The origins of these methods stretch back to the 1960s, when anthropologists and ethnographers began incorporating photographs and film into their data collection. But the technique that has become most closely associated with participatory health research is photovoice, developed in the 1990s through studies in which rural Chinese women in Yunnan Province photographed scenes they considered representative of their daily lives. The method’s signature analytical tool, the SHOWED question sequence, asks participants what they see in an image, what is really happening, how it relates to their lives, why the situation exists, and what can be done about it. The explicit goal was social change: giving marginalized groups the means to communicate their experiences on their own terms and push for policy reform. That collaborative DNA, the review’s authors note, is precisely what makes visual methods attractive to occupational scientists, whose research agendas increasingly emphasize community engagement and societal responsiveness.

To build their evidence base, the researchers followed the six-stage scoping review framework developed by Arksey and O’Malley and extended by Levac and colleagues, in accordance with Joanna Briggs Institute methodology. They searched PubMed, Web of Science and CINAHL Ultimate in December 2023, with a follow-up search in December 2024, and registered their protocol with the Open Science Framework to increase transparency. The initial search yielded 3,619 references, which were reduced to 2,066 after deduplication in the Rayyan platform. Blind screening by two authors per citation, with a third author resolving disagreements, narrowed the field to 140 articles for full-text review and ultimately 59 included studies. Consultations with three international experts and the follow-up search added 14 more papers, producing a final sample of 73 studies from 68 first-named authors, all published in English between 2001 and 2024. Notably, 79 percent of the included studies appeared in just the last ten years, signaling a rapid acceleration of interest.

The geographical footprint of the evidence is strikingly broad. Europe and North America each contributed 25 studies, accounting for 34 percent of the sample apiece, with Ireland, the United Kingdom, Sweden, the United States and Canada leading the way. Australia and New Zealand produced eight studies, Africa seven, and South America and Asia three each. The authors observed that visual methods gained traction at different times in different regions, with later uptake in Asia, Europe and South America compared with North America, Australia and Africa. They attribute this pattern to differences in academic traditions, technological resources, cultural alignment with participatory approaches, and the influence of methodological innovations emerging from leading research groups. Intriguingly, studies are also increasingly appearing in journals outside occupational therapy and occupational science, including publications focused on rehabilitation, social sciences, education and qualitative methodology, a sign of expanding interdisciplinary reach.

The populations studied span every age group and health status. Children and adolescents featured in 26 papers, adults in 47, with and without disabilities or health conditions. Among adults, conditions recurring across multiple studies included mental health difficulties, cancer, stroke and terminal illness, alongside less common conditions such as spinal cord injury, diabetes, Addison’s disease, upper limb injuries and spina bifida. Some studies worked with dyads, exploring parents with disabilities, people with early onset dementia and their caregivers, and couples managing chronic conditions together. Among children with disabilities, eleven papers examined populations ranging from children with specific diagnoses to those with varied physical and developmental disabilities and even food allergies. The breadth suggests that visual methods are not confined to any single clinical niche but function as a genuinely general-purpose instrument for understanding occupation in context.

What were these researchers actually studying? Just over half of the papers, 37 in total, focused on specific occupations. Play topped the list with twelve studies, encompassing digital play, object play, risky play, playground use, and the play of infants and toddlers at home. Self-care and caregiving occupied seven studies, from caring for a dying relative to the pre-sleep routines of typical adults and the home-making practices of people experiencing homelessness. Seven papers examined occupations of dyads, groups or communities, including an older couple’s shared walks, the multispecies occupation of humans and horses, youth cycling groups, community gardening and partying. The remainder covered return to work after injury or cancer, tapestry weaving, religious practices, powered wheelchair use and computer use. Nineteen papers explored general experiences of daily life rather than a single occupation, fourteen examined concepts related to occupation such as quality of life, well-being and occupational identity, and three addressed occupational justice, including how gender and material poverty shape occupational choices.

Methodologically, photovoice dominated the toolkit, appearing in 23 studies, or 32 percent of the sample, followed by photo-elicitation in 19 papers, videography and video observation in 11, unstructured photography in 7, and drawing and collage techniques in 3. Ten studies combined multiple visual methods within a single design. In 31 studies the visual method was the primary and only data collection approach, typically paired with the semi-structured or focus group interviews that photovoice and photo-elicitation protocols prescribe. In 22 other studies, visual methods served as one component among several, combined with contextual observations, behavioral mapping and interviews. The authors illustrate this with studies of outdoor play among autistic preschoolers, where researchers deployed video recordings, participant photography, observation and caregiver interviews simultaneously, and of tapestry weaving in residential aged care, which layered photographs, video, field notes and interviews. Ethnography, used in 12 studies, and phenomenology, used in 11, were the most common overarching frameworks, and 93 percent of all included studies were qualitative.

