Breaking barriers: doctoral student helps document breastfeeding challenges for Black mothers, shares their voices — and finds her own

A photo speaks louder than words.

That’s the proverbial premise behind the Savannah H.O.P.E. Photovoice Project, a visual, community-based research project led by Georgia Southern University researchers that helps identify social, cultural and physical barriers that Black mothers in Chatham County face while breastfeeding. The project won a 2021 Health Innovation Award from Healthy Savannah.

As part of a Centers for Disease Control and Prevention’s $3.4 million grant, Healthy Opportunities Powering Equity (H.O.P.E.), the localized project allows those who seldom have the chance to voice their concerns share their experiences with the hope of creating social change.

Double Eagle Christina Cook (’16,’19) has assisted Savannah H.O.P.E. Photovoice Project lead Nandi Marshall, DrPH, associate professor in the Jiann-Ping Hsu College of Public Health (JPHCOPH) and associate dean of Academic Affairs, for the last three years. First serving as the JPHCOPH graduate assistant while completing a master’s in public health and now as Marshall’s graduate assistant in the public health doctoral program, Cook has taken pride in helping others amplify their voices.

In turn, she found her own.

“Personally, what this has done for me is solidify my direction,” said Cook. “As someone who likes to navigate a lot of different paths, and someone who is an intuitive and does-this-feel-right type of person, doing the work has really led me down the path of what I want to do because I am very committed to a sense of justice.”

The photovoice method, a groundbreaking visual research methodology that empowers marginalized individuals to document their experiences and communicate their concerns, was utilized, as participants captured images that represent local breastfeeding barriers. Some snapped shots in corporate settings and public areas without access to breastfeeding areas, while others hinted at a lack of family support or pushback based on cultural norms, captured with photos in familial surroundings.

“A lot of them are physical barriers,” said Cook. “There is just not a space available. It was really surprising. Even in churches, one of the moms said that whenever she would go to church the only place for her to go was the bathroom. Or someone was ushered into the office to nurse there.

“The other ones have been sociocultural like this is something that Black people don’t do or what family members would say. Or going into a public park and people just staring at the moms while they breastfed.”

Sessions facilitated by Cook and Marshall allowed participants to talk about the photos, their perspectives and ideas for change with one another to help guide resolutions to overcome barriers for improved local breastfeeding equity.

Marshall praised Cook’s integral role in the project.

“She is by far an essential team member,” said Marshall. “Her involvement in community-based, participatory research allows her to implement her classroom knowledge while building on skills that will allow her to continue the work of achieving health equity when she graduates. Truly understanding how to engage communities and ensure they not only feel supported but cared for, is a skill that can’t be taught in the classroom. It comes from showing up, by being authentic, being present and keeping the needs of the community in the forefront. Christina continues to show up time and time again. She has proven to be invaluable and a tremendous asset in improving the health outcomes of the communities we work with.”

If you are a journalist looking to learn more about the Savannah H.O.P.E. Photovoice Project led by Georgia Southern University and would like to connect with Double Eagle Christina Cook or Nandi Marshal - then let us help.  Simply  contact Georgia Southern Director of Communications Jennifer Wise at jwise@georgiasouthern.edu to arrange an interview today.