Mixed Methods Examination Research Articles

Adjustment of Israeli undergraduate students to emergency remote learning during COVID-19: a mixed methods examination

ABSTRACT Using a mixed method approach, the study examined the emotional and academic adjustment to higher education amongst undergraduate students, in light of the Spring, 2020 COVID-19 pandemic outbreak. The undergraduate students’ social, emotional, institutional and academic adjustment, during the COVID-19 outbreak pandemic was compared with a database of undergraduates examined before the pandemic, which served as a control group. Four hundred and twenty-three undergraduates from 30 academic institutions in Israel participated in the study: 226 before COVID-19 and 197 undergraduates examined during the Spring, 2020 COVID-19 outbreak. The results indicated that undergraduate students during the Spring, 2020 pandemic had significantly lower academic, social, emotional and institutional adjustment compared with controls tested before the pandemic. In the COVID-19 sample, higher self-perception of satisfaction with life predicted better adjustment. Emotional stress as well as financial burden reported by undergraduates were associated with lower adjustment. Qualitative analysis revealed that social isolation was considered the most disturbing factor. Findings showed that there is a need to support students’ social, emotional and academic concerns during COVID-19 and also highlighted the role of instructors’ and support staff in particular.

A Mixed-Methods Examination of the Impact of the Partnerships to Improve Community Health Produce Prescription Initiative in Northeastern North Carolina.

To conduct a mixed-methods examination of the impact of the Partnerships to Improve Community Health produce prescription initiative in northeastern North Carolina. Quantitative surveys were conducted among participants before and after the distribution of produce prescription vouchers. Univariate statistics were used to describe the participant population, and paired t tests were used to examine change in fruit and vegetable intake. Qualitative, in-depth telephone interviews were conducted among participants, health educators, and food retailers and coded for themes. Eight health promotion programs, 2 food pantries, and 11 food retailers. In each health promotion program or food pantry, between 6 and 97 participants were enrolled. Produce prescription vouchers were distributed to participants and redeemed at local food retailers. An increase in local fruit and vegetable purchasing and consumption. Of the produce prescription participants who completed the baseline survey (n = 93), 86% were female, 64% were African American, and 68% were food insecure. The voucher redemption rate was 18%. The majority of participants indicated that they visit farmers' markets more now than before the produce prescription initiative, that shopping at the farmers' market made it easy to include more fresh produce in their family's diet, and that they tried a new farmers' market because of the produce prescription initiative. All health educators and food retailers who participated felt that the initiative benefited their program or operation and were willing to partner with the program again. While redemption rates were lower than anticipated, the produce prescription initiative had positive impacts on participants' local fruit and vegetable purchasing and consumption. Because of COVID-19, the initiative was not implemented until late in the North Carolina produce season. Moving forward, the program will start earlier and work with local food retailers to connect with their communities to increase redemption rates.

Is knowledge of evolution useful? A mixed methods examination of college biology students’ views

ABSTRACT This mixed methods study explores college biology students’ perceptions of the utility of evolution knowledge. In Phase I, 14 college biology students from an upper-level Evolution course were interviewed about their evolution acceptance and perceptions of the utility of evolutionary knowledge. In Phase II, findings from Phase I were used to develop a 28-item quantitative Usefulness of Evolution Knowledge Survey. Then, 472 college biology students enrolled in three biology courses were given the Usefulness of Evolution Knowledge survey to identify (1) evolution topics that have the highest utility value for evolution learners, (2) careers for which evolution knowledge is deemed most useful, and (3) relationships among evolution utility value and other constructs. The most useful evolutionary topics were genetic variation and adaptations of particular organisms to particular environments. Evolutionary knowledge was deemed most useful for conservation careers, with less utility for medical and forensic careers, and far less utility for careers in physics or chemistry. Significant relationships were found between perceptions of the usefulness of evolution and evolution acceptance, understanding of evolution, and intended career. Findings are discussed within the framework of the Expectancy Value Theory, and implications for future pedagogical interventions and associated research are provided.