How the visual material itself is analyzed emerged as one of the review’s most revealing findings. Thematic analysis, most often citing the influential framework of Braun and Clarke, was the dominant analytical approach, used in 27 papers, or 37 percent, applied to both textual and visual data. Phenomenological analysis appeared in eight papers, and six followed the photovoice analysis process described by Wang and Burris. Yet the review uncovered a methodological soft spot: in 16 studies the visuals served only to stimulate discussion and were not themselves analyzed, and in 12 studies the authors made no explicit mention of analyzing the visual materials at all. Only 31 percent of the papers discussed ethical considerations specific to collecting, analyzing and publishing visual data, a striking gap given that photographs and videos can expose identities, homes and intimate moments in ways that interview transcripts cannot. Eight studies did share findings publicly through photograph exhibitions, participant-produced booklets and websites, hinting at the participatory promise the methods hold.

The review’s implications are clear-eyed about both promise and peril. Visual methods, the authors argue, are not merely novel gimmicks but powerful instruments that capture the complexity, context and lived texture of occupation in ways traditional verbal methods often miss. They can open the door to participants who communicate more comfortably through images than words, and they are naturally suited to community-based participatory research. But the field needs rigor: researchers should articulate a clear purpose for using visual methods, follow or transparently adapt established protocols, document the practical details of data collection such as device type, time frame and participant instructions, and explain whenever visuals are excluded from analysis or publication. The authors also flag emerging frontiers, including occupational mapping, digital storytelling, participatory video and the study of multispecies occupations involving animals as active partners rather than passive props. As the discipline matures, the challenge will be to match the creativity of the camera with an equally disciplined methodology, ensuring that what researchers see through the lens translates into knowledge that is rigorous, ethical and genuinely useful for the people whose lives it depicts.

Subject of Research: The use of visual research methods such as photovoice and photo-elicitation in occupational science and occupational therapy research

Article Title: Using visual research methods to study occupations: A scoping review

Article References: Bratun, U., Morgenthaler, T., & Lee, B. D. (2025). Using visual research methods to study occupations: A scoping review. Scandinavian Journal of Occupational Therapy, 32(1), Article 2519261. https://doi.org/10.1080/11038128.2025.2519261

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2519261

Keywords: visual research methods, photovoice, photo-elicitation, occupational science, occupational therapy, scoping review, qualitative research, videography, participatory research, thematic analysis, human occupation, community-based research

The significance of the review lies partly in its methodology. Previous reviews of Métis health and wellness existed, but none spanned more than four decades or included comprehensive searches of the grey literature—the vast universe of government reports, organizational publications, and community documents that never appear in peer-reviewed journals. The research team systematically searched 14 electronic databases and supplemented this with hand-searching of Métis government and organization websites, a step that is critical for a population whose health knowledge is often produced outside traditional academic channels. The review followed the established scoping review methodology of Arksey and O’Malley, and the research question was developed collaboratively between the MNO and the research team, including Métis citizens themselves.

That collaborative, distinctions-based approach matters because the Métis are not a subset of a generic Indigenous population. They possess a unique culture, history, language, and way of life, and their rights are recognized and affirmed under Section 35 of Canada’s Constitution Act, 1982, alongside First Nations and Inuit. Health research that lumps Métis people into pan-Indigenous categories risks obscuring the specific drivers of their health outcomes. The review’s insistence on Métis-specific evidence reflects a broader movement in Indigenous health research toward distinctions-based approaches, in which each distinct people is studied on its own terms rather than as an undifferentiated category.

The headline numbers tell a story of rapid recent growth. Of the 112 studies and reports identified, the overwhelming majority—81—were Métis-specific rather than pan-Indigenous, and 99 had been published since 2010. In other words, the volume of Métis-specific health research has roughly tripled since 2010 compared with the three decades before. This surge coincides with growing national attention to Indigenous health equity, increased Métis governance capacity in health research, and funding structures that increasingly require Indigenous community engagement. Yet the review also shows that the field remains young: nearly nine-tenths of everything ever published on Métis health dates from the last fifteen years.

The methodological profile of the literature is equally revealing. Quantitative studies dominated the landscape, accounting for 71 of the 112 publications. While numerical data are essential for tracking disease burden and health service use, the imbalance suggests that the lived experience behind the statistics—how Métis people understand health, wellness, and illness in their own terms—remains comparatively underexplored. Qualitative and community-based work, which can capture cultural determinants of health and the impacts of historical and ongoing colonization, made up a much smaller share of the record. For a population whose health is inseparable from identity, land, and community, that gap is more than academic.

