Exploring the Feasibility of Photovoice through WhatsApp in Evaluating MTV Shuga Peer Education Program

2. Abstracts describing work other than Formal Research
Venetia Baker1 , Sarah Mulwa1, Aimee Searle2, Tsephiso Nhemachema2, Andrea Dr Jong2, Eli Berkowitz2, Cherie Cawood2, Isolde Birdthistle1
1 The London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, Department of Population Health, London, UK
2 Epicentre Health Research, KZN, South Africa

Abstract
 Issues: As digital spaces become a significant part of young people’s lives using these platforms for health research has opportunities and challenges. In evaluating the MTV Shuga Peer Education program in South Africa, we utilized WhatsApp to engage young people and explore their perspectives on key health topics through participatory photography.

Project: The WhatsApp photo activity was implemented in two settings: Pietermaritzburg (PMB) and Cape Town (CT). In WhatsApp chats participants received prompts from researchers on topics such as accessing sexual health services, stigma, bullying, healthy relationships, and wellbeing, inviting them to share their own photos and captions to illustrate their experiences. Participants received mobile airtime for each submission.

In PMB, 310 young people (ages 14-25) in the MTV Shuga program received study invitations via cards distributed by peer educators, linking to a consent website. The 155 young people who consented and provided valid phone numbers received an automated text describing the activity and providing instructions, followed by weekly prompts and reminders. 19 participants submitted original photos while 16 participated by sending AI-generated or online-sourced images. In CT, 67 participants in the Peer Education Programme consented via the website, and 20 were selected for the photovoice activity using a stratified sampling method by age and gender. The study team met all participants in person to explain the activity and show examples before they joined the WhatsApp group, receiving biweekly texts and reminders. All young people chose to participate sending in original photos and captions.

Lessons learned:

  1. Trust and Engagement: Digital platforms can potentially reach many participants quickly at a low cost, but, in this activity, personal engagement with researchers enhanced meaningful participation. This may be particularly relevant for topics related to sexual health and relationships. Meeting participants in person in CT resulted in better engagement and higher quality responses, compared to PMB's digital-only approach.
  2. Barriers to Participation: Despite clear text instructions, many participants in PMB misunderstood the project's purpose, which may have contributed to low engagement, as digital interactions didn’t provide the same opportunity for questions and explanations as in-person communication.
  3. Access to Technology: Some participants used shared phones with inconsistent access. While WhatsApp is widely used, intermittent access to phones and data created challenges for sustained participation.
  4. AI Usage: Some participants used AI-generated images, raising questions about the authenticity of digital data As AI improves, we might not know if responses are generated by participants or AI tools.
The study demonstrated that WhatsApp can be a tool for engaging young people virtually in participatory photography, especially when combined with in-person opportunities for researchers to build trust, understanding, and relationships. Key challenges to this approach include young people's inconsistent access to technology and their growing use of AI to generate images and content.