Int. J. Environ. Res. Public Health 2009, 6 2. Data Collection and Methods 2484 The methodological foundations of critical ethnography were well suited to this inquiry, because they encourage attention to the social organization of everyday activity [27,28]. We augmented focus groups and in-depth interviews with photo-elicitation techniques [29-31]. First, focus group discussions encouraged 4-6 participants to share insights gained through learning about their risk for CHD, setting personal goals, and making lifestyle changes to modify their risk factors. Following focus groups, disposable cameras were distributed and participants were instructed to take pictures of everyday scenes or objects that influenced their health or represented their experiences with risk modification. This offered the opportunity to creatively and dramatically show us some of the geographic, social and practical influences on health behaviour change. After the photographs were developed, individual, hour-long, semi-structured interviews were focused on the images to elicit in-depth discussion of the issues they represented. That is, the photos themselves were not analyzed; rather, they were used as a focal point within the interviews. In many cases, participants were able to reflect on habitual and infrequently acknowledged dimensions of their everyday lives as they considered what to photograph, created photographic images, and reviewed images in conversation with an interested and active listener [29-31]. Photographs were digitally anonymized by blurring facial features. Signs identifying businesses or restaurants were also blurred and replaced with representative generic terms such as “Fast Food”. 2.1. Recruitment Research Ethics Board approval was obtained from the University of Toronto, Laurentian University, Sudbury & District Health Unit, and all hospitals that assisted with recruitment for the intervention study. Participants were recruited from Toronto (a densely populated urban metropolis) and Sudbury (a mid-sized city surrounded by a sparsely populated rural area). We sent letters of invitation to those who were registered in the larger intervention study sample. Sudbury and the surrounding rural area are home to clusters of French-Canadians, so we sought to include members of these communities by sending a French letter of invitation to the few participants in the larger intervention study who identified French as their first language. We also recruited francophone participants from a local cardiac rehabilitation program, because its participants were similarly aware of their risk factors and had received information about risk modification. Interviews and data analysis for each subgroup were conducted separately by locally situated research sub-teams; francophone subgroup data collection and analysis were done in French. Analysis was concurrent with data collection, and sub-teams communicated throughout the study using email, teleconferences, and intensive, one or two- day site meetings. 2.2. Theoretical Foundations and Analysis Focus group discussions and interviews were professionally transcribed. Reflexive discussions and observations about the data were shared within and between sub-teams. The photographs were scanned and catalogued so that they could be referred to during analysis, but they were not individually