Among public health researchers, there is growing interest in film methods due to their ability to highlight subtleties in practices, capture emotions, engage hard-to-reach populations, and advocate for social change. Still, little is known about strengths and challenges associated with using film methods in public health. This review synthesizes peer-reviewed, public health research studies that apply film methods, and describes opportunities and challenges. Of the 3,431 identified articles, 20 met the inclusion criteria. Fifteen different film methods were found that offer numerous methodological strengths, including the ability to provide rich descriptions, capture emic perspectives, increase comfort in participation, empower participants, and be used for advocacy. Future studies may explore engaging participants throughout the entire research process and using visuals created in the study to communicate findings. Keeping in mind their challenges, film methods are long overdue in public health and provide unique opportunities to capture sensory data.
Filmmaking is a visual method that provides a unique opportunity for generating knowledge, but few studies have applied filmmaking in public health research. In this article, we introduce Collaborative Filmmaking as a public health research method, including a description of the six steps for implementation and an illustrative example from Nepal. Collaborative Filmmaking is an embodied, participatory, and visual research method in which participants are trained to create, analyze, and screen films to answer a research question. The method is useful for exploring sensitive health topics and providing nuanced insight into practices, relationships, and spaces that are difficult to capture using existing methods; however, its use requires close attention to ethical considerations. Building upon the trajectory of other visual and community-based research methods, Collaborative Filmmaking is valuable for gathering granular details and sensory data, co-analyzing data in partnership with participants, and producing participant-generated films that serve as powerful and authentic advocacy tools.
A magnitude 7.8 earthquake struck Nepal in 2015, followed by hundreds of aftershocks that led to physical destruction, loss, and negative mental health outcomes. Yet, in the days, months, and years following the disaster, numerous forms of community art rose from the rubble, such as urban murals, spoken word poetry, public dance performances, and sacred art. This study explored the relationship between community art and health, social cohesion, and community resilience in postearthquake Nepal. We utilized photography and audio recorders to capture 19 unique artworks/projects created in the aftermath of the earthquake and conducted in-depth interviews with 19 artists and/or experts about the relationship between art and health in postdisaster contexts. The 19 postearthquake artworks/projects ranged from contemporary paintings to Buddhist ritual dance and reflected the unique combination of the traditional and contemporary necessary for salvaging and restoring Nepali heritage. Findings revealed three key themes regarding linkages between art and mental health in the context of postearthquake Nepal. First, community art offers relief and is a mechanism for coping, through the creation or observation of art. Second, community art can be used as a means of communication, both as a tool for promoting connections and conversations in the community and by communicating messages of hope. Third, community art can promote community cohesion and ultimately serve as a tool to create physical and emotional safe spaces. Overall, there is promise for initiatives that engage artists and communities in arts-based initiatives following traumatic events, such as natural disasters, which can positively affect health. Funding support and development of partnerships with grassroots artists and creators should be promoted in health and development programming, especially for risk reduction and recovery after disasters.
Chhaupadi is a form of menstrual seclusion practiced in Nepal in which women and girls are isolated during their menstrual cycles and follow numerous restrictions. The tradition dates back centuries and can have serious physical and mental health consequences. While the practice was criminalized in 2017 with fines and jail time, this legislative action comes after more than a decade of legal history, from an initial ban in 2006, to declaring it a form of violence against women in 2009, and finally, its criminalization in 2017. Exploring levels of awareness regarding the 2017 chhaupadi criminalization, perceptions of the legal penalties, and whether or not criminalization will lead to behaviour change are imperative next steps for informing the development of evidence-based interventions targeting chhaupadi. In this qualitative investigation conducted in Kalikot district, six focus group discussions and 33 in-depth interviews were conducted with a total of 81 participants. School-going girls, girls who have dropped out of school before completing twelfth grade, mothers, fathers, teachers, health care providers, religious leaders, traditional healers, grandmothers and police participated in the study. The results indicate that criminalization is generally perceived as a positive step for initiating chhaupadi behaviour change, and one-third of participants expressed that they plan to change their behaviours after learning that chhaupadi is publishable with fines and/or jail time. However, accurate information about the criminal code is extremely low and therefore interventions ensuring communities and law enforcement are informed of the criminalization and associated penalties are urgently needed. In addition, even after its criminalization, chhaupadi behaviour change is anticipated to be gradual and is expected to require long-term interventions targeting social pressure associated with upholding the tradition and raising awareness via appropriate trainings, engaging the media, and beyond.
Racial/ethnic disparities in health behaviors and disease outcomes on the national level have persisted over time despite overall improvements in public health. To better understand the changes over time in racial/ethnic health disparities at the county level, we examined the Allegheny County Health Survey (ACHS) for Pittsburgh, PA and the surrounding area, which was conducted in 2009/2010 and 2015/2016 using random digit dialing of residents aged 18 and older. The prevalence rates and rate ratios at each time period were calculated using survey weights and general linear models. The change in prevalence over time was calculated using race-time interaction terms. The results showed a significant improvement in asthma, stroke, cholesterol, and fair or poor health disparities as well as persistent disparities in diabetes and hypertension after adjustment for socioeconomic factors. The change over time in the prevalence of fair or poor health in black compared to white respondents was significant, with absolute improvement of approximately 5% versus <1%, respectively (p = 0.01). These findings demonstrate that some disparities improved while others persist, noting the importance of monitoring the changes over time at the local health department level.
Community-engaged classrooms (CECs) offer many advantages to both students and community-based organizations by creating an environment that enriches student learning and contributes to meeting needs identified by the community. Students who are engaged with communities during their studies report that they learned to apply skills, develop networks, and increase their decision-making skills, confidence, professional portfolio, and ownership of projects. In this article, we report on a CEC model for a graduate-level course called “Overview of Health Communications” at the University of Pittsburgh’s Graduate School of Public Health, which has been sustained for nine semesters. This article outlines the approach for developing the CEC model, steps for implementing the course, course evaluation design, and results. We also present lessons learned from both the community organizations’ and students’ perspectives and recommendations to inform future CEC projects.
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