, University of Pittsburgh School of Medicine, USAFollow
Keri L. Rodriguez, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, USA; University of Pittsburgh School of Medicine, USA; Veterans Engineering Resource Center, VA Pittsburgh Healthcare System, USA
Adam J. Gordon, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, USA; University of Pittsburgh School of Medicine, USA; VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, USA
Lauren M. Broyles, Center for Health Equity Research & Promotion, VA Pittsburgh Healthcare System; University of Pittsburgh School of Medicine, USA; VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, USAFollow
Gala True, VA South Central (VISN 16) Mental Illness Research, Education and Clinical Center, Southeast Louisiana Veterans Healthcare System, New Orleans, LA, USA; General Internal Medicine and Geriatrics, Tulane University School of Medicine, New Orleans, LA
Salva N. Balbale, Northwestern University Feinberg School of Medicine, Institute for Public Health and Medicine, Center for Education in Health Sciences, USA; Department of Veterans Affairs, Center for Evaluation of Practices and Experiences of Patient-Centered Care, USA
James W. Conley, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, USA; VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, USAFollow

Abstract

Participatory photography research methods have been used to successfully engage and collect in-depth information from individuals whose voices have been traditionally marginalized in clinical or research arenas. However, participatory photography methods can introduce unique challenges and considerations regarding study design, human subject protections, and other regulatory barriers, particularly with vulnerable patient populations and in highly regulated institutions. Practical guidance on navigating these complex, interrelated methodological, logistical, and ethical issues is limited. Using a case exemplar, we describe our experiences with the planning, refinement, and initiation of a research study that used photo-elicitation interviews to assess the healthcare experiences of homeless and marginally housed United States Veterans. We discuss practical issues and recommendations related to study design, logistical “pitfalls” during study execution, and ensuring human subjects protections in the context of a study with a highly vulnerable patient population taking place in a highly risk-averse research environment.

Keywords

Homeless Persons, Photography, Qualitative Research, Veterans, Veterans’ Health

Author Bio(s)

Michael Mitchell, MA is a qualitative analyst with the Office of Data Analysis, Research, and Evaluation, Allegheny County Department of Human Services, Pittsburgh, PA, and a former fellow in the VA's Interprofessional Advanced Fellowship in Addiction Treatment. Correspondence regarding this article can be addressed directly to: mike.mitchell@alleghenycounty.us.

Daniel Hedayati, BS is a medical student at the University of Pittsburgh School of Medicine. Correspondence regarding this article can also be addressed directly to: daniel@medstudent.pitt.edu.

Keri L. Rodriguez, PhD is a medical sociologist and Research Health Scientist at the Center for Health Equity Research and Promotion and the Veterans Engineering Resource Center, VA Pittsburgh Healthcare System. She is also an Assistant Professor of Medicine at the University of Pittsburgh.

Adam J. Gordon, MD, MPH is a physician and addiction health services researcher at the VA Pittsburgh Healthcare System and Professor of Medicine at the University of Pittsburgh School of Medicine. At the VA, he is Co-Director of the Pittsburgh site of the VA's Interprofessional Advanced Fellowship in Addiction Treatment.

Lauren M. Broyles, PhD, RN is an addiction health services researcher at the VA Pittsburgh Healthcare System and Assistant Professor of Medicine at the University of Pittsburgh. At the VA, she is Co-Director of the Pittsburgh site of the VA's Interprofessional Advanced Fellowship in Addiction Treatment. Correspondence regarding this article can also be addressed directly to: lauren.broyles@va.gov.

Gala True, PhD is an anthropologist and Research Health Scientist at the VISN 16 Mental Illness Research, Education and Clinical Center, Southeast Louisiana Veterans Healthcare System, and a Research Associate Professor at the Tulane University School of Medicine.

Salva Balbale, MPH is a Project Manager and Social Science Research Analyst at the Department of Veterans Affairs, Center for Evaluation of Practices and Experiences of Patient-Centered Care. She is also a doctoral student at Northwestern University.

James Conley, BA is a Study Coordinator at the Center for Health Equity Research and Promotion, and the VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System. Correspondence regarding this article can also be addressed directly to: james.conley@va.gov.

Acknowledgements

Disclaimer: The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government. Declaration of conflicting interests: All manuscript authors declare that there are no conflicts of interest (i.e., financial and personal relationships between themselves and others that might bias their work). Funding: This work was supported by a pilot research grant from VISN 4 Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System (PIs: Michael A. Mitchell, MA; Lauren M. Broyles, PhD, RN). This work was also supported by Department of Veterans Affairs, Health Services Research & Development (HSR&D) Service, locally initiated research funding (PI: Michael A. Mitchell, MA; 72-079). Finally, this work was supported by the Department of Veterans Affairs, Office of Academic Affiliations Advanced Fellowship Program in Addiction Treatment (Michael A. Mitchell, MA), a Career Development Award (CDA 10-014) from the Department of Veterans Affairs, Health Services Research & Development service (Lauren M. Broyles, PhD, RN) and with resources and facilities at the VA Pittsburgh Healthcare System, Pittsburgh, PA.

Publication Date

7-16-2016

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 License.

 

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