Box 1. How are general practitioners GPs responding to possible child maltreatment in England? A mixed methods study There is considerable debate about the role that GPs should play in the management of child maltreatment abuse or neglect.
This study aimed to describe and understand the types of responses that GPs were making when faced with a child or family who prompted concerns about child maltreatment. The broad research question about GP responses to child maltreatment prompted several sub-questions; each answered by either a quantitative or qualitative methodology. In this study, there were two stages of analysis. First, we analysed the data from each study separately and presented findings from each of the data as answers to the sub-questions.
Secondly, we integrated the two data and findings to provide a multi-faceted insight into the broader research question about GP responses to maltreatment. A mixed methods design was chosen to facilitate increased breadth and range of study findings; both illuminated different aspects of the same complex issue. In this case, the two methods allowed access to data and insights that each method alone could not provide.
Insights from the mixed methods design included differences between the type of maltreatment concerns that are recorded by GPs in the quantitative dataset and the types of concern that were preoccupying and resource-intensive according to the interviews. The interview and observation data also provided an understanding of a wide range of relevant GP responses, from the perspective of the primary care team, whereas the quantitative dataset could only provide data about recording practices.
Box 2. This is a complex question encompassing medical and sociocultural factors. Each type of data was analysed separately with findings from one analysis informing the other. Data were also compared and contrasted at the interpretation stage. Where appropriate and feasible, the quantitative and qualitative data has been presented in an integrated way, rather than as separate studies. The quantitative phase enabled us to identify potentially important disparities in outcomes and health care access.
The qualitative phase allowed us to understand what may be driving these disparities, whilst also identifying previously neglected aspects of pregnancy in this group of women such as stigma within health care settings. Open in a separate window Usually, quantitative research is associated with a positivist stance and a belief that reality that can be measured and observed objectively.
Strengths of quantitative research include its procedures to minimize confounding and its potential to generate generalizable findings if based on samples that are both large enough and representative. It remains the dominant paradigm in health research. MM practitioners promote the development of a theory-based set of three hypotheses. Specialists encourage researchers to construct three separate types of hypotheses for an MM research project. There can be more than three hypotheses but there must be at least one of each type.
The first hypothesis should be quantitative and the second should be qualitative. The third hypothesis will be an MM hypothesis. Integration of these data is often complex, even when there is a strong theoretical rationale for doing so. Data integration occurs when quantitative and qualitative are combined in a data set.
Yet understanding the overall reasoning for using MM and how to best combine the approaches in practice can help lessen the challenge of MM data integration Bryman, Types of MM Research There are dozens of MM designs, but for the purpose of this article, six MM designs will be presented: The sequential explanatory method employs two different data-collection time points; the quantitative data are collected first and the qualitative collected last. The sequential exploratory design is best for testing emergent theory because both types of data are interpreted during the data integration phase.
The sequential transformative approach has no preference for sequencing of data collection and emphasizes theory. Concurrent triangulation is the ideal method for cross-validation studies and has only one point of data collection. The concurrent nested design is best used to gain perspectives on understudied phenomena. The concurrent transformative approach is theory driven and allows the researcher to examine phenomena on several different levels.
Another strength of MM is the dynamic between the qualitative and quantitative portions of the study. An effort was made to include researchers who had worked on studies which had been assessed as exploiting the potential of mixed methods research, or not, in the quantitative component of the study[ 13 ].
The purpose of this latter sampling strategy was to ensure that we could explore both facilitators and barriers to exploiting the potential of mixed methods studies. When we selected individuals for interview, we sent them a letter asking for written informed consent to participate in an interview.
All interviews were undertaken face-to-face in the interviewee's workplace. Our topic guide was focused on the project included in the quantitative component of our wider study, as well as mixed methods research generally.
Our assumption was that our definition of mixed methods research was the same as that of the interviewees.
We did not explicitly explore differences in definitions with interviewees but this did not arise as a problem because we had selected interviewees who had worked on studies which we had defined as mixed methods research.
That is, our definition of mixed methods research was imposed on the data collection. By the 15th interview we noted that few new insights were emerging from interviews. By the time 20 interviews had been undertaken we felt that the available data were of sufficient breadth and depth to address our research question. One interviewer AOC undertook all the interviews in Interviews were recorded and transcribed verbatim.
They lasted an hour on average, varying between 35 minutes and 90 minutes. Ethics approval was granted from the University of Sheffield Ethics Committee. Analysis We read the interview transcripts to aid familiarisation with the data, and wrote a short summary of each transcript to maintain a case focus within the analysis.
We developed a thematic framework based on the first ten transcripts. The themes were mainly descriptive, for example, when researchers explicitly or implicitly talked about publishing in peer-reviewed journals we organised this under a theme 'journals'. We applied the thematic framework to all transcripts, coding all parts to a theme or sub-theme using the computerised qualitative software package WinMAX [ 23 ].
We read the data extracts for each theme or sub-theme and undertook further coding within them to organise and understand the data. During this process we identified articles on cross discipline research as significant to the analysis [ 24 , 25 ]. These articles shaped our interpretation of the themes. We discuss here only the themes related to structural issues; other themes were identified such as the effect of team types on research outcomes, and reasons for undertaking mixed methods research.
Results We requested an interview with 22 researchers, 20 of whom agreed to be interviewed. The sample has been described in detail elsewhere [ 10 ]. Briefly, it included 11 quantitative and 9 qualitative researchers; researchers on 6 studies using a combination of randomised controlled trials and qualitative research, 8 on evaluation studies, 4 on studies using survey and fieldwork, and 3 on instrument development studies; 9 researchers were identified from studies assessed as exploiting the potential of mixed methods research.
