title: Photovoice: A Strategy to Better Understand the Reproductive and Sexual Health Needs of Young Mothers.
abstract: OBJECTIVE
  Adolescent women face significant sexual and reproductive health challenges and are more vulnerable than their male peers. Photovoice methodology might allow them to provide more meaningful and accurate representations of the health challenges they encounter. Our objectives were to: (1) use Photovoice to understand how young mothers frame reproductive and sexual health within the context of their lives; (2) explore how they define reproductive and sexual health; (3) identify youth perspectives on how their life situations influence their ability to affect their health; and (4) connect their perspectives to social determinants of health framework to facilitate implementation of effective programs and policies to address their needs. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: This was a prospective qualitative community-based participatory research study involving young women (ages 15-25 years) recruited from a local youth outreach center. A 9-step validated qualitative participatory approach that combined documentary photography with focus groups was used. Qualitative analysis was conducted with NVivo version 10 software (QSR International Inc., Burlington, MA, USA). Data were coded and themes were developed.
  
  
  RESULTS
  Thirty women were recruited and nine women completed the study. Key themes included: personal sexual health practices and coping skills, influence of poverty, physical environments, community resources and sexual health services, education, and stigma of pregnancy. Participating in community-based participatory research empowered participants to advocate for their own health.
  
  
  CONCLUSIONS
  Photovoice methodology contributes to understanding complex factors influencing sexual and reproductive health of young mothers. This participatory-based methodology highlights their individual situations, allowing us to seek connections, create analytical perspectives from which to relate their situations to root causes, and consider strategies for change.
authors.affiliation: Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: roopan.gill@gmail.com.
authors.forename: Roopan
authors.initials: R
authors.lastname: Gill
authors.affiliation: Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Gynecology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
authors.forename: Amanda
authors.initials: A
authors.lastname: Black
authors.affiliation: Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Gynecology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Tania
authors.initials: T
authors.lastname: Dumont
authors.affiliation: Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Division of Gynecology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Fleming
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D055812:Community-Based Participatory Research; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006801:Humans; D009035:Mothers; D010781:Photography; D011203:Poverty; D011247:Pregnancy; D011446:Prospective Studies; D036301:Qualitative Research; D060728:Reproductive Health; D012111:Residence Characteristics; D012307:Risk Factors; D055815:Young Adult
keywords: Adolescent girls; Photovoice; Policy; Qualitative; Reproductive and sexual health; Social determinants of health