• Nazleen Bharmal, David Kennedy, Loretta Jones, Charles Lee-Johnson, D'Ann Morris, Ben Caldwell, Anthony Brown, Tina Houston, Charlene Meeks, Roberto Vargas, Idalid Franco, A Rab Razzak, and Arleen F Brown.
• American Heart Association/Pharmaceutical Roundtable-Spina Outcomes Research, Center at UCLA, 710 Westwood Plaza, C109 RNRC, Los Angeles, CA, USA. nbharmal@mednet.ucla.edu
• J Gen Intern Med. 2012 Feb 1; 27 (2): 153159153-9.

BackgroundPremature mortality and disparities in morbidity observed in African-American men may be associated with factors in their social, economic, and built environments that may be especially influential during the transition to adulthood.ObjectiveTo have young, African-American men from Los Angeles County identify and prioritize factors associated with their transition to manhood using photovoice methodology and pile-sorting exercises.DesignQualitative study using community-based participatory research (CBPR) and photovoiceParticipantsTwelve African-American men, ages 16-26 years, from Los Angeles County, California.ApproachWe used CBPR principles to form a community advisory board (CAB) whose members defined goals for the partnered project, developed the protocols, and participated in data collection and analysis. Participants were given digital cameras to take 50-300 photographs over three months. Pile-sorting techniques were used to facilitate participants' identification and discussion of the themes in their photos and selected photos of the group. Pile-sorts of group photographs were analyzed using multidimensional scaling and hierarchical cluster analysis to systematically compare participants' themes and identify patterns of associations between sorted photographs. Sub-themes and related quotes were also elicited from the pile-sorting transcripts. The CAB and several study participants met periodically to develop dissemination strategies and design interventions informed by study findings.Key ResultsFour dominant themes emerged during analysis: 1) Struggles face during the transition to manhood, 2) Sources of social support, 3) Role of sports, and 4) Views on Los Angeles lifestyle. The project led to the formation of a young men's group and community events featuring participants.ConclusionsCBPR and photovoice are effective methods to engage young, African-American men to identify and discuss factors affecting their transition to manhood, contextualize research findings, and participate in intervention development.

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