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. Both studies, similar in their objectives and study populations, are the basis for comparing both techniques. The comparison considered the following methodological aspects: study design, logistic aspects, commitment and involvement, ethical issues, and data analysis.

Results: We identified differences, similarities, potentialities, and limitations of each technique with their corresponding results. We found that depending on the research objectives, one technique was more beneficial than the other. If the objective is producing new knowledge, using focus group would be the most appropriate technique, whereas if the objective includes generating social change, photovoice would be more suitable. We found that photovoice is a powerful technique in public health, especially studying social processes related to population health, requiring extra effort from researchers and a special care with the related ethical considerations.

Conclusions: Increasing participants' awareness, involving decision makers to channel proposals, the atypical role of researchers and ethical implications of photography are aspects to be considered when choosing photovoice instead of focus group.