Integrating a Social Ecological Model With Focused Ethnography for Culturally Informed Health Behavior Research

The majority of chronic diseases are attributable to modifiable lifestyle behaviors. Healthcare practitioners, policymakers, and researchers desiring to help individuals and communities change behavior must understand the factors influencing the behavior of interest, including social and cultural context. Qualitative research addressing culture and context can give decision-makers a rich understanding of people’s experiences, attitudes, and beliefs to help people adopt and maintain healthy behaviors. Integrating a theoretically-driven conceptual framework in qualitative investigations of complex health behavior-related phenomena can provide a structure from which to investigate and analyze the findings. This structure can support future quantitative research by identifying saturated concepts within a theory. Few resources are available for independent researchers or small teams desiring to conduct robust, trustworthy, and meaningful research. In this article, we describe a process for integrating a conceptual framework and updating the framework using the findings from a focused ethnography study of eating behavior influences among emerging adults in the U.S. military as an exemplar. We provide recommendations for collecting and analyzing multiple qualitative data sources and interpreting findings within a compressed timeline despite COVID-19 public health restrictions. These recommendations may benefit doctoral students aiming to complete an impactful qualitative dissertation or novice researchers looking for ways to scope a complex health behavior study.