Photovoice versus focus groups: a comparative study of qualitative health research techniques.

Objective: To compare, from an empirical point of view, the use of focus group and photovoice as we conducted two studies on food environment in neighbourhoods with different socio-economic profiles.

Method: The European project Heart Healthy Hoods studied the association between the physical and social environment of Madrid (Spain) and the cardiovascular health of its residents. Two ancillary studies were developed to further expand the study of urban health inequalities using focus group and photovoice.

Urban and social determinants of alcohol and tobacco consumption among adolescents in Madrid.

Objective: This study aims to describe the accessibility to and promotion of alcohol and tobacco around secondary schools in Madrid and its distribution in relation with area-level socioeconomic deprivation; analyze the relationship between this exposure and individual consumption characteristics of students between 14 and 18 years old; and explore other facilitators of this consumption.

Method: Mixed-methods study conducted in three phases: 1) we collected data on accessibility to and promotion of alcohol and tobacco in the environment using systematic social observation around 55 secondary schools; 2) we administered 2287 questionnaires among the students in these centers to gather information about characteristics and determinants of consumption; and 3) we conducted 20 semi-structured interviews and one discussion group to deepen in the results obtained in surveys and systematic social observation. We will use Geographic Information Systems to integrate and analyze the data from a spatial perspective.

Using photovoice to generate policy recommendations to improve the alcohol urban environment: A participatory action research project.

The place where we live, work and play may influence our alcohol drinking behaviours. This study aimed to present local policy recommendations on urban determinants for alcohol consumption prevention in a low-income and a high-income area of Madrid (Spain) using a participatory action research method, with photovoice and nominal group techniques. Participants (n = 26) engaged in a photovoice project initiated a process of critical reflection by discussing and analysing their alcohol environment based on photographs they took themselves.

Trends and determinants of social inequities in cardiovascular risk factors in Spain: a mixed-methods study.

This sequential mixed-methods study aims to: 1) assess spatial and temporal trends in cardiovascular risk factors by socioeconomic position from 2001 to 2020 in Spain; 2) explore public health professionals' perspectives regarding interventions that might have impacted these inequities; and 3) analyze determinants on social inequities in cardiovascular risk factors. First, we will measure the change in absolute and relative social inequities in eight cardiovascular risk factors through time trend analysis using repeated cross-sectional data from both National and European Health Surveys for Spain from 2001 to 2020. Second, we will interview key informants -both at the regional and national level-, to contextualize data obtained in phase 1 and capture the content and variation of policies across regions.

Gender Matters: Identity, Risk Perception and Preventive Interventions for Alcohol Consumption among Adolescents Using a Qualitative Approach.

The epidemiological information available in Spain and the Community of Madrid highlights two relevant facts regarding alcohol consumption: an increase in binge drinking in teenagers and a reduction/reversal of the gender gap, particularly at young ages. This article aims to describe some of the factors related to alcohol use in teenagers, especially those related to gender and risk perception. A qualitative study was designed with semi-structured interviews and a discussion group with students from the city of Madrid aged 14 to 18 years.

Changes in perceptions of the alcohol environment among participants in a Photovoice project conducted in two districts with different socio-economic status.

Perceptions of the alcohol environment may influence alcohol consumption patterns. The purpose of this study was to describe changes in perceptions of the urban alcohol environment as experienced by residents of two districts with different socio-economic status after taking part in a Photovoice study. The study was conducted in Madrid, Spain, in a district with a high socio-economic status (HSES) and another district with a low socio-economic status (LSES).

Residents perceptions of the alcohol environment: A participatory photovoice project in two districts with different socio-economic status in a large city.

The purpose of this study was to present the alcohol environment as perceived by its residents in two districts of Madrid using the Photovoice participatory methodology. Secondly, we compared the results according to the socio-economic status of the districts. The study was conducted in the city of Madrid, Spain, in two districts with different socio-economic status.

Availability, Promotion, and Signs of Alcohol Consumption: A Mixed Methods Study of Perceived Exposure and Objective Measures.

This study describes the alcohol environment comparing residents' perceptions and objective measures in two different income-level districts. Measures were gathered between 2017 and 2018 in two districts with different income levels in Madrid, Spain. We obtained perceived measures using Photovoice.

[Health assets and quality of life in people diagnosed with severe mental disorder].

Objective: To identify health assets and describe quality of life for people diagnosed with severe mental disorder through their own testimonies; to understand the necessities and barriers that affect their quality of life; and offer improvement recommendations.

Method: A qualitative, descriptive analysis based on the information obtained through semi-structured interviews and asset mapping.

Results: Assets are similar to those found in undiagnosed people, while needs and barriers differ in both groups.