Coping, Social Support, and Caregiver Well-Being With Families Living With SCI: A Mixed Methods Study.

To explore coping, problem solving, social support, and well-being among family caregivers of adults with spinal cord injury (SCI). This was a mixed methods study (qualitative interviews and standardized surveys) with a diverse sample of 39 adults with SCI and their caregivers from four rehabilitation hospitals in the United States, including one Veterans Affairs (VA) hospital. Cluster analysis was used to explore whether distinct profiles of caregivers could be identified, and it was used in conjunction with qualitative data to explore patterns in well-being. Measures of well-being included leisure time satisfaction, social integration, anxiety, depression, physical health complaints, caregiver burden, and quality of life. The importance of individual and extra-individual resources, namely coping and social support, emerged from early qualitative analyses and guided subsequent mixed methods examination of the data. A cluster analysis yielded three caregiver profiles: (1) effective problem solvers with moderate satisfaction with social support, (2) mixed problem solvers with stronger negative orientations and mixed satisfaction with social support, and (3) low endorsers overall. Profiles helped us explore patterns across our data set and efficiently identify differences in caregiver social support, coping, well-being, and unmet needs. Data echo the need for multimodal interventions aimed at skill development, respite options, and screening, support, information, and referral around mental health and burden. SCI care and rehabilitation programs should consider incorporating strategies for bolstering effective caregiver problem-solving skills, reducing negativity and ambivalence, and enhancing social support.

A mixed-methods examination of public attitudes toward vascularized composite allograft donation and transplantation.

Background:This mixed-methods study examined the general public’s knowledge and attitudes about vascularized composite allografts. The availability of these anatomical gifts to treat individuals with severe disfiguring injuries relies largely on decisions made by family members. If vascularized composite allograft transplantation is to become more readily available, the knowledge and beliefs of the general public must be explored to ensure vascularized composite allograft donation approaches adequately support the donation decision-making process.Methods:We conducted six focus groups with 53 members of the general public, which were audio-recorded for accuracy and transcribed. Before each session, participants completed a brief survey assessing donation-related knowledge, attitudes, and beliefs. Analysis of qualitative data entailed the constant comparison method in the development and application of a schema for thematic coding. Descriptive statistics and Spearman’s rank coefficient were used in the analysis of the quantitative data.Results:Respondents were most knowledgeable about solid organ donation and least knowledgeable about vascularized composite allograft donation. Six major themes emerged: (1) strong initial reactions toward vascularized composite allografts, (2) limited knowledge of and reservations about vascularized composite allografts, (3) risk versus reward in receiving a vascularized composite allograft, (4) information needed to authorize vascularized composite allograft donation, (5) attitudes toward donation, and (6) mistrust of the organ donation system.Conclusion:The general public has low levels of knowledge and high levels of hesitation about vascularized composite allograft donation and transplantation. Education campaigns to familiarize the general public with vascularized composite allografts and specialized training for donation professionals to support informed family decision-making about vascularized composite allograft donation may address these issues.

"It just took something from me": A mixed-methods examination of intimate partner violence victimization and perpetration among U.S. Indigenous peoples.

Indigenous peoples of the United States experience disproportionate rates of intimate partner violence (IPV). The framework of historical oppression, resilience, and transcendence (FHORT) was used to understand risk factors for IPV victimization and perpetration. In this exploratory sequential mixed-methods study, data were collected with 436 participants in the qualitative portion and 127 participants in the quantitative portion. After listwise deletion of missing variables, 117 participants were included in the main analyses. Thematic reconstructive analysis was used to qualitatively investigate how Indigenous peoples describe IPV victimization. T-test and regression analyses examined the following risk factors for IPV victimization and perpetration: (a) perceived oppression, (b) adverse childhood experiences (ACEs), (c) alcohol and other drug (AOD) abuse, (d) posttraumatic stress disorder (PTSD), (e) anxiety, (f) younger age, and (g) female gender. Qualitative results revealed ACE, infidelity, and AOD abuse were frequently mentioned among IPV victimization for participants, with women experiencing more severe violence. Quantitative results indicated PTSD and IPV victimization were higher among women. Oppression, ACE, AOD abuse, PTSD, and female gender were risk factors for victimization, whereas younger age, anxiety, and alcohol use were risk factors for perpetration. Indigenous peoples in these samples experienced rampant IPV, which was exacerbated and triggered by alcohol, drug use, and infidelity. To prevent IPV for adults, it is germane to prevent exposure to violence and substance abuse across the life course. Family-focused and culturally grounded interventions that focus both on AOD abuse, emotional regulation, and violence prevention are recommended. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A mixed methods examination of emotional expression and its impact on emotion regulation effectiveness in borderline personality disorder

