Mixed Methods Case Study Research Articles

Partnership between a consumer-led mental health research network and a large mental health research organisation: an Australian mixed methods case study

Partnership between a consumer-led mental health research network and a large mental health research organisation: an Australian mixed methods case study

Unravelling motives and time use of additional leave in a flexible benefits plan: a mixed-methods case study in Belgium

Working-time reduction emerges as a promising measure for fostering a well-being economy, as it allows to reconsider time allocation between paid labour and other activities, potentially improving human and environmental well-being. This study investigates the motives for and planned time use of additional leave in the context of a flexible benefits plan, a specific form of working-time reduction that is increasingly popular among employees and employers. Despite its popularity, little is known about the rationale behind this choice and its potential to create socio-environmental benefits. Data were collected from a Belgian media company in 2022 using a mixed-methods approach, comprising a survey (N = 241) and semi-structured interviews (N = 13). The findings reveal that a mix of motives matters for choosing additional leave, including push, pull, personal and contextual factors, as well as the specifics of the flexible benefits plan. While the desire for more leisure emerges as a primary driver, difficulties in taking up the standard amount of leave present a key barrier. Employees plan to use their extra leave for diverse activities, mainly personal and social activities, household tasks, travel, and ad-hoc pursuits. However, preferences vary based on parental status, with couples having children primarily intending to use the leave for caregiving responsibilities. Notably, the primary activities for intended time use align with increased well-being and have relatively low environmental impacts, although positive effects may be partially offset for well-being (such as when paid work is replaced with unpaid care or household work) or for the environment (such as when spending the extra leave on environmentally intensive (travel) activities). These findings tentatively suggest that choosing additional leave in flexible benefits plans could contribute to a well-being economy.

Changing Workplace Relations and Sites of Belonging in Swedish University Administration

Based on a mixed-methods case study, this article explores the impact of formal affiliations and informal associations in professional organizations, relating these questions of belonging to workplace dynamics and collectives. Using the experience of departmental administrators within a Swedish university as an ideal case to investigate the formal and informal connections at work, this article argues that a multiplicity of belongings within organizations brings strain and opportunities, altering the relations at work. The study contributes to discussions on belonging and social relationships at the workplace level by applying the concept of belonging to different sites in the organization. It suggests that sites of belongings within organizations can serve as a discrete concept, useful for adding insights into the dynamics of work organizations.

Improving Retention and Success of African American Students in Computer Science: A Mixed-Method Case Study at an HBCU

This case study introduces the STARS (Supporting Talented African American Undergraduates for Retention and Success) project, designed to foster the retention and success of academically talented African American computer science students from low-income backgrounds at Historically Black Colleges and Universities (HBCUs) in the U.S. The STARS program employs a holistic approach, integrating four primary pillars of support: academic, social, career, and financial. Specific support provided includes near-peer mentoring, technical skill development seminars, undergraduate research, and high school outreach activities. To explore the program’s effectiveness and areas of improvement, a mixed-method evaluation study was conducted, collecting data through surveys, observations, individual interviews, and focus group interviews. The findings revealed that the STARS program contributed to high levels of retention among its scholars, and the mentoring program provided valuable networking opportunities. The study suggests that the program’s comprehensive approach, tailored to scholars’ needs, and combined with a culturally affirming learning environment, facilitates the retention and success of talented African American students in computer science.

Design and implementation of blue-green infrastructure for socio-cultural benefits at community scales: the case of Wigram Basin in Ōtautahi Christchurch

