Background: Visual material, such as photos or images, can serve as tools for communication, capable of evoking memories, emotions, and fostering dialogue. Particularly for individuals facing vulnerabilities such as physical and mental health issues, substance abuse, and/or distrust towards authorities, photos can provide alternative communication channels. Using visual material can offer individuals choices and interpretative space, but also serve as an ice-breaker in conversations.

Aim: Describing the process of using visual material in a collaborative project where photos and images were an integral part of data collection and clinical improvement efforts.

Methods: Photos associated with health and well-being, as well as with living conditions during Covid-19, were used in research interviews with women in homelessness. Visual material was used to inform about support services related to abuse and to raise awareness about violence when being homeless.

Three approaches were used to identify photos:

1. Researcher-generated photo-elicitation with photos chosen by the research team.

2. Collaborative photo-elicitation, where the research group provided a large number of photos forselection by women with firsthand experiences of homelessness and violence.

3. Development of visual material through iterative exchanges between the research group, women with firsthand experiences of homelessness and violence, and healthcare personnel from a primary care unit specializing in acute homelessness.

Results: The selection process for photos unveiled varying perceptions among different groups regarding the visual material. Overall healthcare personnel deemed photos more emotionally charged and offensive compared to women with experiences of homelessness and violence. For the interviewing researcher, photos were perceived to enable a sensitive approach with regard to the target group's ability to engage in research but for the women being interviewed the photoes could have less of an impact.

Conclusion: Photos convey diverse meanings, highlighting the necessity of considering multiple perspectives in the selection process. While participant-generated photos might have proven more effective, the utilization of available options provided valuable insights.