pets Archives - CHAIM Centre /chaimcentre/tag/pets/ ĐÓ°ÉÔ­´´ University Thu, 09 Jan 2020 18:06:36 +0000 en-US hourly 1 https://wordpress.org/?v=6.3.1 Exploring Links between Bonds with Pets & Human Well-Being /chaimcentre/2019/exploring-links-between-bonds-with-pets-human-well-being/?utm_source=rss&utm_medium=rss&utm_campaign=exploring-links-between-bonds-with-pets-human-well-being Wed, 16 Oct 2019 13:20:17 +0000 /chaimcentre/?p=2851 By Maria Pranschke, M.Sc., Department of Neuroscience

Can having a pet improve your health? Ask any pet owner with a close relationship to their dog or cat and you’ll probably get a resounding “Yes!” Many researchers will also tell you that the scientific findings regarding the association between having pets and health look pretty positive. Links have been found between owning pets and multiple aspects of physical and mental well-being, including (Kramer, Mehmood, & Suen, 2019), better heart health (Mubanga et al., 2017), better sleep and exercise habits (Headey, Na, & Zheng, 2008), and less loneliness (Stanley, Conwell, Bowen, & Van Orden, 2013).

While the scientific literature on pets and health is promising, a closer look reveals that the story isn’t always consistent. Some studies have been unable to detect links between owning an pet and key health outcomes (Wright, Kritz-Silverstein, Morton, Wingard, & Barrett-Connor, 2007), and some researchers have even found that owning a pet can predict negative health outcomes (Koivusilta & Ojanlatva, 2006). Some of the inconsistencies can probably be traced back to variations in the way studies were conducted, but it might also be that different individuals and social groups experience pet ownership differently. In other words, there could be key social, psychological, and even biological factors that influence how much (or little) benefit people get out of sharing their lives with animals. The goal of our research was to move beyond just asking whether or not pets are good for our health, to focus instead on characteristics that might alter this relationship. For example, is a pet’s presence enough, or does the strength of the bond matter? Does having a supportive social network affect the way you feel about your pet? Do stressful life circumstances (like illness, homelessness, or poverty) change our relationships with animals and how important they are for our health?

At the same time as we try to better understand the psychosocial factors that contribute to the benefits of pet ownership, a growing body of research has converged on oxytocin (a hormone known for its role in stress reduction, bonding, and many other social behaviours) as a possible major biological player in our interactions with animals. Prior studies have shown that oxytocin levels in our body change in the presence of a friendly animal, particularly when it’s an animal we’ve bonded with (Handlin et al., 2011). Oxytocin appears to impact our brain and body’s stress response, potentially connecting positive social behaviours (like turning to a friend for help) to the reduction of distress (Heinrichs, Baumgartner, Kirschbaum, & Ehlert, 2003). Differences in genes that are responsible for oxytocin functioning appear to impact the way we relate to others on a social level, including how we pursue and respond to social support (Chen et al., 2011; Kim et al., 2010). If bonds with cats and dogs are similar to bonds with people, could genetic variation in our oxytocin system similarly affect human-animal relationships?

To explore these questions, we conducted a series of studies that combined survey measures (assessing emotional attachment to pets and facets of human health & well-being) with genetic analysis. By isolating DNA from saliva samples, we were able to look at small variations known as (or SNPs) in oxytocin-related genes and test for links between people’s genetics and their survey responses.

The research began in the fall of 2017 when we rented booth space at the Ottawa Pet Expo, a weekend event for pet enthusiasts. While there, we gathered survey responses and saliva samples from 100+ pet owners—mostly people with dogs and cats but a few with other types of animals. In a second study, we set up our booth at public locations around Ottawa and repeated this procedure; this time we also encouraged participation from non-pet owners as a comparison group. Finally, our third study took place at events organized by , an organization that provides free veterinary care for low-income, marginally housed community members in Ottawa. Gathering data from these different populations allowed us to look at how the role of pets might differ based on personal circumstances.

As soon as we began analyzing the data, the results challenged our assumptions. We had predicted that strong feelings of attachment towards a pet would be linked to improved mental well-being, but in fact an opposite pattern emerged – in all three groups, participants who were more strongly bonded to their animals were also more likely to report experiencing poorer well-being, including more symptoms of depression, loneliness, and lower feelings of social connection. Strong attachment to pets was also associated with being more likely to have a physical illness.