Stormwater-related blue-green infrastructure (BGI) has been shown to play an important role in enhancing the socio-ecological-cultural resilience of communities under stress from climate change and in the wake of the COVID-19 pandemic. BGI has been defined as natural, semi-natural, and artificial spaces that deliver valued bio-physical and socio-cultural benefits to communities through the facilitation of natural processes, with a particular focus on stormwater management. While studies have identified a range of benefits associated with BGI, research has only partially examined their valuation, especially concerning socio-cultural outcomes. Research has also failed to consider the ways in which BGI operates at community scales, and how this may be influenced by the design process of individual projects. This study examines the range of socio-cultural benefits associated with BGI projects, alongside the design characteristics which may influence these outcomes using a mixed-methods case study of Wigram Basin. Results found that while a range of benefits were associated with the implementation of local BGI, broader socio-cultural outcomes such as social cohesion, the facilitation of a sense of place, and the ability to practice cultural values were infrequently identified by respondents. Results also demonstrated that the transdisciplinary design team, specific project priorities, and the approach taken to community and Indigenous engagement may have influenced the range of benefits achieved by Wigram Basin. As such, this research recommends that the design of BGI considers the range of disciplines required to be involved in project design, the pathways required to provide socio-cultural benefits, early, ongoing, and place-based community and Indigenous engagement and education, and the ongoing assessment and valuation of all project outcomes to maximize BGI implementation.

Police Leadership Education: Digital Didactics, Perceived Learning and Perceived Increased Competence as Police Leaders

Police leadership is an essential part of policing, as is the education of police leaders. Our study responds to the call for research on how to transform police leadership education into practice. In this longitudinal mixed-methods single case study we investigate two research questions: 1) How do the digital didactics of the digital police leadership course contribute to students’ perceived learning? 2) How are the knowledge and skills acquired in the digital police leadership course perceived to be applied 1.5 years after course completion? We collected data from students enrolled in a 12-week course. This course offered 24 students a two-day on-site course introduction, while the rest of the course was taught online. Data was collected through five surveys and follow-up interviews with six participants. The results show that police leaders perceived increased competence in being a police leader, report enhanced ability to bridge theory and practice, and improved their digital skills. They also reported increased confidence in the leadership role and increased sharing of competence after study completion. The findings suggest that digital didactics may achieve embedded police education as it can provide an interplay of individual and organizational factors.

Evaluation of focused antenatal care services quality at University of Gondar Comprehensive Specialized Hospital, Central Gondar zone, Northwest Ethiopia.

Antenatal care is the care that women receive during their pregnancy to ensure the health of the mother and her baby. The provision of information on birth preparedness in Ethiopia is still low, which implies identification of pre-existing health conditions that may affect the outcome of pregnancies was not provided. Even if the Focused Antenatal Care service was provided in our setup, maternal death was still high. In addition, as far as our search, the quality of antenatal care service in this facility has not yet been evaluated. As a result, the purpose of this study was to assess the quality of focused antenatal care services at the University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia. A mixed method case study evaluation design was employed at the University of Gondar Comprehensive Specialized Hospital from February 29 to March 29, 2020. Quantitative data was collected through exit interviews of 411 mothers who attended antenatal care follow-up and review of 422 clients' cards 2 months prior to the study period. Similarly, 35 items of resources inventory, 10 direct observations, and 12 key informant interviews were conducted. The data were entered into Epi-Data version 4.6 and exported to SPSS version 25 and it was analysed with the Evaluation judgment matrix analysis method. Qualitative data were transcribed, translated and analysed by using thematic analysis. The evaluation focused on availability, compliance, and satisfaction dimensions with 25 indicators to judge the quality of antenatal care services. The overall quality of focused antenatal care services was judged as good, based on pre-set judgment criteria (76.7%), to which availability of resources, healthcare provider's compliance with the national guideline, and maternal satisfaction contributed, 73.3, 77.75, and 78.8%, respectively. Auditory and visual privacy were practiced which enhances patient confidentiality and personal dignity. The waiting area was perceived to be satisfactory by the majority (89%) of ANC clients, but there is no separate waiting area for ANC clients. Ten (10) client/provider interactions were observed, demonstrating that all clients were counseled about pregnancy danger signs. The overall focused antenatal care services quality was relatively good, although the availability of resources was fair. Some essential drugs and medical equipment were out of stock. Therefore, the hospital had better fulfill crucial medicines and equipment for better service quality.

Virtual Hospitals and Patient Experience: Protocol for a Mixed Methods Observational Study.

