Picture is worth a thousand words: Program uses art to engage at-risk kids and identify needs

The study was based on Visual Voices programs conducted with 22 children ages 8 to 15 in two low-income and predominantly African-American communities in Baltimore and Pittsburgh. During the Visual Voices sessions, participants created paintings and drawings to share their perceptions, both positive and negative, of community safety and violence, as well as their hopes for the future. Afterward, they combined their individual art projects into two "visual voice" exhibits that were publicly displayed in each city.

Michael A. Yonas, Dr.P.H., Visual Voices creator and assistant professor, Department of Family Medicine, University of Pittsburgh School of Medicine, and colleagues at Pitt and the Johns Hopkins Center for Injury Research and Policy, used qualitative research methods to review and code the participants' art projects for themes. Factors that participants identified as important to safety included school and social networks -- family, friends and the local community. Places that they identified as unsafe were corner stores, streets and alleys with poor lighting, and abandoned houses. Other contextual factors identified as unsafe were drugs, smoking, drinking, gambling, guns and violence.

"Community members are experts in their own lives much more so than those who reside outside their communities," said Dr. Yonas. "Visual Voices helps incorporate residents' unique expertise into the research process in a non-intrusive and fun way, and creates valuable data about their life experiences."

Visual Voices is different than surveys or focus groups because it uses tools -- crayons, paint and markers -- that are familiar to children, and it can lead to in-depth discussions, encourage self-efficacy and help build trusting relationships between academic researchers and the communities they serve, added Dr. Yonas. It also can help experts prioritize public health interventions.

In Pittsburgh, for example, findings were shared with the local police department to develop potential intervention opportunities and to increase law enforcement's understanding of young peoples' perceptions of safety.

"The heart of Visual Voices is to ask and listen," said Jessica G. Burke, Ph.D., study co-author and assistant professor, Department of Behavioral and Community Health Sciences, Pitt's Graduate School of Public Health. "You need to first ask what it is people care about in order to develop public health interventions that are appropriate for specific communities."

As an artist who specializes in painting, Dr. Yonas created Visuals Voices in 1993 to bring youth together in a common venue for artistic expression. He has conducted the program in nine cities across the U.S.

The project was funded by a grant from the Centers for Disease Control and Prevention to the Johns Hopkins Center for Injury Research and Policy. Co-authors of the study include Kimberly Rak, University of Pittsburgh; Antoine Bennett, New Song Urban Ministries; Vera Kelly, University of Pittsburgh Medical Center; and Andrea C. Gielen, Sc.D., Sc. M., Johns Hopkins Bloomberg School of Public Health.