Funding and funding bodies Funding bodies appeared to be powerful shapers of the type of research undertaken. Interviewees described how they monitored funding bodies' constituency and values. Although some funding bodies were identified as supporting mixed methods studies, and others as not, overall, some of the key funding bodies were seen as actively promoting mixed methods studies. This in turn had an impact on local work environments as different disciplines were employed or co-located in research units and departments, to facilitate mixed methods research and access to funding.
Over time, as more mixed methods studies were undertaken in local environments, this approach was seen as the norm. Funding bodies favouring mixed methods research was perceived as a facilitator for the existence of these studies, but not for exploiting the potential of this approach. The attraction of funding could encourage researchers' strategic use of mixed methods research, where the aim of combining methods was to gain funding rather than integrate methods for further insights [ 10 ].
Indeed there was no discussion of how funding bodies positively influenced the exploitation of mixed methods research by valuing integration between components of a study or publication of integrated outputs. In fact some interviewees argued that there was a cost to integration because it took time and did not seem possible within the timeframe of a two or three year study.
Tight deadlines were identified as problematic particularly when using methods sequentially. It may be that we're just very badly organised with our timetables. And you know you're always under pressure aren't you to do something in two years, maybe three years. But if you tried, if you said this is going to take us four years, I think your chances of getting funding would be pretty slim. This approach is a hallmark of most biocultural research, and those of us committed to this approach believe that the triangulation of multiple methods is a more effective way of capturing human experience than an approach that attempts to represent only quantitative trends or only qualitative individual experience.
Mixed methods also have the potential to make our work more intelligible to those outside of anthropology who transact primarily in the quantitative—those, for instance, in public health, psychiatry, or sociology.
This requires a fair amount of time, money, training, and logistic agility. Let me give an example. This kind of comparative enterprise obviously requires that there be some standardization in the methods used to measure important outcome variables like food insecurity and mental health across locations.Table 1. The research environment, within local departments and the general research community, was described as continuing to improve, for example with the development of groups of qualitative researchers rather than lone qualitative researchers, which allowed them to assert their approach to research within mixed methods studies. Our assumption was that our definition of mixed methods research was the same as that of the interviewees. Qualitative data are often prioritized in exploratory studies as little information is already known. Indeed, as with traditional qualitative or quantitative methodologies, best practices should be applied rigorously across the multiple methods, but also in the way the quantitative and qualitative strands are articulated. Research design: Qualitative, quantitative, and mixed researches approaches. It remains the dominant paradigm in health research. The 'hierarchy of evidence' appeared to create a 'hierarchy of methods' which essay writing template tes described as a tide which qualitative methods had to swim against, because of the. They lasted an hour on average, varying between 35 minutes and 90 articles. However in reality the effect of this with of evidence appeared to go mixed effectiveness studies by pervading the structures of health research.
Incorporate figures and tables into your qualitative codebook to deepen the conceptualizations for the coders and provide a few examples of already coded data in order to provide thorough instructions. This in turn had an impact on local work environments as different disciplines were employed or co-located in research units and departments, to facilitate mixed methods research and access to funding. Critical appraisal of mixed methods research is as important as the critical evaluation of purely qualitative or quantitative research. Some structures such as ethics committees were described as set up to deal with methods at the top of the effectiveness hierarchy. Toward a definition of mixed methods research.
My response at the time was to say that we as a group are indeed aware of this limitation and to point to some of the more nuanced mental health work we have done in other contexts. We discuss here only the themes related to structural issues; other themes were identified such as the effect of team types on research outcomes, and reasons for undertaking mixed methods research. This was a component of a wider mixed methods study of how qualitative and quantitative methods are combined within health care research. Why are mixed methods approaches used? Methods The authors each independently carried out a narrative literature review and met to discuss findings. Structural change, as well as change in researcher behaviour, will be necessary if researchers are to fully exploit the potential of using mixed methods research.
It is necessary to describe the quantitative component of this wider mixed methods study before going on to describe the qualitative interview component, because interviewees were sampled from this quantitative component. Also, evidence of structural issues affecting mixed methods research was based on scholars' viewpoints rather than empirical study, and thus may not have identified the variety and complexity of perceptions of structural issues.
There are various alternatives for the presentation of mixed methods projects in the literature. Email: ku. Developing theory with the grounded-theory approach and thematic analysis. Semi-structured interviews with a sub-group of those surveyed may allow us to explore barriers to adherence. This requires a fair amount of time, money, training, and logistic agility. The 'hierarchy of evidence' also affected publications from mixed methods studies, with researchers placing more importance on publishing the randomised controlled trial than the qualitative component.
Little attention has been paid to the structural issues affecting this mixed methods approach. In fact some interviewees argued that there was a cost to integration because it took time and did not seem possible within the timeframe of a two or three year study. Researchers are agents who may also support current structures - journal reviewers and editors, and directors of postgraduate training courses - and thus have the ability to improve the structural support for exploiting the potential of mixed methods research. Our topic guide was focused on the project included in the quantitative component of our wider study, as well as mixed methods research generally. Conclusion The environment for health research in the UK appears to be conducive to mixed methods research but not to exploiting the potential of this approach. We discuss here only the themes related to structural issues; other themes were identified such as the effect of team types on research outcomes, and reasons for undertaking mixed methods research.
It may be that we're just very badly organised with our timetables. Mixed method design. However, this deductive approach is less suited to generating hypotheses about how or why things are happening, or explaining complex social or cultural phenomena.