Virtual care is increasingly incorporated within routine health care settings to improve patient experience and access to care. A patient's experience encompasses all the interactions an individual has with the health care system. This includes a greater emphasis on actively involving carers in the decisions and activities surrounding a patient's health care. This study aimed to investigate the variety of health care delivery challenges encountered in a virtual hospital and explore potential ways to improve the patient experience. Focusing on acute respiratory, this protocol outlines a mixed methods study exploring the patient experience of a virtual hospital in Australia, Royal Prince Alfred Virtual Hospital (rpavirtual). We will use an exploratory mixed methods approach comprising of secondary data analysis, observations, interviews, and co-design focus groups. Participants will include patients, their carers, and health care workers who are involved in the acute respiratory virtual hospital model of care. Together, the data will be triangulated to explore views and experiences of using this model of care, as well as co-designing recommendations for further improvement. Findings from this study will identify current barriers and facilitators to implementing virtual care, such as work-as-done versus work-as-imagined, equity of care, the role of carers, and patient safety during virtual care. As of August 2024, a total of 25 participants have been interviewed. This protocol outlines a mixed methods case study on the acute respiratory model of care from Australia's first virtual hospital, rpavirtual. This study will collect the experiences of patients, carers, and health care workers to co-design a series of recommendations to improve the patient experience. DERR1-10.2196/58683.

Untangling the dominant culture in China’s elite universities

AbstractWestern literature has shown that elite universities are not culturally inclusive, presuming that these institutions predominantly reflect the culture of the affluent middle class. While cultural inclusion of socioeconomically disadvantaged students is a globally relevant issue, the overarching presumption does not necessarily apply to non-Western societies. This article reconsiders this assumption in the Chinese context, addressing the lack of systematic research untangling the dominant culture in elite Chinese universities. A two-phase, mixed-methods case study was conducted at two top-ranked universities in eastern and western China. In the first phase, a content analysis of the stories of the universities’ award-winning seniors was combined with a thematic analysis of the in-depth interviews with 49 graduating seniors to untangle the formal and informal dominant culture in China’s elite universities. The findings led to a three-fold model of dominant culture characterized by an emphasis on individual academic performance, loyalty to Communist Party ideology, and the significant influence of students from advantaged family backgrounds. In the second phase, three hypotheses about the impacts of this dominant culture on students’ socio-cultural integration were tested, largely supporting the three-fold model and highlighting the roles of academic and political performance in facilitating cultural inclusion. This study sheds new light on cultural capital studies in non-Western contexts and emphasizes that cultural (dis)advantages should be cautiously examined considering the historical and ideological context shaping higher education.

“Throw Dat Hat!”: Educational Experiences, Attainment, and Aspirations of Adolescent Female Trafficking Survivors in a Residential Facility

This study addresses the gap in research on the educational experiences of adolescent human trafficking survivors, with a focus on their past, present, and future educational experiences and goals. Its objective is to inform the best practices for educational programming within female adolescent residential care centers in the United States. Drawing on a subset of data from a broader mixed-methods case study conducted at the Allasso House residential facility, this research involved 11 current residents. The data sources included case files detailing their past educational experiences, assessments of their current educational achievements, and interviews exploring their future aspirations. The findings reveal key themes related to the residents past risk factors, current educational successes and barriers, and tensions in setting future goals. Most of the residents expressed a desire to attain high school equivalency, identifying financial stability as a primary motivation. They also aspired to form healthy families, while placing significant value on material success. Unlike studies that define success primarily through survival, sobriety, and the avoidance of re-trafficking, this research highlights the broader aspirations of these adolescents, emphasizing the critical role of education in general wellbeing, risk mitigation, and future success. This study underscores the importance of prioritizing educational attainment and long-term aspirations in future research and in the design of residential programs for adolescent survivors of trafficking.

