"I see salt everywhere": a qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi

Bissett, M. et al. (2022) "I see salt everywhere": a qualitative examination of the utility of arts-based participatory workshops to study noncommunicable diseases in Tanzania and Malawi. PLoS Global Public Health, 2(12), e0000927. (doi: 10.1371/journal.pgph.0000927) (PMID:36962765) (PMCID:PMC10022006)

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Abstract

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.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gray, Professor Cindy and Strachan, Dr Zoe and Gill, Professor Jason and Bunn, Dr Christopher and Perry, Professor Mia and Bissett, Maria and Abdulla, Dr Sharifa and Lwanda, Dr John Lloyd and Mtenga, Dr Sally and Crampin, Professor Mia
Creator Roles:
Bissett, M.Formal analysis, Writing – original draft
Gray, C. M.Conceptualization, Formal analysis, Funding acquisition, Investigation, Methodology, Supervision, Validation, Writing – original draft
Abdulla, S.Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing – review and editing
Bunn, C.Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing – review and editing
Crampin, A. C.Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing – review and editing
Gill, J. M.R.Conceptualization, Formal analysis, Funding acquisition, Writing – review and editing
Lwanda, J.Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing – review and editing
Perry, M.Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing – review and editing
Strachan, Z.Conceptualization, Formal analysis, Funding acquisition, Methodology, Writing – review and editing
Mtenga, S. M.Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Supervision, Validation, Writing – original draft
Authors: Bissett, M., Gray, C. M., Abdulla, S., Bunn, C., Crampin, A. C., Dillip, A., Gill, J. M.R., Kaare, H. C., Kalima, S., Kambulu, E., Lwanda, J., Makoye, H. F., Mtema, O., Perry, M., Strachan, Z., Todd, H., and Mtenga, S. M.
Subjects:H Social Sciences > H Social Sciences (General)
N Fine Arts > NX Arts in general
R Medicine > RA Public aspects of medicine
College/School:College of Arts & Humanities > School of Critical Studies > English Literature
College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Social Scientists working in Health and Wellbeing
College of Social Sciences > School of Education > Culture, Literacies, Inclusion & Pedagogy
College of Social Sciences > School of Social and Political Sciences
College of Arts & Humanities > School of Culture and Creative Arts > Theatre Film and TV Studies
Journal Name:PLoS Global Public Health
Publisher:Public Library of Science
ISSN:2767-3375
ISSN (Online):2767-3375
Copyright Holders:Copyright © 2022 Bissett et al.
First Published:First published in PLoS Global Public Health 2(12): e0000927
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
302373Culture and bodies: an interdisciplinary approach to non-communicable disease prevention in Malawi and TanzaniaLucinda GrayMedical Research Council (MRC)MC_PC_MR/R024448/1Arts - English Literature