What could these results mean? While it’s possible that strong emotional ties with an animal directly negatively impact human well-being (perhaps because caring for a pet might strain time and financial resources), we believe that it’s more likely that when people are highly emotionally stressed (depressed, lonely, or socially isolated), they may be more likely to turn to their pets for comfort. Some evidence for this possibility exists in the form of research showing that many pet owners view their animals as unique and important sources of support, especially when they are strongly attached to their pet (Meehan, Massavelli, & Pachana, 2017). If people are turning to their pets as a way of coping with things like stress and loneliness, this could explain why animal relationships are often so important to people who are isolated or socially marginalized, like older adults and individuals who are homeless. In fact, in our own research, we found that participants who were living with poverty and housing insecurity were especially likely to say that they were highly attached to their pets.

We also found that a SNP of the oxytocin receptor gene was linked to owning a pet. Results from a large twin study released earlier this year suggested that a tendency towards having animals (in this case, dogs) might be (Fall, Kuja-Halkola, Dobney, Westgarth, & Magnusson, 2019), which makes this a particularly interesting finding. However, the relatively small number of participants in our own study means that this finding should be taken with a grain of salt; repeating this research with a larger group would be one way to check if the association is meaningful or not.

As with any study, it’s important to remember that lots of different factors might have affected the results, including when and where we gathered data, who was motivated to take part in the research, and how we chose to measure things like attachment and well-being. While our findings were unexpected, the takeaway from this research is not that we should ignore pets and their role in human health—these are important phenomena that need to be studied and explored, especially when pets seem to be so important to so many people. But as with research into any interesting human behaviour, the relationships between pet ownership, emotional bonds with animals, and health & well-being are bound to be complex. Learning more about these links will be challenging, but worthwhile.

References:

Chen, F. S., Kumsta, R., Dawans, B. v., Monakhov, M., Ebstein, R. P., & Heinrichs, M. (2011). Common oxytocin receptor gene (OXTR) polymorphism and social support interact to reduce stress in humans. PNAS USA, 108(50), 19937-19942.

Fall, T., Kuja-Halkola, R., Dobney, K., Westgarth, C., & Magnusson, P. (2019). Evidence of largegenetic influences on dog ownership in the Swedish twin registry has implications forunderstanding domestication and health associations. Scientific Reports, 9(1), 7554-7.

Handlin, L., Hydbring-Sandberg, E., Nilsson, A., Ejdebäck, M., Jansson, A., & Uvnäs-Moberg, K. (2011). Short-term interaction between dogs and their owners: Effects on oxytocin, cortisol, insulin and heart rate—An exploratory study. Anthrozoös, 24(3), 301-315.

Headey, B., Na, F., & Zheng, R. (2008). Pet dogs benefit owners’ health: A ‘natural experiment’ in  China. Social Indicators Research, 87(3), 481-493.

Heinrichs, M., Baumgartner, T., Kirschbaum, C., and Ehlert, U. (2003). Social support and oxytocin interact to suppress cortisol and subjective responses to psychosocial stress. Biological  Psychiatry, 54, 1389–1398.

Kim, H. S., Sherman, D. K., Sasaki, J. Y., Xu, J., Chu, T. Q., Ryu, C., . . . Taylor, S. E. (2010). Culture, distress, and oxytocin receptor polymorphism (OXTR) interact to influence emotional support  seeking. PNAS USA, 107(36), 15717-15721.

Koivusilta, L. K., & Ojanlatva, A. (2006). To have or not to have a pet for better health? PloS °ż˛Ô±đ,Ěý1(1), e109.

Kramer, C. K., Mehmood, S., & Suen, R. S. (2019). Dog ownership and survival: A systematic review and meta-analysis. Cardiovascular Quality and Outcomes.

Mubanga, M., Byberg, L., Nowak, C., Egenvall, A., Magnusson, P. K., Ingelsson, E., . . .  Institutionen för kirurgiska vetenskaper. (2017). Dog ownership and the risk of cardiovascular  disease and death – a nationwide cohort study. Scientific Reports, 7(1), 1-9.

Stanley, I. H., Conwell, Y., Bowen, C., & Van Orden, K. A. (2014). Pet ownership may attenuate loneliness among older adult primary care patients who live alone. Aging & Mental Health, 18(3), 394-399.