Enhancing classroom climate and emotional intelligence through board games: A mixed-methods case study with moroccan students of spanish as a foreign language

This mixed-methods case study explores the impact of board games on enhancing classroom climate and emotional intelligence among Moroccan students learning Spanish as a foreign language. The research employed a sample of 86 students. The experimental group implemented board games as an educational intervention over six sessions. The mixed-methods design incorporated quantitative surveys to assess changes in classroom climate and emotional intelligence and qualitative interviews to delve deeper into the students' perceptions and experiences. The findings indicate that board games positively affect classroom climate and emotional intelligence by fostering a collaborative and engaging learning environment. Qualitative results further reveal that the experience was universally perceived as enjoyable, engaging, and conducive to collaborative creativity. However, this study acknowledges some limitations, such as a relatively small sample size and the short-term nature of the intervention. Future research should investigate larger and more diverse samples, employing longitudinal studies to assess the long-term sustainability of these effects. In conclusion, this research illuminates the potential of board games as a valuable tool for enhancing a positive classroom climate, ultimately enriching the educational experience for students of Spanish as a foreign language.

Multilingualism rather than English-only: policy and practice in classical music higher education

ABSTRACT The rise of English-medium education in (European) higher education has attracted considerable attention, but most analyses of the topic to date have been conducted in traditional universities. Highly international fields such as that of classical music higher education (CMHE) remain under-researched. Dafouz, E., and U. Smit. 2016. “Towards a Dynamic Conceptual Framework for English Medium Education in Multilingual University Settings.” Applied Linguistics 37 (3): 397–415 and Dafouz, E., and U. Smit. 2020. ROAD-MAPPING English Medium Education in the Internationalised University. Palgrave Macmillan. The ROAD-MAPPING framework provides an analytical tool for examining such complex contexts and unpacking the various factors at play in these multilingual university settings. In this paper, we present a mixed-methods case study at one of Austria’s largest state-funded music universities, comprising a policy analysis, a survey and semi-structured interviews with students, teachers and management. Using the ROAD-MAPPING framework to guide our analysis, we found that university policy and reported practice were coherent among all groups, with German as the default medium of education. English is explicitly designated the second academic language, while multilingualism and multimodality are actively promoted as a means of achieving educational and professional goals. However, we also noted that many strategies for coping with these multilingual teaching and learning contexts seem to be rather ad hoc, suggesting that there is a need for more awareness of multilingual pedagogy, and confirming the value of the ROAD-MAPPING framework for examining such complex settings.

Retraining professionals as STEM teachers: the potential and the challenges

ABSTRACT Israel suffers from a severe STEM teacher shortage. To mitigate it, two retraining projects were developed: one recruiting academic high-tech professionals and the other – practical engineers. This study evaluated both projects by exploring stakeholders’ perspectives and examining graduates’ retention. Applying a mixed-methods case study design, interviews were conducted with 35 graduates, 21 programme leaders and 6 school principals. Short demographic surveys were answered by 584 academic professionals and 356 practical engineers, and another 57 practical engineers answered a longer evaluation survey. The study found retention rates of 78% for academic professionals and 62% for practical engineers. To improve retention, both cohorts need better preparation in pedagogy, stronger support at school, higher wages and efficient administrative care. To realise their potential contribution, professional autonomy and principal’s support are necessary.

Improving access and quality of primary healthcare through women and adolescents' user committees: A mixed-methods case study in Kinshasa, Democratic Republic of the Congo.

