Abstract
BackgroundTo describe the ethical issues and experiences of scientists conducting mixed methods health services research and to advance empirical and conceptual discussion on ethical integrity in mixed methods health research.MethodsThe study was conducted with 64 scholars, faculty and consultants from the NIH-funded Mixed Methods Research Training Program (MMRTP) for the Health Sciences. This was a cross-sectional study. Survey results were analyzed using descriptive statistics to characterize responses and open coding to summarize strategies about eight ethical mixed methods research issues. Respondents completed an online survey to elicit experiences related to eight ethical issues (informed consent, confidentiality, data management, burden, safety, equitable recruitment, communication, and dissemination) and strategies for addressing them.ResultsOnly about one-third of respondents thought their research ethics training helped them plan, conduct, or report mixed methods research. The most frequently occurring ethical issues were participant burden, dissemination and equitable recruitment (> 70% endorsement). Despite occurring frequently, < 50% of respondents rated each ethical issue as challenging. The most challenging ethical issues were related to managing participant burden, communication, and dissemination. Strategies reported to address ethical issues were largely not specific or unique to mixed methods with the exception of strategies to mitigate participant burden and, to a lesser degree, to facilitate equitable recruitment and promote dissemination of project results.ConclusionsMixed methods health researchers reported encountering ethical issues often yet varying levels of difficulty and effectiveness in the strategies used to mitigate ethical issues. This study highlights some of the unique challenges faced by mixed methods researchers to plan for and appropriately respond to arising ethical issues such as managing participant burden and confidentiality across data sources and utilizing effective communication and dissemination strategies particularly when working with a multidisciplinary research team. As one of the first empirical studies to examine mixed methods research ethics, our findings highlight the need for greater attention to ethics in health services mixed methods research and training.
Highlights
To describe the ethical issues and experiences of scientists conducting mixed methods health services research and to advance empirical and conceptual discussion on ethical integrity in mixed methods health research
An example of complexity is that Mixed methods research (MMR) often includes multidisciplinary teams from diverse disciplines, all of which may have a unique code of ethics and disciplinary cultures that affect conduct of research
Selected scholars participate in 1) a three-day in-person retreat with lectures and interactive discussions about their projects, 2) webinars on mixed methods topics, and 3) ongoing support from a mentor selected from network of consultants created for the Mixed Methods Research Training Program (MMRTP) who each have content and mixed methods expertise [5, 17, 18]
Summary
To describe the ethical issues and experiences of scientists conducting mixed methods health services research and to advance empirical and conceptual discussion on ethical integrity in mixed methods health research. In response to the recognition of the value of mixed methods in health services research, resources for guiding MMR development, conduct and dissemination have proliferated, including textbooks, courses, formal training programs [5] and the NIH Office of Behavioral and Social Sciences Research Best Practices for Mixed Methods Research in the Health Sciences [1, 6]. That little conceptual and virtually no empirical work has been conducted to advance guidance in mixed methods ethics may be surprising given the need for researchers to gain study approvals from various ethical review boards (i.e., institutional and community).
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