Wright, J. D., Kritz-Silverstein, D., Morton, D. J., Wingard, D. L., & Barrett-Connor, E. (2007). Pet ownership and blood pressure in old age. Epidemiology, 18(5), 613-618.

]]>
2019 One HEALtH Student Challenge Launch Event /chaimcentre/2019/2019-one-health-student-challenge-launch-event/?utm_source=rss&utm_medium=rss&utm_campaign=2019-one-health-student-challenge-launch-event Wed, 09 Oct 2019 16:47:37 +0000 /chaimcentre/?p=2823 This past Friday marked the official launch of the 2019 One HEALtH Student Challenge! The kickoff event featured 2 fascinating guest speakers, several expert consultants, 6 graduate mentors, and 30+ excited undergraduate competitors eager to start tackling this year’s topic from a One Health perspective. The students came from a wide range of disciplines, including psychology, neuroscience, biology, health sciences, public policy, and economics.

The day began with an introduction to the meaning of One Health by Dr. Kim Matheson, Culture & Gender Mental Health Research Chair at ĐÓ°ÉÔ­´´ and Director of the CHAIM Centre. Dr. Matheson also introduced the topic of this year’s challenge, which is to develop a framework for designing a plan for the Ottawa inner city area to create the environment and social conditions that allow anyone, including marginalized or vulnerable populations, to be able to effectively care for and derive the health benefits of companion pets.

After a light lunch, , a professor and research chair in One Health & Wellness at the University of Saskatchewan, spoke to students about the concept of (reciprocal benefits between humans and animals) and emphasized the importance of the human-animal bond for promoting wellness. In her research with animal-assisted interventions, Dr. Dell has found that people struggling with substance use sometimes connect to animals in unique ways, reacting to the unconditional acceptance and non-judgmental support offered by furry helpers. In Dr. Dell’s words, “The animals were able to provide something that the humans couldn’t, or wouldn’t.”

Next students heard from Dr. Sue Kilborn, a veterinarian and board member of , an organization that provides pro-bono animal care alongside human health services to low-income pet owners. Dr. Kilborn spoke to students about how veterinary care for pets can act as a gateway into a vulnerable person’s life: “Because in many cases [pets] are the single most important relationship in their life, they’ll do anything to get care for them. Once that’s delivered, people are open to dialogue about their own health care.” In this way, pets may be catalysts for positive health and behaviour changes.

Towards the end of the day, team mentors facilitated a short activity with students meant to get them thinking about the Challenge topic and prepare them for managing group dynamics over the course of the competition. With these perspectives in mind, students will spend the next 6 weeks working in interdisciplinary teams to develop their own framework to promote healthy human-pet interactions in a dense urban area. Each team will be supported by a graduate mentor and will have access to a host of project consultants with expertise in neuroscience, health psychology, urban design, public policy, and other related areas. We’re looking forward to seeing what the teams come up with!

Check back here or follow us on Twitter @CHAIM_Centre for more updates as the Challenge progresses!

]]>
Endlessly Curious /chaimcentre/2017/endlessly-curious/?utm_source=rss&utm_medium=rss&utm_campaign=endlessly-curious Mon, 14 Aug 2017 19:58:03 +0000 /chaimcentre/?p=2090 By: Miski Dahir

Growing up, one of my favourite trips was to the doctor’s office. We would get in the car and drive to the doctor’s. I would sit in the waiting room, eagerly waiting for the moment the receptionist called out my name and said “please follow me to your room”. The doctor would finally come in, ask how I was doing and tell me to explain what I was visiting for. A few checkup procedures and five minutes later, I would walk out with a prescription in one hand, a sticker on the other, and torrent of thoughts in mind.

See, what fascinated me about the doctor’s office wasn’t the stickers (though I absolutely loved them). Rather, I was fascinated by how the doctor could ask me for a list of symptoms, check whatever was hurting me and figure out what was going on with my health. Health. What an awesome word. Five-year-old me was fascinated by health. What exactly was health? What did it encompass? Five-year-old me however, built a definition of health based on doctor visits and medical documentaries on television. I thought health only encompassed the physical human body. I thought that health could only be approached from a medical perspective, and could only be treated by doctors.

As I grew older though, I came across other words. Words like stress, anxiety, depression and eventually, mental health. With this, I learned that health was so much more complex than just the physical human body. The World Health Organization defines health as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” I particularly like this definition because it outlines all the other aspects of health I hadn’t been aware of, or really thought about when I pondered health.