Patient engagement is seen as a fundamental strategy for achieving quality patient-centred care, especially in community-based primary healthcare. Despite growing interest in patient engagement in Sub-Saharan Africa, few patient engagement initiatives have been identified, and those often are limited to lower levels of engagement, in participation in health research or in health system improvement. With the aim of giving a voice to under-represented community groups in healthcare governance, the Access to Health services in Kinshasa (ASSK) project supported the implementation of primary health services user committees in the Democratic Republic of the Congo, designed to enable the representation of two user groups with specific unmet sexual and reproductive health (SRH) needs: women and adolescents. Using a mixed-method case study design combining quantitative secondary data (from the national health management information system-DHIS2) and qualitative data from two research World Café (WC1: Women user committees (WUC) n=55; WC2: Adolescents user committee (AUC) n=63), this paper looks at the implementation facilitators and barriers, and at the results of this initiative. Women and adolescent members of the user committees highlighted that their participation resulted in increased knowledge of SRH and their related rights, as well as in their 'soft skills' such as communication and leadership. In addition, participants reported greater transparency and accountability on the part of the community primary health centres (e.g. by displaying fees for procedures to counter over-billing). Ultimately, WUC and AUC were associated with improved health practices in the community such as increased use of SRH services (increase of 613% for Makala and 160% for Maluku II), including adolescent family planning (increase of 320% for Makala and 12% for Maluku II) and assisted childbirth for women15-49years old (increase of 283% for Makala and 23% for Maluku II)). Patient user committees for specific marginalised or under-represented groups appear to be an effective way of improving the quality of primary health care services. Further research is needed to better understand how to maximise its potential.

In-depth mixed-method case study to assess how to support and communicate with the families of hospitalised patients during COVID-19: a social innovation embedded in clinical teams

ObjectivesThe purpose of this study is to describe and evaluate, in a real-life context, the support and communicate with families (SCF) team’s contribution to maintaining communication and supporting relatives when...

Perceptions of scientific assessment effectiveness

The science-policy interface process known as ‘scientific assessment’ convenes large numbers of experts, policymakers, and stakeholders to deliberate and synthesise cross-disciplinary knowledge. Considering the increasingly frequent and widespread use of scientific assessments over the past 30 years, globally and in South Africa, it is surprising that few effectiveness evaluations have been undertaken. A case-study mixed methods approach was used to evaluate the perceived effectiveness of six scientific assessment cases – two global, two regional and two national. To measure perceptions, a Generic/Procedural framework was developed, consisting of thirteen indicators based on the science-policy ‘dimensions’ of Credibility, Relevance and Legitimacy (CRELE). The cases were perceived to have performed better than average with respect to Output quality, Procedural fairness, Use in decision-making, Trustworthiness and Iterativity, and below average for Coproduction, Capacity building, Media communications, Transdisciplinarity and Financial resources. Perceptions of effectiveness varied based on participant role, age, and country income levels, revealing both pluralistic viewpoints and the subjective nature of participant-led evaluations. While Relevance is often considered the keystone dimension of CRELE, the cases performed better for indicators foundational to Credibility and Legitimacy, rather than those foundational to Relevance. Future successful scientific assessment practice will require more conscious consideration of Relevance, coupled with innovative epistemic practices in the spirit of the Pragmatic-Enlightened Model (PEM) of science-policy interaction.

Protocol for a mixed-methods exploratory investigation into the role of health information technology for the provision of cancer care in Indonesia

Background Cancer and its management can incur high costs, high risks and high demand. In Indonesia, there remains gap in the availability of national cancer data despite the establishment of a National Committee for Cancer Control. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. However, it is not yet clear to what extent these approaches influence patient management or the experience of cancer patients themselves. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia. Methods The study will adopt an observational mixed-methods single case study design of health facilities involved in the delivery of cancer services in a sub-national health system. We will collect data through face-to-face interviews with a range of health professionals involved in the delivery of cancer care. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. Alongside interviews, we will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems. Data analysis will include framework analysis for qualitative data alongside descriptive analyses of quantitative data. Findings will be used to inform conceptual maps to be presented as part of Theory of Change workshops focused on understanding how the existing cancer referral system works, why and for whom, with a focus on future refinement and intervention development. Conclusion Our findings will inform critical thinking around the design, implementation, adaptation, and evaluation of existing systems. Through early engagement and participation of key stakeholders and project partners, we intend that findings will have immediate utility.

