title: Using Photovoice and Asset Mapping to Inform a Community-Based Diabetes Intervention, Boston, Massachusetts, 2015.
abstract: Diabetes self-management takes place within a complex social and environmental context.  This study's objective was to examine the perceived and actual presence of community assets that may aid in diabetes control.
  
  
  
  We conducted one 6-hour photovoice session with 11 adults with poorly controlled diabetes in Boston, Massachusetts.  Participants were recruited from census tracts with high numbers of people with poorly controlled diabetes (diabetes "hot spots").  We coded the discussions and identified relevant themes.  We further explored themes related to the built environment through community asset mapping.  Through walking surveys, we evaluated 5 diabetes hot spots related to physical activity resources, walking environment, and availability of food choices in restaurants and food stores.
  
  
  
  Community themes from the photovoice session were access to healthy food, restaurants, and prepared foods; food assistance programs; exercise facilities; and church.  Asset mapping identified 114 community assets including 22 food stores, 22 restaurants, and 5 exercise facilities.  Each diabetes hot spot contained at least 1 food store with 5 to 9 varieties of fruits and vegetables.  Only 1 of the exercise facilities had signage regarding hours or services.  Memberships ranged from free to $9.95 per month.  Overall, these findings were inconsistent with participants' reports in the photovoice group.
  
  
  
  We identified a mismatch between perceptions of community assets and built environment and the objective reality of that environment. Incorporating photovoice and community asset mapping into a community-based diabetes intervention may bring awareness to underused neighborhood resources that can help people control their diabetes.
authors: Boston Medical Center, Section of General Internal Medicine, 801 Massachusetts Ave, Crosstown No. 2094, Boston, MA 02119. Email: jfloria@bu.edu.
authors: Jana
authors: J
authors: Florian
authors: Boston Medical Center, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors: Nicole M St Omer
authors: NM
authors: Roy
authors: Boston Medical Center, Section of General Internal Medicine, Boston, Massachusetts.
authors: Lisa M
authors: LM
authors: Quintiliani
authors: Boston Medical Center, Section of General Internal Medicine, Boston, Massachusetts.
authors: Ve
authors: V
authors: Truong
authors: Boston Medical Center, Section of General Internal Medicine, Boston University School of Medicine, Boston, Massachusetts.
authors: Yi
authors: Y
authors: Feng
authors: Boston University, Center for Psychiatric Rehabilitation, Boston, Massachusetts.
authors: Philippe P
authors: PP
authors: Bloch
authors: Boston University, Center for Psychiatric Rehabilitation, Boston, Massachusetts.
authors: Zlatka L
authors: ZL
authors: Russinova
authors: Boston Medical Center, Section of General Internal Medicine, Boston, Massachusetts.
authors: Karen E
authors: KE
authors: Lasser
mesh_terms: D001900:Boston; D055812:Community-Based Participatory Research / Q000379:methods*; D003920:Diabetes Mellitus / Q000628:therapy*; D000072001:Diet, Healthy; D004777:Environment; D015444:Exercise; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008875:Middle Aged; D010781:Photography; D012648:Self Care