"I see salt everywhere": A qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi.
"I see salt everywhere": A qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi.
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“我到处都看到盐”：对基于艺术的参与式研讨会的实用性研究，以研究坦桑尼亚和马拉维的非传染性疾病。
DOI：
10.1371/journal.pgph.0000927
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发表时间：
2022
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包括高血压、糖尿病和癌症在内的非传染性疾病（NCD）的负担在坦桑尼亚和马拉维等撒哈拉以南非洲国家正在上升。这种增长反映了不同的社会，环境，生物和政治因素之间的复杂相互作用。因此，为了成功地进行干预，需要采取新的方法，了解当地对常见非传染性疾病的知识和态度如何影响健康行为。本研究比较了使用一种新的基于艺术的参与式方法和更传统的焦点小组的效用，以产生对非传染性疾病及其风险因素的当地知识，态度和行为的新理解。在坦桑尼亚和马拉维与当地社区举办了基于单一性别艺术的参与性讲习班和重点小组讨论。专题分析比较了研讨会和焦点小组的成绩单的内容和研究人员参与层次的深度。此外，符号学分析检查了讲习班活动的照片对了解参与者对NCD风险因素的经验和信念的贡献。以艺术为基础的参与式讲习班对参与者关于非传染性疾病及其影响的看法进行了深入、生动、充满感情的叙述（例如，“.“糖尿病是一个快速杀手”）。讲习班还使参与者能够自主地开展活动，揭示了他们对非传染性疾病几乎压倒性的负面看法。然而，使与会者能够引导研讨会活动的重点也带来了挑战，包括成见的长期存在（例如，将与糖尿病症状相关的气味与污水进行比较）。对研讨会照片的符号学分析，除了从文字记录中获得的信息外，几乎没有提供额外的见解。在坦桑尼亚和马拉维，基于艺术的参与性讲习班有望成为一种新方法，为制定与文化相关的非传染性疾病预防方法提供信息。未来的研究应纳入更多的参与者在研讨会期间反思的结构化机会，以尽量减少任何新出现的耻辱的伤害。
The burden of noncommunicable diseases (NCDs) including hypertension, diabetes, and cancer, is rising in Sub-Saharan African countries like Tanzania and Malawi. This increase reflects complex interactions between diverse social, environmental, biological, and political factors. To intervene successfully, new approaches are therefore needed to understand how local knowledges and attitudes towards common NCDs influence health behaviours. This study compares the utility of using a novel arts-based participatory method and more traditional focus groups to generate new understandings of local knowledges, attitudes, and behaviours towards NCDs and their risk factors. Single-gender arts-based participatory workshops and focus group discussions were conducted with local communities in Tanzania and Malawi. Thematic analysis compared workshop and focus group transcripts for depth of content and researcher-participant hierarchies. In addition, semiotic analysis examined the contribution of photographs of workshop activities to understanding participants’ experiences and beliefs about NCD risk factors. The arts-based participatory workshops produced in-depth, vivid, emotive narratives of participants’ beliefs about NCDs and their impact (e.g., “… it spreads all over your body and kills you—snake’s poison is similar to diabetes poison”), while the focus groups provided more basic accounts (e.g., “diabetes is a fast killer”). The workshops also empowered participants to navigate activities with autonomy, revealing their almost overwhelmingly negative beliefs about NCDs. However, enabling participants to direct the focus of workshop activities led to challenges, including the perpetuation of stigma (e.g., comparing smells associated with diabetes symptoms with sewage). Semiotic analysis of workshop photographs provided little additional insight beyond that gained from the transcripts. Arts-based participatory workshops are promising as a novel method to inform development of culturally relevant approaches to NCD prevention in Tanzania and Malawi. Future research should incorporate more structured opportunities for participant reflection during the workshops to minimise harm from any emerging stigma.