The research project we are working on this summer is “Our Pets and Our Health: a photovoice pilot study.” This project is exploring how pets affect the health of people who are vulnerably housed or are dealing with homelessness. I vividly remember my first conversation with Dr. Kim Matheson on the project. During our conversation, she asked me if I’d ever heard of One Health. I hadn’t. When I shook my head and said “No,” she went on to explain what One Health meant. One Health is a multidisciplinary approach to health. It recognizes that human health is interconnected with the health of animals and the environment. It unites multiple fields for the improvement of health. To my great surprise, that one conversation with Dr. Matheson left me with a different understanding of health and many thoughts, insights and curiosity.

Just how closely is human health interconnected with animal health? This is one area of curiosity I just had to satisfy this summer. During the first few weeks of the summer, we spent time reading journal articles and familiarizing ourselves with the literature on this topic. The results of my readings? More insights. Even more curiosity. The benefits people derive from animals is incredible. From their great use in animal assisted therapy to the unconditional love and support they provide to people as pets, their important roles in the lives of people is unrivaled. I am really excited about the Our Pets and Our Health project, as it will provide us with more insights on how pets can positively impact the lives of vulnerable populations.

I never had any pets growing up. Due to this, I never really thought about the ways in which animals played a role in my life. I never thought that animal and human health could be interrelated, especially for someone who had never had a pet. However, working on this research project has allowed me to reflect on how animals have, in fact, played a role in my life. When I look back on my childhood, I have memories of walking to a park by the Rideau River with my family. My dad and I would feed the geese (though we probably shouldn’t have). We would go to hills and watch groundhogs come out. Despite not having a cat ourselves, we would play with the neighbourhood cats. Some of my favourite trips were those to the Agricultural Museum where we would watch horses, cows and other farm animals.

I recently talked to an uncle of mine who had gone on vacation. When I asked for pictures, I didn’t receive pictures of him. I was sent pictures of cats and baby goats. When I go through my camera roll on my phone, I find pictures I’ve taken of animals without giving much thought. Why is that? I’m starting to think it all goes back to One Health. Regardless of whether you’re a pet owner or not, you interact with animals and environment all the time. Ultimately, they do impact your health and play a very important role in your life. This summer has shown me that animals do play a role in our lives and discovering the health benefits we can derive from them is something I’m really looking forward to. I am eager to learn the findings of our research and to continue to expand my definitions, and understanding of health.

]]>
When Research Meets Passion /chaimcentre/2017/when-research-meets-passion-2/?utm_source=rss&utm_medium=rss&utm_campaign=when-research-meets-passion-2 /chaimcentre/2017/when-research-meets-passion-2/#comments Thu, 10 Aug 2017 14:29:45 +0000 /chaimcentre/?p=2079 By: Jyllenna Wilke

At least once a week, I make the mistake of looking at videos of dogs on Instagram and promptly text my boyfriend to tell him that I want a dog. When I drive by someone walking a dog, I seriously consider pulling over and asking to pet the dog. The biggest challenge in moving away from home for university was leaving behind my two dogs and three cats. I am pretty sure one of my parent’s biggest concerns is me adopting a dog or cat that I am not able to take care of. My future plans include raising a puppy and baby goat together so they grow up to become best friends.

So you might say I really like animals. More accurate, though, is that I love animals.

I especially find a certain kind of hope and love in rescue animals. Through the years, my family has been able to foster several dogs and several litters of kittens for various rescue organizations. All the pets we’ve owned have been rescued. Sometimes our pets proved challenging. When you have a rescue animal, there can be a lot of curveballs thrown your way. Some animals have had bad experiences with people, and you have to work to gain their trust. They might not have been trained properly or may have developed bad habits along their journey, and you have to train them to have proper manners. You might lose a few pairs of shoes and run outside in your bathrobe calling your pet’s name more often than you’d like, but that love in the animal’s eyes is so worth it in the end.

Growing up with animals, I took their presence for granted. I loved them and used them for support, but I never really considered the effect they had on my life until I moved away. Looking back, I see how my pets helped me through depression and anxiety. They were always there to listen and offer me their paw in support. Other times, I took comfort in seeing them bounce up to me and lick my face all over. Their happiness and love for life was contagious. Honestly, a few tears come to my eyes as I write this. The bond with them was so strong. Having animals that loved me so unconditionally truly gave me a reason to live. They were with me, and I knew I could face the day.

