Related Experiment Video
Updated: Jul 1, 2025

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Black Veterans Experiences with and Recommendations for Improving Weight-Related Health Care: A Photovoice Study
Jessica Y Breland1, Lamont Tanksley2, Michelle A Borowitz2
1Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA. jessica.breland@va.gov.
Background:
Non-Hispanic Black or African American (hereafter Black) veterans lose less weight than other users of the Veterans Health Administration's (VHA) weight management program (MOVE!), despite higher enrollment.
Objective:
To understand factors that affect weight loss disparities between Black veterans and other veterans.
Design:
Qualitative study using Photovoice methods.
Participants:
Self-identified Black veterans in MOVE! across the USA (two women, seven men).
Approach:
We conducted six virtual Photovoice sessions with Black veterans. Session one provided orientation to the goal of understanding factors that might affect weight loss disparities. Participants chose missions related to weight management and VHA care, bringing photos or other media (e.g., poems) to discuss during remaining sessions. Facilitators/participants identified themes related to each session in real time. Between and after sessions, facilitators/investigators conducted rapid qualitative analysis of transcripts/audio to group similar themes, identify illustrative quotes/photos/other media, and prepare dissemination products (e.g., this manuscript). Participants provided feedback on the manuscript during an additional session.
Key Results:
Themes were identified across three categories: (1) Food in Our Lives and Health Care; (2) Body Image; and (3) Healthcare Bias and Discrimination. The emotional impact of food and the negative effects of bias and discrimination on health care quality and trust were especially salient. Participants provided recommendations for weight-related and general care. Notable recommendations included the need for VHA to hire and retain providers-especially Black providers-who understand and respect Black patients and are committed to delivering evidence-based, culturally sensitive care. In addition, weight management care should be tailored to individual patients' diets and health beliefs and deemphasize body mass index.
Conclusions:
Photovoice resulted in concrete targets that could reduce health disparities. Institutions should consider Photovoice and similar approaches to build trust with and incorporate input from marginalized communities. This approach requires sustained commitment from leaders to engage stakeholders and implement solutions.
More Related Videos
Related Concept Videos
Role of Communication in the Nursing Process II: Planning and Implementation
Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
Surveys
Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results...
Changes in Skin Color: Clinical Perspectives
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Stress Prevention and Stress Management Techniques VI
Motivation and Self-Determination
Motivation, the driving force behind behavior, plays a pivotal role at every stage of the change process. The research...

