Using Photovoice as participatory action research to identify views and perceptions on health and well-being among a group of Burmese refugees resettled in Houston

The main purpose of this study was to understand the views and perceptions of health and well-being among a group of resettled Burmese refugees in Houston, Texas. People from Burma are among the largest number of relocated refugees in the state of Texas, yet relatively little is known about their health status. Through participatory action research and Photovoice, the study explores topics such as the resettlement process, their everyday challenges and what is needed to improve their livelihood from an ecological perspective. Increased attention focusing on these topics is important to consider for a better understanding of the resettlement experiences, the process of adjustment, and integration into American society, and advancing the nation’s health status.

The study employed qualitative research methods consistent with participatory action research, and convenience sampling for the identification of participants that fit the established inclusion criteria. The study was guided by empowerment theory and utilized a collaborative approach in viewing individuals as active participants and experts in their lives. Research participants were able to capture images that represent different aspects of health and well-being years after resettlement. Through an in-depth discussion via focus groups guided by the Principal Investigator (PI), an initial contextualization of information started to emerge. Data analysis included the transcription of audio recordings and the identification of emerging themes and categories. NVivo Pro 11 Computer Assisted Qualitative Data Analysis Software was utilized to classify, sort, and arrange unstructured data for the qualitative analysis. The thematic analysis followed the social constructivist approach and focused on adhering to “their own voices” and understanding “their own stories” to deconstruct complex data. Results indicated three emerging categories and a discourse on the role of community agencies in enhancing all systems that sustain health and well-being. The study discovered a pronounced need for systems that sustain family well-being and financial stability, safety, and preventive education and understanding health and health-related material. Additionally, the continuous role of community agencies was seen as crucial and included the inclusion of Burmese staff, identification of Burmese community leaders, as well as intentional and culturally sensitive outreach programs.