Photovoice as a Participatory Needs Assessment to Explore Stress in Teens.

摘要

Teenagers experience feeling of stress, confusion, pressure to succeed, self-doubt, and other fears while navigating their way to adulthood. Teens have common experiences of stress across race, ethnicity and economic background, but there are stressful experiences during the teen years that differ due to the context of the community and school environment. Research related to stress in high-achieving schools is limited. With the increasing pressures of achievement and competition for college entrance, particularly in a community with higher parental expectations and a long standing history of academic excellence, exploring stress through the eyes of those living the experience is needed to understand their experiences, identify the supports that exist to help them cope and initiate additional resources that may be needed to further support their healthy journey through high school and beyond. Photovoice has been an effective method for conducting participatory needs assessments.;Students, parents, and high school faculty/staff in a high-achieving, Midwestern, suburban high school were engaged in conducting a participatory needs assessment. Students used a threeround, six-week photovoice project to depict their stressors and coping, whereas parents and faculty/staff participated in focus groups to discuss their perceptions of the high school student stress and coping. The overarching themes related to stress identified by the students, parents and faculty/staff included belonging and acceptance, time, expectations of school and success, and substance use. The themes related to coping identified by the students included reflections of self and situation, using nature and animals, positive relationships, finding an escape or distraction, and making choices to move on. Students also identified a two-stage process of coping which involved using emotion-focused coping strategies to deal with the stressful situations in the moment and then using problem-focused coping strategies to effectively "move on" through the stress. The parents and faculty/staff identified the major theme of student use of distractions or procrastination to cope.;Students recommended increasing opportunities for peer connection as a way to decrease the stress of social acceptance. Both students and parents identified that students needed more training and better coping skills. Parents also suggested that the role of the school nurse be strengthened and expanded to include specific mental health training and to be a more visible resource for the students and also suggested that a more detailed guide be designed for parents and students (junior year) for the college search to assist in managing the stress related to that process. The faculty/staff identified enhanced emotional capacity of parents and teachers (or other adult resources at the school) as a critical coping resource for students and suggested that emotional capacity be included in screening of new faculty/staff hires. In addition it was recommended that current faculty/staff receive education and training in enhanced emotional capacity as part of professional development and suggested that this could be offered as part of a district wellness program for employees.;The findings from this study support the concept of coordinated school health as well as school connectedness which have been shown to improve adolescent health and well-being. School health and wellness professionals and wellness teams can use this research to guide health and wellness needs assessments and evaluations within their school district. Health education professionals within the school can use this information to creatively engage students in exploring their perceptions of various health topics through the photovoice process. Other educators can use an adapted photovoice process as an innovative teaching strategy to stimulate discussion and writing about various topics.