How the choice of ethnic indicator influences ethnicity-based inequities in maternal health care in four Latin American countries: who is indigenous?

Background: The current focus on monitoring health inequalities and the complexity around ethnicity requires careful consideration of how ethnic disparities are measured and presented. This paper aims to determine how inequalities in maternal healthcare by ethnicity change according to different criteria used to classify indigenous populations.

Methods: Nationally representative demographic surveys from Bolivia, Guatemala, Mexico, and Peru (2008-2016) were used to explore coverage gaps across maternal health care by ethnicity using different criteria.

Obstacles and opportunities for monitoring ethnicity-based inequalities in maternal health care: Lessons from Mexico.

Background: Monitoring and reducing inequalities in health care has become more relevant since the adoption of the Sustainable Development Goals (SDGs). The SDGs bring an opportunity to put the assessment of inequalities by ethnicity on the agenda of decision-makers. The objective of this qualitative study is to know how current monitoring is carried out and to identify what factors influence the process in order to incorporate indicators that allow the evaluation of inequalities by ethnicity.

Understanding Urban Health Inequalities: Methods and Design of the Heart Health Hoods Qualitative Project.

Objective: Qualitative methods may help to understand features related to health urban inequalities as a way to include citizens' perceptions of their neighbourhoods in relation to their health-related behaviours. The aim of this article is to describe the methods and design of a qualitative urban health study.

Methods: The Heart Healthy Hoods (HHH) analyses cardiovascular health in an urban environment using mixed methods: electronic health records, quantitative individual questionnaires, physical examination, semi-structured Interviews (SSIs), focus groups (FGs) and participatory technics such as photovoice.

Creating a Collaborative Platform for the Development of Community Interventions to Prevent Non-Communicable Diseases.

Chronic diseases, also known as non-communicable diseases (NCD) are one of the most important public health problems of our time. Many of these diseases can be reduced by achieving healthy lifestyles. Community interventions are very useful in reducing these types of diseases since they have a direct impact over daily conditions and are adjustable to the complex situations that they carry.

Social Norms Influencing the Local Food Environment as Perceived by Residents and Food Traders: The Heart Healthy Hoods Project.

Exploring subjective elements of the food environment remains key to understand why and how residents purchase food. Our aim was to explore and describe the social norms relating to the local food environment and food purchasing behaviors, as perceived by residents and food traders in Madrid, Spain. This qualitative study took place in a middle socioeconomic status neighborhood of Madrid between January 2015 and May 2016.

Indigenous language and inequitable maternal health care, Guatemala, Mexico, Peru and the Plurinational State of Bolivia.

Latin America and the Caribbean still have high maternal mortality rates and access to health care is very uneven in some countries. Indigenous women, in particular, have poorer maternal health outcomes than the majority of the population and are less likely to benefit from health-care services. Therefore, inequities in maternal health between different ethnic groups should be monitored to identify critical factors that could limit health-care coverage.

A Community-Driven Approach to Generate Urban Policy Recommendations for Obesity Prevention.

There is an increasing research interest in targeting interventions at the neighborhood level to prevent obesity. Healthy urban environments require including residents' perspectives to help understanding how urban environments relate to residents' food choices and physical activity levels. We describe an innovative community-driven process aimed to develop environmental recommendations for obesity prevention.

Uneven chances of breastfeeding in Spain.

Background: No large scale studies on breastfeeding onset patterns have been carried out in Spain. This work aims to explore the prevalence and the risk factors for not initiating breastfeeding in hospitals from Catalonia (CAT) and Valencia (V), two regions accounting approximately for 30% of the annual births in Spain.

Methods: The prevalence of not initiating breastfeeding was calculated by maternal/neonatal characteristics and type of hospital, and logistic regression models were used to estimate crude and adjusted risks of not breastfeeding in each region.

Shortening of gestational length among native-born and immigrants in Spain (1997-2008).

During the last decade there have been significant socio-demographic changes in Spain with potential impact on gestational length. The aim of the study was to describe the evolution of gestational age during 1997-2008, separately for native-born and immigrant population, in order to assess their contribution to the overall pattern of gestational length. A cross-sectional study of 5,018,229 singleton births born between 1997 and 2008 was carried out.

[Health Impact Assessment: assessing the effectiveness of policies in population health].

Health Impact Assessment is a comprehensive methodology proposed by the World Health Organization to determine the impact on health of projects, policies and strategies that are no originally specifically health-related but that could have on effect on health. This work aims to review the methodological approaches to Health Impact Assessment, and determine its value in Public Health. Health Impact Assessment is a multidisciplinary process that combines both qualitative and quantitative evidence in a decision-making frame.