Background and objectivesEmotional expression (i.e., identifying and labeling emotion using specific words), is theorized to reduce negative emotion and facilitate emotion regulation. However, it remains unclear how individuals with borderline personality disorder express emotion, and whether this influences their emotion regulation. This study examined whether: 1) emotional expression in borderline personality disorder differed from healthy controls based on word valence, emotionality, and vocabulary; and 2) whether such characteristics predict emotion regulation effectiveness across self-reported and physiological emotion domains differentially across these groups. MethodsIndividuals with borderline personality disorder (n = 29) and age and sex-matched healthy controls (n = 30) listened to an evocative story, expressed emotion, and regulated emotion by applying Mindfulness or Cognitive Reappraisal. Emotion regulation was measured by changes in self-report, parasympathetic, and sympathetic emotion, while implementing the emotion regulation strategies. The words used to express emotion were coded based on valence, emotionality, and depth of vocabulary. ResultsGeneralized estimating equations revealed no differences between groups in valence, emotionality, and vocabulary. Additionally, using a larger emotional vocabulary predicted more effective sympathetic emotion regulation, and using more negatively valenced words predicted more effective parasympathetic emotion regulation across groups. LimitationsAmong other things, this study is limited by its predominantly female sample, and that it does not determine whether valence, emotionality, or vocabulary independently predict emotional expression effectiveness. ConclusionsEmotional expression may not be deficient in borderline personality disorder across the indices studied. Using more negative words and broadening vocabulary while expressing emotion may offer emotion regulation benefits.

A Mixed-Methods Examination of Inpatient Breastfeeding Education Using a Human Factors Perspective.

Objective: The objective of this study was to examine postpartum, inpatient mother-lactation educator (LE) breastfeeding education, resulting perceptions, and patient-reported worries and outcomes. In the breastfeeding literature, there is inadequate insight into the mother-LE relationship, and specifically, the extent to which contextual factors are elicited and information is tailored accordingly. In this study, we were specifically interested in maternal contextual factors.Materials and Methods: Using a mixed methods approach, we (1) captured 20 postpartum, inpatient mother-LE breastfeeding education sessions and analyzed them for the presence of maternal contextual factors, (2) administered separate perception questions to mothers and LEs, and (3) conducted 13 follow-up interviews with mothers after being discharged from the hospital.Results: Inpatient breastfeeding education is delivered in dynamic and busy clinical settings, characterized by potential distractions such as delivery of medical care. Maternal contextual factors are infrequently elicited during the education. Although both LEs and mothers rate the sessions positively, potential gaps remain as highlighted by the analyses of semistructured interviews with mothers.Conclusion: Human factors perspective, theories, and methods are relevant to the characterization of facilitators and barriers of current breastfeeding education, as well as to the development of interventions to support the delivery of human-centered, effective, and timely breastfeeding education.

Finding MyVOICE: A Mixed-Methods Examination of Health Outcomes of Young Adults with Chronic Illness Transitioning from Pediatric to Adult Health Care.