Encouragingly, the review found meaningful evidence of Métis leadership in the research enterprise. Fifty-eight percent of the included studies—65 publications—showed evidence of Métis authorship or collaboration with a Métis community. This figure marks substantial progress from an era when research about Indigenous peoples was routinely conducted without their participation, and it aligns with principles of Indigenous data sovereignty, which hold that communities should govern how data about them are collected, interpreted, and used. Still, the fact that more than four in ten studies lacked demonstrated Métis involvement indicates that community engagement has not yet become the default standard across the field.

What has been studied, and what has not? Non-communicable diseases emerged as the most heavily researched health outcomes, with 38 publications addressing conditions such as diabetes, cardiovascular disease, and cancer. Chronic disease epidemiology, in other words, forms the backbone of the existing evidence base. By contrast, the review identified striking gaps: research on Métis children and youth is thin, in-depth qualitative work on Métis men’s health is scarce, communicable diseases have received little dedicated attention, and intervention studies—research that actually tests whether programs, policies, or treatments improve Métis health—are notably rare. Each of these gaps has practical consequences, from the design of pediatric services to pandemic preparedness.

The absence of intervention research deserves particular emphasis. Descriptive studies can document that a health disparity exists, but they cannot tell communities and policymakers which solutions work. Without trials, evaluations, and implementation studies grounded in Métis communities, the field risks producing an ever-longer catalogue of problems without a corresponding evidence base for action. Similarly, the scarcity of research on Métis children and youth means that early-life determinants of lifelong health—areas where targeted investment often yields the greatest returns—remain poorly characterized for this population. The review’s gap analysis thus functions as a research agenda, pointing funders and investigators toward the areas of greatest unmet need.

The review also demonstrates the value of including grey literature in syntheses of Indigenous health research. Métis governments and organizations produce health reports that reflect community priorities and often contain data unavailable elsewhere; excluding them would have produced an incomplete and potentially distorted picture of the field. By hand-searching Métis government and organization websites alongside 14 academic databases, the team ensured that community-produced knowledge counted as evidence. This methodological choice models an approach that other scoping reviews of Indigenous health could adopt, and it underscores that the boundary between ‘research’ and ‘community knowledge production’ is porous in productive ways.

Ultimately, the review offers a double message. On one hand, Métis health research has never been more active: output has tripled since 2010, Métis-specific studies now dominate over pan-Indigenous work, and a majority of publications involve Métis authors or community collaboration. On the other hand, the field’s growth has been uneven, concentrated in quantitative chronic disease research while children and youth, men’s health, communicable disease, and interventions remain understudied. Led by the Métis Nation of Ontario and published open access, the review provides researchers, policymakers, and Métis communities themselves with a verified map of what is known—and a clear, evidence-based agenda for what must come next.

Subject of Research: A scoping review of Métis-specific health research in Canada from 1980 to 2024

Article Title: The landscape of Métis health research 1980–2024: a scoping review

Article References: The landscape of Métis health research 1980–2024: a scoping review. (n.d.). https://doi.org/10.1186/s12939-026-03034-3

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03034-3

Keywords: Métis health, scoping review, Indigenous health, health equity, Canada, social determinants of health, Métis Nation of Ontario, non-communicable diseases, grey literature, community-based research, public health, research gaps

The research team, a collaboration between the university’s Department of Psychology and the Mel and Enid Zuckerman College of Public Health, surveyed 363 people across Tucson’s south side and a carefully matched comparison neighborhood. Among participants who lived, worked, or attended school in the contaminated area before 1981, or whose parents did, 34 percent reported enough symptoms to cross a screening threshold that clinicians routinely use to flag probable post-traumatic stress disorder. That figure was drawn from a seven-item checklist asking respondents whether worry about the contamination had produced specific experiences during the past month, including avoiding places that brought the contamination to mind, sleeping poorly, or feeling cut off and detached from other people. Reporting four or more of the seven criteria was treated as the threshold for further clinical attention.

The study was led by Harrison Schmitt, who carried out the work as his doctoral dissertation at the University of Arizona and is now an assistant professor of psychology at Skidmore College. Daniel Sullivan, the study’s senior author and an associate professor in the Department of Psychology, said the persistence of the effect was the most startling element of the results. “It was pretty striking how long the impact of this seems to have been,” Sullivan said. For a community whose exposure officially ended when the city stopped serving contaminated water on its south side in 1981, the survival of trauma symptoms across four decades suggests that environmental contamination can function not merely as a past event but as an ongoing, inherited burden carried through families and neighborhoods.

To contextualize the magnitude of that burden, Sullivan’s team administered the same screening instrument in 2025 to Los Angeles residents whose homes were threatened by wildfires, a group experiencing an acute, vivid, and recent disaster. Roughly 35 percent of those respondents scored at or above the PTSD screening threshold, a figure nearly identical to the rate found among Tucson’s south side residents remembering exposures that ended generations ago. The parallel is consequential for the field of disaster psychology, which has historically calibrated its expectations around discrete, cinematic catastrophes such as tornadoes, floods, and fires. Sullivan, who studied tornado survivors in Kansas for his own dissertation, has long argued that technological disasters deserve separate theoretical treatment because they unfold over years, lack a single identifiable day of damage, and often involve prolonged institutional silence or denial about what occurred.

