J Am Acad Audiol 2019; 30(05): 406-416
DOI: 10.3766/jaaa.18034
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Examining the Utility of Photovoice as an Audiological Counseling Tool

Gabrielle H. Saunders
*   VA RR&D National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR
†   Eriksholm Research Centre, Snekkersten, Denmark
Lauren K. Dillard
*   VA RR&D National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR
‡   Communication Sciences and Disorders, University of Wisconsin, Madison, WI
Melissa T. Frederick
*   VA RR&D National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR
ShienPei C. Silverman
*   VA RR&D National Center for Rehabilitative Auditory Research, Portland VA Medical Center, Portland, OR
› Author Affiliations
Further Information

Publication History

30 September 2018

03 October 2018

Publication Date:
26 May 2020 (online)



Photovoice is a participatory action research method in which people take photographs to represent real-world experiences, so that issues of interest/concern can be documented. There are no published studies in which photovoice has been used in audiological rehabilitation (AR). The purpose of this feasibility study was to examine whether photovoice could have application in audiology.


A feasibility study was designed to determine whether photovoice could be adapted for use as a clinical auditory rehabilitation tool (1) to facilitate provision of tailored communication strategy counseling, (2) as a post–hearing aid fitting counseling tool, (3) to enhance communication between partners regarding hearing loss, and (4) to provide an understanding of the emotional impacts of hearing loss.

Research Design:

In this combined qualitative and quantitative feasibility study, a photovoice intervention was given to four groups of participants.

Study Sample:

Twenty-four individuals were recruited from a research subject data repository at the National Center for Rehabilitative Auditory Research.

Data Collection and Analysis:

The study involved two visits to the laboratory during which participants received instruction in photovoice methodology (visit 1) and then, one to two weeks later, discussed their photographs during a debriefing session (visit 2).


The mean number of photographs taken by participants was 12.6 (range: 4–29); the mean duration of the debriefing sessions was 40:39 min:sec (range: 14:30–66:22 min:sec). Participants reported that participating had made them think more about their hearing problems, appreciate their hearing aids more, and be more aware of the situations in which their hearing aids did and did not help. The taking and discussion of the photographs was also described as a learning tool, and it had facilitated conversations with others about hearing problems. Participants who completed the study with their communication partner (use case 3) said it had assisted with problem-solving and gave insight into the perspective of their partner. The research team noted that photovoice facilitated highly tailored counseling and provision of evidence-based recommendations for hearing assistive technology, enhanced interaction between communication partners, provided insight into participants’ lifestyle and communication needs, and seemed to generate rapport and trust.


This feasibility study indicated that participants were willing to engage in photovoice and that it could be used to guide selection of rehabilitation recommendations and for postfitting counseling. Its application in audiological practice would seem timely and valuable for improving patient-centered and family-centered AR.

This study was supported by funding by the Department of Veterans Affairs (VA), Veterans Health Administration, VA Office of Research and Development award #C9230C.

Aspects of this work were presented at the American Auditory Society Meeting, Scottsdale, AZ, March 1–3, 2018.

The views are those of the authors and do not necessarily represent the position or policy of the US Department of Veterans Affairs or the US government.


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