1. How to make the best of qualitative phases of mixed method research Professor Kim Usher Centre for Chronic Disease Prevention Mixed Methods in Prevention and Health Services Research

2. Mixed Methods Research Types Principles Importance of stand-alone phases Integration

3. Quantitative data collection Quantitative data analysisQualitative data collectionQualitative data analysisIntegration

4. Sequential Exploratory Mixed Methods Design

5. Mixed Methods Explanatory Design

6. What do we mean by quantitative and qualitative research? Usual distinctions QuantitativeQualitative Type of reasoning DeductiveInductive objectivitySubjectivity CausationMeaning

7. Type of question Pre-specifiedOpen-ended Outcome-orientedProcess-oriented Type of analyses Numerical estimationNarrative description Statistical inferenceConstant comparison

8. Chronic illnesses Prime examples of conditions that by their very nature need to be studied from many perspectives.

9. Hierarchies for evaluating evidence Most based on criteria for rigor developed for quantitative research designs Design ranked according to extent the study is internally valid or free from bias RCTs best evidence

10. Qualitative research is evidence too! Just because excluded from hierarchies does not mean it is less valuable Implementation of interventions in real world requires knowledge about patients’ values and experiences

11. Why have qualitative phases? Evaluate the effects of interventions on health outcomes Examine views of participants Distinguish between components of interventions Understand a non-significant outcome

12. Why have qualitative phases? To develop measures To identify relevant phenomena To interpret/explain quantitative data Investigate complex phenomena Study special populations

13. Designing intervention studies with qualitative components Before a trial To ‘trial’ the trial To develop the intervention To test tools

14. Designing intervention studies with qualitative components During a trial To describe and explain within and between subject variation discerned from instruments To understand whether intervention delivered as planned Patient reaction to intervention

15. Designing intervention studies with qualitative components After a trial To select individuals for more intensive study based on scores Interview or observe to validate outcomes To help explain non-significant findings

16. Qualitative approaches Phenomenology How one or more individuals experience a phenomenon Ethnography Learning the culture of a group and what it is like to be a member of that group from the perspective of the members

17. Qualitative approaches Case study A detailed account of one or more cases- focus on each case a a whole unit as it exists in the world Grounded theory An inductive approach for generating theories or explanations

18. Future directions Qualitative studies enhance the meaningfulness of interventions Situate them in the real world of patients and their caregivers Shed light on facilitators and barriers to the uptake of promising interventions Illuminate aspects of the patient experience

19. Future directions Can identify barriers to implementing and sustaining community-based prevention programs Ensure patient safety, including reduction of misuse of medical therapies and oversights of clinical care

20. Conclusion Not everything that can be counted counts, and not everything that counts can be counted. Albert Einstein