1. Reinforcing Hope in Limited English Proficient African Immigrants
Through Photovoice
Monica Orjuela, Shannon Dunleavy, Amanda Ronning
Nursing, Texas Christian University, Fort Worth, TX
Supervising Faculty: Pamela Jean Frable ND, RN
BACKGROUND
Hurst Euless Bedford, Texas, has a large
community of African immigrants.1
• First United Methodist Church Hurst
established an African Outreach Program
with a full-time Congolese pastor.
• TCU public health nursing student
researchers collaborated with the
community to identify strengths and needs.
Assessment data revealed hope as a major
factor in immigrants’ experience in the United
States.
• Hope brought immigrants to America and
hope allows them to persevere when faced
with obstacles and hardships.
• Hope is one of the community’s greatest
strengths; maintaining this sense of hope
can be challenging.
Hope is a nursing construct prevalent in the
literature.
• Four key components contribute to one’s
ability to be hopeful: the experiential,
spiritual, rational, and relational process by
which one endures human trials. 2
• Hope is believed to occur between persons
and is strongly influenced by the hope of
others.
• Hope is a major factor in individual and
community resilience. 2
• The promotion of hope within a vulnerable
community has the potential to have long-
lasting benefits.
PURPOSE
1. Reinforce awareness of hope among
immigrants participating in the FUMCH
English class.
2. Identify key themes promoting hope within
the immigrant community.
3. Determine effects of photovoice on
participants’ English language
development.
PROPOSED PROTOCOL
1. Researchers will invite immigrants
identified as more advanced by the English
teacher to participate in a photovoice pilot
study.
2. Pilot participants will
• Provide input into the instructions and
consent for the design of the pilot study.
• Use disposable cameras to capture photos
that show hope after consenting,
reviewing instructions, and practicing
using cameras in the English class.
• Return cameras for photos to be
developed.
• Write English captions for selected
photos.
• Share selected photos and perspectives
with the English class.
3. Researchers will collaborate with
participants to identify themes that
promote hope within their community.
4. Following the pilot study, participants will
provide feedback to revise the protocol and
identify best practices and barriers to
successful completion of the full
photovoice project.
5. The revised photovoice protocol will be
implemented as a full research study.
KEY COMPONENTS
• Public health nursing collaborates with the
community as an equal partner while
aiming to create conditions in which
populations can thrive through research,
education, and empowerment. 3
• Photovoice combines documentary
photography with Paulo Freire’s “critical
consciousness” in an effort to understand
the interplay of society, politics, and power
relationships within a community. 4
• Service learning is a mutually beneficial
pedagogy designed to meet both the
community and student’s learning
objectives through experiential education
and community service. 5
• Community-based participatory research
involves all partners in the research process
by recognizing strengths within the
community and collaborating with
stakeholders to improve health outcomes. 6
• Limited English proficient refers to those
who self-report speaking English less than
“very well.” 7
• Asylees are aliens in the United States who
are unable to return to their country of
nationality due to persecution. 8
• Refugees are persons located outside of the
United States who are granted entrance into
the United States due to persecution. 8
• Immigrants (permanent resident aliens) are
foreign-born persons granted lawful
permanent residence in the United States. 8
BEST PRACTICE
Photography is an effective tool for
empowering vulnerable populations because
photos can be understood regardless of
language, culture, and other barriers that inhibit
dialogue. Photovoice has been implemented
and researched in vulnerable populations
around the world. Researchers completed a
literature review to identify best photovoice
practices.
• Photovoice is participatory and
collaborative from the beginning through
project planning, implementation, and
evaluation. 4
• Participants learn how to operate cameras
and take photos in an ethical and safe
manner.4
• Participants have opportunities to discuss
photos and reflect on their experiences in
small groups. 4
• Participants may choose to share photos
with community members, policy makers,
friends and family, and other stakeholders. 4
References1 Wagner, H. (2014). “Une nouvelle vie”: Health care and identity of
Congolese immigrants in Texas. Retrieved from
http://digitalrepository.smu.edu/upjournal_research/56/
2 Miller, J.F. (2007). Hope: A construct central to nursing. Nurse Forum,
42(10), 12-19. DOI: 10.1111/j.1744-6198.2007.00061.x
3 American Nurses Association. (2013). Public health nursing: Scope and
standards of practice (2nd ed.). Silver Spring, MD: American Nurses
Publishing.
4 KU Work Group for Community Health and Development. (2014). Section
20. Implementing photovoice in your community. In Ch. 3. Assessing
community needs and resources. Retrieved from http://ctb.ku.edu/en/table-of-
contents/assessment/assessing-community-needs-and-
resources/photovoice/main
5 Boyd, R. (2007). Service learning update 2007-2008. Retrieved from
http://www.sds.tcu.edu/community
6 Community-Campus Partnerships for Health (2015). Community-based
participatory research. Retrieved from: http://www.ccph.info
7 Whatley, M., & Batalova, J. (2013). Limited English proficient population
of the United States. Retrieved from
http://www.migrationpolicy.org/article/limited-english-proficient-population-
united-states
8 U.S. Department of Homeland Security. (2013). U.S. citizenship and
immigration services: Definition of terms. Retrieved from
http://www.uscis.gov/humanitarian/refugees-asylum/refugees
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