Before the survey was even designed, Sullivan spent years attending community meetings on Tucson’s south side, an investment in local trust that shaped every subsequent stage of the project. Beginning in the summer of 2022, approximately twenty undergraduate volunteers collected the survey door to door in pairs, with each pair including at least one bilingual student so that questionnaires could be offered in both English and Spanish. The ground-level method produced insights that no mailed questionnaire could capture. Many of the volunteers came from the south side themselves, and several learned in the course of their canvassing that their own relatives and neighbors had lived through the contamination and had rarely, if ever, spoken about it. The data collection thus doubled as an act of oral history, surfacing family silences that had persisted alongside the symptoms the survey was designed to measure.

A critical methodological safeguard was the construction of a comparison group. The researchers deliberately selected a second Tucson neighborhood matched to the south side on income, race and ethnicity, and housing characteristics, ensuring that differences in trauma symptom rates could be attributed to the contamination itself rather than to the chronic socioeconomic stressors both areas share. This design choice strengthens the study’s central inference considerably. Residents of the matched neighborhood face comparable economic pressure, comparable discrimination, and comparable housing instability, yet they did not carry the same psychological load, pointing to the contaminated water as the decisive distinguishing exposure.

Elizabeth Yee, a co-author and Ph.D. student in psychology who first worked on the survey as an undergraduate and later led the effort to report the findings back to residents, described the emotional texture of the canvassing work. “You’re talking to people and it’s every other house. At a community level, the findings are validating. At an institutional level, it still feels like, ‘When is it going to be enough evidence to act?'” she said. Her remark captures a tension running through the entire research program: the same data that affirms residents’ lived experience also documents how slowly institutional recognition has moved relative to the scale of harm. The researchers describe the pattern they uncovered as collective trauma, a framework in which a devastating event is shared across a community and transmitted through common experiences and stories rather than being experienced and processed only as individual psychological injury.

The study’s community-facing dimension owes much to Alisha Vasquez, a disability cultures folklorist at the Southwest Folklife Alliance and a co-director of Tucson’s Mexican American Heritage and History Museum. Vasquez helped connect the research team with south side residents and convened a community meeting that shaped how the survey results are now being deployed for political action. “They fought their entire lives, not just for restitution, but to be heard and believed,” Vasquez said. Her framing underscores a theme that quantifies poorly but matters enormously in the epidemiology of environmental injustice: the harm of contamination compounds when survivors’ accounts are dismissed, and part of the healing process involves official acknowledgment that the harm was real. In December 2025, a memorial honoring the victims of the historic contamination was unveiled in Mission Manor Park as part of Vasquez’s community-based arts initiatives on the topic, a physical landmark for a history that many families had carried silently.

The research has already moved beyond the pages of an academic journal. Working with Vasquez and other community activists, the research team has presented its findings to Tucson Water, the Environmental Protection Agency, and the Tucson Mayor and Council. The City Council responded by passing a resolution urging the Pima County Health Department to address the impacts of the contamination, converting a psychological survey into an instrument of municipal policy. For the researchers, that trajectory reflects the specific history of the place rather than a novelty. “Tucson was a historic leader in fighting for recognition of these issues,” Sullivan said. “This is a community with a lot of resilience.” The authors declared no potential conflicts of interest with respect to the research, its authorship, or its publication.

The scientific implications of the study extend well beyond southern Arizona. As climate-driven wildfires, industrial accidents, and aging water infrastructure expose growing populations to environmental threats, the Tucson findings suggest that the mental health consequences of such events may be measured in generations rather than news cycles. A screening threshold crossed by one in three exposed residents forty years after the fact implies that standard disaster-response timelines, which concentrate psychological services in the weeks and months following an acute event, are poorly matched to slow-onset technological disasters. The Tucson study offers both a warning and a template: the warning that contamination quietly externalizes its costs onto community mental health for decades, and the template that door-to-door, bilingual, community-partnered research can document those costs with enough rigor and legitimacy to compel institutional response.

Subject of Research: Long-term psychological trauma among residents exposed to historical water contamination in Tucson

Article Title: One in three Tucsonans exposed to historic water contamination still report signs of psychological trauma

Article References: One in three Tucsonans exposed to historic water contamination still report signs of psychological trauma. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: Tucson, water contamination, PTSD, collective trauma, environmental injustice, groundwater, industrial solvents, public health, Journal of Health Psychology, community-based research, disaster psychology, University of Arizona