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