This study examines health use outcomes of young adults with chronic illness following participation in a transition program and identifies variables that impact outcomes. A sample of 119 ethnically diverse, low-income young adults (mean age=21.8 years) was interviewed 6 months post-transition. Chi-square tests and logistic regression analyses examined the relationship between variables and outcomes. Responses to open-ended questions provided context to findings. Primary care and insurance linkage were significantly higher for patients enrolled in a fully-formed clinic than patients enrolled early in the clinic's development. Patients with multiple diagnoses reported significantly more hospitalizations and specialty care engagement. Hospitalizations and possession of medical records differed significantly by subspecialty. Visit number predicted hospitalizations after accounting for subspecialty, but not after accounting for the number of conditions. This study highlights the impact of disease type and severity on post-transition outcomes following participation in a transition program serving socially and medically complex patients.

Supplemental Material for “It Just Took Something From Me”: A Mixed-Methods Examination of Intimate Partner Violence Victimization and Perpetration Among U.S. Indigenous Peoples

Supplemental Material for “It Just Took Something From Me”: A Mixed-Methods Examination of Intimate Partner Violence Victimization and Perpetration Among U.S. Indigenous Peoples

Perceived barriers and facilitators to participating in the North Carolina Healthy Food Small Retailer Program: a mixed-methods examination considering investment effectiveness.

The North Carolina Legislature appropriated funds in 2016-2019 for the Healthy Food Small Retailer Program (HFSRP), providing small retailers located in food deserts with equipment to stock nutrient-dense foods and beverages. The study aimed to: (1) examine factors facilitating and constraining implementation of, and participation in, the HFSRP from the perspective of storeowners and (2) measure and evaluate the impact and effectiveness of investment in the HFSRP. The current analysis uses both qualitative and quantitative assessments of storeowner perceptions and store outcomes, as well as two innovative measures of policy investment effectiveness. Qualitative semi-structured interviews and descriptive quantitative approaches, including monthly financial reports and activity forms, and end-of-programme evaluations were collected from participating HFSRP storeowners. Eight corner stores in North Carolina that participated in the two cohorts (2016-2018; 2017-2019) of the HFSRP. Owners of corner stores participating in the HFSRP. All storeowners reported that the HFSRP benefitted their stores. In addition, the HFSRP had a positive impact on sales across each category of healthy food products. Storeowners reported that benefits would be enhanced with adjustments to programme administration and support. Specific suggestions included additional information regarding which healthy foods and beverages to stock; inventory management; handling of perishable produce; product display; modified reporting requirements and a more efficient process of delivering and maintaining equipment. All storeowners reported several benefits of the HFSRP and would recommend that other storeowners participate. The barriers and challenges they reported inform potential approaches to ensuring success and sustainability of the HFSRP and similar initiatives underway in other jurisdictions.

Gender-affirming psychological assessment with youth and families: A mixed-methods examination.

Gender-affirming psychological assessment with youth and families: A mixed-methods examination.

A Mixed-Methods Examination of Referral Processes to Clinic-Community Partnership Programs for the Treatment of Childhood Obesity.

Background: Partnerships with community programs have been used to improve access to obesity care and address clinical barriers to childhood obesity management; however, little is known about the program referral process. The objective of this study was to identify factors that affect the referral from clinics to community-based programs. Methods: Active Recreation through Community-Healthcare Engagement Study (ARCHES) is a mixed-method, implementation study designed to test the feasibility of establishing clinic-community partnerships to treat childhood obesity. We collected clinical referral and program attendance data from the six ARCHES clinic-community partnerships and conducted semistructured interviews (n = 19) with key stakeholders. Logistic regression models were used to identify referral characteristics associated with ever attending a community program. We used deductive thematic analysis to examine contextual factors affecting the clinical referral and subsequent attendance at the community programs. Results: Patients referred from individual providers [odds ratio (OR): 3.20, 95% confidence interval (CI): 1.08-9.48], specialty clinics (OR: 2.73, 95% CI: 1.48-5.05), and community wellness clinics (OR: 3.42, 95% CI: 1.05-11.13), had greater odds of ever attending the programs compared with patients from primary care clinics. Patients referred to cohort-based programs compared with open enrollment programs had greater odds of ever attending the programs. Stakeholders emphasized the value of communication within the partnership and with patients in clinical settings. Effective provider communication with patients involved engaging and program endorsing conversations to explain the value of the program. Conclusions: We identified factors that may improve the referral process in clinic-community partnerships to provide resources to primary care providers looking to address childhood obesity. Clinical Trial Registration number: NCT03246763.

