Implementation of Photovoice by extensionists as a potential strategy to face the COVID-19 pandemic or post-pandemic in Primary Health Care

Abstract

During the experience of extension workers in territories covered by Primary Health Care (PHC), it was observed that the care of people in situations of high social vulnerability goes through many challenges. With the COVID-19 pandemic, this situation worsened, depriving people of human rights and the protection of life, and revealed the depletion and saturation of resources and health professionals. Through university extension activities, it is possible to provide dialogic spaces, developing actions that imply the reception, communication and empowerment of people. The aim of this study was to know during the pandemic and post-pandemic of COVID 19 the experiences lived by vulnerable populations and by health workers of the PHC; identify barriers and facilitators strategies related to coping with COVID-19 in PHC and in the territory; and, finally, to implement and evaluate the Photovoice intervention as a strategy that favors the empowerment of community leaders and PHC health workers. The research will be developed based on the theoretical-methodological assumptions of Popular Education in the Freirian perspective, following the path systematized by Participatory Research Based on the Community and an evaluative component structured in the RE-AIM model, it is a qualitative and quantitative approach. Nine meetings are planned per digital platform, lasting 60 to 90 minutes with community leaders and health workers (Nurses, nursing technicians and Community Health Agents) in two Basic Health Units (UBS): Americanópolis and Jardim Lourdes. Through an intentional sample, we will select 24 people, 12 participants from each UBS, being: 6 health workers (2 nurses, 2 nursing technicians and 2 Community Health Agents) and 6 community leaders. In the first meeting, we will have a focus group to know the lived experiences and from the second we will apply the intervention of the Photovoice method for image production. At the last meeting, we plan to hold an event to disseminate/disseminate the results. The research will only start after approval by the Research Ethics Committee. Qualitative data will be obtained from guiding questions and analyzed based on Bardin's Content Analysis framework. With a quantitative and qualitative approach, we will evaluate indicators of adoption, reach, effectiveness, implementation and maintenance of the Photovoice intervention. The analysis of continuous variables will be performed by calculating the mean, standard deviation, median, minimum and maximum, and for categorical variables, frequency and percentage. As the main outcome variable, we will assess empowerment before and after the end of the Photovoice workshop. The paired t-student test or the Wilcoxon Signed Ranks test will be used, parametric and non-parametric tests will be used to assess the behavior of the scale according to the covariates. The level of significance will be 5%, the statistical software R version 4.0.2 will be used. (AU)