I was excited to move away from home for university. I looked forward to new experiences and challenges. But I underestimated how much I would miss my pets. My parents have even said that I probably miss the pets more than my human family. Facing the stressors of studies and relationship challenges without that constant, non-judgemental support and love was harder than I anticipated. I compensated for this by having pictures of my pets everywhere. When I skyped my family, I always had them bring the dogs and cats to the camera so I could talk to their very confused (and adorable) faces. I also visited the therapy dog in residence several times. My bond with my pets is one of the reasons I am so excited about this research. Given that I hadn’t even realized how they impacted me until I took time to consciously reflect, I am excited to see what data collection and analysis will reveal about the human animal bond.

I am a Neuroscience and Mental Health student. My own battles with mental health have made me extremely passionate about this issue. I want to both directly help people as well as research new ways of helping individuals that struggle. I am also passionate about rescuing animals and giving them the quality of life they deserve. When Dr. Matheson started describing the Pets and Our Health research project, I was beyond excited. I hadn’t heard of the One Health framework, the idea that the health of humans, animals, and the environment are related, or the Community Veterinary outreach, which provides veterinary services to individuals who would otherwise be unable to access animal care while also providing human health services. I didn’t know people were actually researching how animals effect our health.

Knowing the impact that animals have had in my life, even when I had a strong support network around me, I can only imagine how individuals who are homeless or vulnerably housed value their pets. During my internship, I’ve been reading journal articles about the relationship between vulnerable individuals and their pets. My eyes have been opened. For many of these individuals, their pets truly are their only supporters. They value the pets to the extent that it’s common to put the animal’s needs ahead of their own needs.

My hope through this research is that we are able to help to improve the quality of life for both people and their pets. I hope that the data that is collected will fuel further studies and provide a spark for future programs to help people and their pets in new ways. I hope that partnerships will form between different healthcare providers and animal organizations so that new, innovative ways of battling homelessness, mental illness, and animal neglect can be developed.

]]>
/chaimcentre/2017/when-research-meets-passion-2/feed/ 1
Exploring How Homeless People Derive Health Benefits From Their Pets /chaimcentre/2017/1978/?utm_source=rss&utm_medium=rss&utm_campaign=1978 /chaimcentre/2017/1978/#comments Tue, 06 Jun 2017 15:27:27 +0000 /chaimcentre/?p=1978 By Miski Dahir & Jyllenna Wilke

It’s been said that the best therapists have fur and four legs, and many individuals can provide anecdotal evidence for the healing power of animals. The idea of animals playing a role in human health and well-being has been frequently found in literature and popular culture. In many homes and communities, poor animal welfare is often indicative of poor human welfare, and there is also a link between animal abuse and family violence. The scientific community is also beginning to explore the links between animal and human welfare. Researchers have explored the idea of zoonosis, diseases which can be transmitted to humans from animals. But they are increasingly considering zooeyia, which refers to the positive impact that relationships with animals can have on human health. The concept of One Health considers how humans, animals, and the environment interact to affect human health. The framework of One Health can be utilized to explore how the welfare of animals is related to human welfare as well as how their environmental (or community) can enhance this relationship.

Biophilia, the connection an organism has with other living organisms in nature, is viewed as a basic, biological human need. Isolation and disconnect can result in negative consequences for the health of humans—mentally, physically, and spiritually. In contrast, connection and a sense of belonging can be indicators of good human health. Animals can meet the need for a connection to the natural world, and by doing so, they can improve the health of humans. One study demonstrated that a dog gazing at its owner significantly increased levels of oxytocin, a hormone responsible for feelings of attachment and happiness, in the owner. This increase in oxytocin could be indicative of one mechanism by which companion animals can improve human health. Other studies indicate that pets appear to improve the quality of life for vulnerable youth by reducing the use of drugs and number of arrests. Often the youth reduced their drug use in order to be able to provide a better quality of life for their pets. These studies support the idea that pets provide youth with stability and responsibility while also teaching them about unconditional love and trust.

More and more research is emerging on the positive effects of human-animal interactions. It appears that pets could be an effective way of helping people from more vulnerable and socially marginalized populations? Yet, understanding the needs of individuals from the populations sometimes requires looking at the world from their perspective, rather than through the administration of rating scales and surveys. Different methodologies can assess needs and impact while also providing opportunities for the individuals to feel comfortable and empowered in their participation in the research. One such methodology is photovoice.

