The value in rapid, multi-site team ethnography for understanding context to design public health interventions: learning from the PASSPORT study

Low levels of physical activity is a global public health challenge, and children are not taking part in recommended amounts of physical activity. To date, the majority of school-based physical activity interventions have not yielded increases in pupils’ physical activity levels, and it is suggested that this is partly due to traditional intervention approaches ignoring the role of individual school context. By context we mean the school setting, ethos, staff, and sociodemographic factors. Public health interventions must consider the context in which they are intervening to be sustainable and to capture complexity. Yet in this field, ethnographic approaches have been limited, especially when used in the development of an intervention. In this paper, we first describe how we conducted a rapid, multi-site team ethnography consecutively in three English primary schools over four months to inform the development of a flexible context-specific intervention to promote physical activity in primary schools. Data collection methods included collecting documentary data, observation, creative activities with pupils, semi-structured interviews with school staff and wider community members, informal conversation, and field notes. Second, we reflect on key learning from this work and its implications for others undertaking rapid ethnography to inform the development of public health interventions. These include practical considerations for the method, as well as illustrating how the approach provides different research insights, can contribute to the complex intervention agenda, and can support the development of more inclusive interventions. In doing so, we illustrate the value of ethnographic approaches in developing contextually-sensitive interventions that can address global public health challenges.