“You Know Baseball? 3 Strikes”: Understanding Racial Disparity with Mixed Methods for Probation Review Hearings

Prior literature on judicial decision-making post-sentencing is relatively scarce, yet with the growth of problem-solving courts and offenders placed on probation, judges are responsible for overseeing compliance of offenders beyond traditional decision-making points. More recently, scholars have called for more nuanced methods of examining judicial decision-making, disparity, and attribution than traditional quantitative methods. This study examines the factors that influence judicial sanctioning of probationers for non-compliance in a domestic violence court. The following research questions are examined: Which factors predict whether a probationer is sanctioned for non-compliance? What are the discourses utilized to frame these violations? Are there differences in discourses utilized based upon a probationer’s race? This study combines participant observation of probation review hearings with agency records for a mixed-methods examination of which factors influence the decision to sanction non-compliant probationers, and whether differences emerge based on race. The sample included 350 cases of probation review hearings with 100 cases selected for critical discourse analysis. Results demonstrated that drug use, missed treatment sessions, gender, race, and family status influenced sanctioning decisions. Qualitative results demonstrated that judges evaluate probationers based upon contextual information, which at times relies on racial discourses of drug use and responsibility.

A mixed-methods examination of the gap between intelligence and adaptive functioning in autistic young adults without intellectual disability.

Adaptive functioning describes the age-appropriate skills necessary for independent living. Research suggests that autistic children, adolescents, and adults who do not have an intellectual disability demonstrate adaptive functioning challenges relative to their intellectual ability. Thus, even though many of these individuals have the intellectual capacity to excel in mainstream educational and vocational settings, their adaptive functioning challenges may serve as an obstacle to independence. The research on adaptive functioning in autistic adults is focused on statistical analysis of standardized assessments (e.g. parent-report on multiple choice questionnaires). Qualitative research that examines the narratives of young adults and their parents is needed to better understand adaptive functioning in young adults and their resulting service needs. This study combined statistical analysis of standardized assessments with qualitative analysis of interview responses from autistic young adults without intellectual disability and their parents. Findings replicated previous reports of adaptive functioning challenges and identified influences on adaptive functioning development, consequences of independence, and service needs. Taken together, findings indicate the need for interventions and services that facilitate adaptive functioning development in autistic adolescents and young adults and provide insight into potential intervention targets and strategies.

Parents as Primary Sexuality Educators for Adolescents and Adults With Down Syndrome: A Mixed Methods Examination of the Home B.A.S.E for Intellectual Disabilities Workshop

Limited research exists on the effectiveness of in-person workshops to help parents talk about sexuality. This study utilizes a parallel mixed methods design to examine the impact of the Home Based Adolescent Sexuality Education (B.A.S.E) for Intellectual Disabilities workshop with 26 parents of individuals with Down syndrome. Quantitative data showed a significant decrease in negative attitudes surrounding sexuality and disability and a significant increase in parents’ self-efficacy discussing sexuality topics. Qualitative data supported these findings, further illuminating parents’ changed behavior. Home B.A.S.E for Intellectual Disabilities is a promising approach to support parents as the primary sexuality educators for their children with intellectual disabilities.

Motivation for physical activity and physcial activity engagement in current and former wearable fitness tracker users: A mixed-methods examination

Wearable fitness trackers (WFTs), like Fitbits, are intended to support physical activity (PA) engagement. It is unclear, however, how WFTs impact both PA and motivation for PA as described by the Self-Determination Theory (SDT). This study examined PA and PA motivation in former and current WFT users using a mixed-methods design, consisting of a survey and semi-structured interviews. The survey included items from the Global Physical Activity Questionnaire (GPAQ) to assess PA and Behavioral Regulation in Exercise Questionnaire version 3 (BREQ-3) to assess motivation. A sample of 288 participants (173 current vs. 115 former users) completed the survey and 17 participants (10 current vs. 7 former users) participated in interviews. Quantitative results indicated that current and former users did not differ in measures of PA. Current users scored higher on introjected regulation and identified regulation for PA. Qualitative results indicated that current users used their device to collect data, rather than for motivation. Former users doubted the device accuracy, and reported feeling guilty when they did not meet WFT goals. We also provide hypothesized models of factors that contribute to persistent WFT use and factors that contribute to abandonment as they pertain to PA motivation and engagement.