Photovoice is a method that uses photography to allow participants to share their views and use it to enhance their community. According to Wang and Burris (1997), photovoice aims to achieve three goals: a) to allow people to record and reflect on their community’s strengths and concerns, b) to use photography to discuss and critically think about important issues in the community, and c) to forward this information onto policy makers. The process involves providing members of a community with a camera and allowing them to capture images of their community, environment, and everyday health. Participants discuss their photographs with one another, and share them with researchers, policy makers and other community members.

As a qualitative research method, the photovoice method has many useful applications. Photovoice allows researchers to have insights as to how a group of people may perceive the world around them. Photovoice is often used in health research with participants from marginalized populations and youth. The photovoice method allows all members of a group to participate and have a voice as long as they are able to learn to use a camera. It is inclusive and does not require participants to be able to read and write. As a result, it is an effective tool in giving a voice to members of marginalized populations who might feel reluctant or disempowered when pushed to communicate to people perceived to be in positions of power, such as researchers. Furthermore, the photovoice method allows participants to share their thoughts on their community and the world around them through a visual representation. As is often said, a picture can be worth a thousand words. This visual representation allows participants to share and document the world around them using a powerful mode. The photovoice method is also effective for people from cultures where storytelling is a traditional method of conveying information, beliefs and values. The use of photovoice as a research method not only gives participants the opportunity to be listened to, but it can also foster trust and social support.

Our Pets and Our Health: A photovoice pilot study will be looking at the impact of pet ownership on the health of vulnerably housed and homeless people in Ottawa, Ontario through the lens of One Health. Our goal for this research is to understand the perception of pets among this population including what motivates pet ownership and the perceived benefits and costs of owning a pet.

This study will be conducted in partnership with Community Veterinary Outreach. This organization provides pro bono animal care to individuals that may not be able to access health care for their pets. Services include vaccinations, spay and neuter, and general check-ups. Additionally, services to enhance human health are also provided, including dental services, support for those living with HIV, and programs to assist with quitting smoking. For many individuals that use the Community Veterinary Outreach service, they would not otherwise be able to access these human health care services. In this way, the clinic embodies the One Health initiative, by directly linking the health of human owners with the health of their pets.

This study has implications to the One Health research as well as policies of organizations working with homeless and vulnerably housed individuals. Our research is further exploring the concept of zooeyia, and it could open doors for further partnerships between animal health and human health professionals. If the research findings support a link between human and animal health and welfare in this population, this could encourage policy changes in organizations working with these individuals. Some changes could include increasing the number of pet-friendly shelters and housing operations, as well as increasing access to affordable animal care. Organizations might also consider the use of animal assisted therapy for client support.

Sources:

Chalmers, Darlene & Dell, Colleen Anne. (2015). Applying One Health to the Study of Animal-Assisted Interventions. Ecohealth, 12(4), 560-562.

Dell, Colleen & Anna Belle. (2015). Questioning “Fluffy”: A Dog’s Eye View of Animal-Assisted Interventions (AAI) in the Treatment of Substance Misuse. Subst Use Misuse, 50(0), 1148-1152.

Hodgson, Kate & Darling, Marcia. (2011). Zooeyia: An essential component of “One Health.”CVJ, 52, 198-191.

Kelly K.J. (2016). Photovoice Capturing American Indian Youths’ Dietary Perceptions and Sharing Behavior-Changing Implications. Social Marketing Quarterly. 23(1), 64-79.Jordan, Tyler & Lem, Michelle. (2014). One Health, One Welfare: Education in practice: Veterinary students’ experiences with Community Veterinary Outreach. CVJ, 50, 1203-1206.

Lem, Michelle, et al. (2013). Effect of Companion Animal Ownership among Canadian Street-involved Youth: A Qualitative Analysis. Journal of Sociology & Social Welfare, 40(4), 285-304.

Wang, C.& Burris, M. (1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education and behavior. 24(3), 369-387.

Wang, C., Cash J.L, Powers L.S. (2000). Who Knows the Streets as Well as the Homeless? Promoting Personal and Community Action Through Photovoice. Health Promotion Practice. 1(1), 81-89.

]]>
/chaimcentre/2017/1978/feed/ 1