Exploring the Ecological Structure of Agricultural Industry School Partnership Systems in the Gippsland Region, Australia

This paper aims to explore the structure of agricultural industry school partnerships (ISPs) by applying Bronfenbrenner’s ecological systems theory to partnerships delivered in Gippsland, Australia. Agricultural ISPs are one potential setting for industry-relevant learning and career education to occur. This may assist in alleviating agricultural workforce shortages and addressing educational issues related to student career outcomes. A mixed methods case study methodology was employed, with data analyzed through frequency counts and Braun and Clarke’s method of thematic analysis. Surveys (n = 111) and semi-structured interviews (n = 57 pre-participation, n = 68 post-participation) were used with educators (n = 56) and industry participants (n = 62) from ISPs delivered through CQUniversity Australia’s Raising Aspirations in Careers and Education—Gippsland project from 2021–2023. This research finds that the agricultural ISPs studied function as interdependent ecological systems. The facilitator played a crucial role in delivering the ISPs, including connecting educators and industry partners. The study is limited by the number of agricultural ISPs explored and by only collecting data from two stakeholders within the system. However, these findings contribute to a greater understanding of the complex structure of agricultural ISPs, which can help those creating ISPs to consider and understand all stakeholders’ needs. Exploring ISPs as ecological systems also provides a lens to approach research improving similar educational practices. Further research could deepen our understanding of these systems.

We need autonomy! The role of job autonomy and autonomous motivation in employees’ work engagement in the outsourcing sector: A systematic mixed-method illustrative case study

The outsourcing sector continues to experience significant growth but is still experiencing rising voluntary turnover due to loss of employees’ engagement. This systematic mixed-method illustrative case study focuses on how leaders can stimulate employees’ work engagement in outsourcing companies. This research is the result of 1 year of intensive fieldwork in an outsourcing organization and includes quantitative data from an online survey and qualitative data from focus group discussions. The results show that employees who have a higher level of work engagement also have higher intrinsic motivation, and the strength of this prototypical autonomous motivation in predicting work engagement is higher than that of other predictors. Leadership practices and relevant behaviors were identified that can be used in interventions in outsourcing companies to stimulate employees’ intrinsic motivation and work engagement.

Dentists’ Mental Health: Challenges, Supports, and Promising Practices

Objectives: The mental health of dentists, like all health professionals, is a growing concern. The objectives of this study were to identify the mental health challenges experienced by Canadian dentists and to describe the support needs and promising practices to better support them. Methods: This study used a mixed-methods case study design to gather data from semistructured qualitative interviews and a survey for triangulation. Results: Thirty-six dentists and 17 stakeholders participated in the interviews, and 397 dentists participated in the survey. The interview and survey data revealed that dentists have experienced several challenges personally, professionally, and socially. Around 44% of participating dentists experienced a wide range of mental health issues, including depression, anxiety, and posttraumatic stress disorder. Sex/gender shaped the mental health experiences of female dentists, who reported more stress related to caring responsibilities. They had a higher percentage of mental health issues (50%) than men (37%). Caretaking emerged as the main challenge in the social and personal domain, particularly for female dentists in both survey and interview findings. The dentists’ role in practice was one of the most frequently reported professional challenges. While practice owners reported challenges with staff and practice management, associate dentists experienced difficulties with the lack of autonomy and conflicts with office managers and owners. Other challenges reported by participating dentists included patient care responsibilities, loneliness, and isolation. To address these challenges and their impact, dentists and stakeholders identified several support needs and promising practices, including increasing awareness about mental health issues, expanding existing mental health resources, incorporating mental health content in dental education, and encouraging engagement in organized dentistry, particularly for women. Conclusions: The impact of mental health challenges on dentists’ career trajectory and productivity is an ongoing concern in Canada. Gender-specific strategies to support the mental health of dentists should be developed. Knowledge Translation Statement: This study identified the mental health challenges of dentists in Canada to inform the development of interventions and strategies to promote the health and well-being of dentists and dental students. It also highlighted the need for clinicians, students, and individuals in leadership positions in institutions and professional organizations to recognize and consider the working conditions of dentists in various positions to avoid negative consequences on their mental health, reduce the attrition from the professional, and improve patient care outcomes.