A Mixed-Methods Examination of Factors Related to HPV Vaccination Promotion in Private Dental Settings, Iowa, 2019.

IntroductionHuman papillomavirus (HPV)-associated oropharyngeal cancer rates are rising, particularly in males, although rates of other HPV-related cancers are decreasing. Although the HPV vaccine is safe and effective, vaccination rates remain below the Healthy People 2030 goal of 80% coverage. Engaging dental providers, who have experience with patient education and oropharyngeal cancer, may prove useful in efforts to increase vaccination rates. Our research explores dental providers’ (dentists, dental hygienists) willingness to participate in continuing education about HPV, educate parents of adolescents, recommend the vaccine for adolescents, and refer parents to medical providers.MethodsWe used a mixed-methods approach and conducted a survey with dental hygienists and semistructured interviews with dental providers. We produced frequencies and descriptive statistics for all variables and used regression modeling to explore factors related to willingness to promote the HPV vaccine. We used a deductive approach to code interview transcripts.ResultsRegression models using survey data (n = 470) showed that after controlling for demographic and practice-level characteristics, higher levels of willingness were associated with thinking that parents would act on a recommendation and thinking that engaging in HPV promotion is within the scope of practice. Interview data reflected willingness of dental providers to work on HPV vaccination, but revealed barriers (eg, time, knowledge) that need to be addressed.DiscussionOverall, dental providers expressed a willingness to participate in HPV vaccine promotion, and future efforts should focus on addressing barriers to doing so. Engaging dental providers in HPV vaccine recommendation and referral can help prevent future HPV-related cancers.

A Cross-Disciplines and Cross-Sector Mixed-Methods Examination of Design Thinking Practices and Outcome

This mixed method study investigated design thinking (DT) practices and outcomes from across disciplinary frameworks within one institution of higher education. Building upon prior DT studies, it examined three interlocking research questions: What DT practices are being implemented across the curriculum? What kinds of outcomes do faculty observe? What are the significant relationships between particular practices and observed outcomes? Thirty-five courses were examined via a faculty survey adapted from Liedtka and Bahr (2019), and a semi-structured interview created by Lake, Ricco, and Whipps (2018). In alignment with liberal arts educational practices, the most frequently utilized DT practices included working in teams that recognize diverse contributions and engaging in active listening in order to find shared meaning. Consistent with expectations for project- and team-based courses, faculty felt such practices yielded valued outcomes, concluding DT practices built trust across teams and increased the quality of solutions. Relationships between practices and outcomes revealed the utilization of more ethnographic tools was associated with a lower frequency of expanding relationships and resources, and that a greater focus on design criteria to find an ideal solution hampered efforts towards trust building. These findings suggest DT requires time and trust which can be constrained by the imposed deadlines of semester-based projects. The survey and interviews pointed to both similarities and differences between disciplines in DT practices. Future research investigating design thinking pedagogy should include faculty, students, and stakeholders with multiple touchpoints for assessment to identify learning experiences that build change-making capacities and yield genuinely valuable and viable real world projects.

Constructivist or Christian: A Mixed-Methods Examination of Teacher Purposes and Practices at Mennonite Schools

Christian educators must regularly articulate the ways in which they add value to the learning experiences of students, recognizing that pedagogy and purpose are inextricably linked. This study investigates the relationship between constructivist teaching practices and the religious beliefs of Christian educators. Drawing on mixed-methods analysis of survey data, the study includes 385 teachers in a network of private preK-12 Mennonite schools stretching from Oregon to Pennsylvania to Florida. Data analysis suggests that while the participants consistently espouse a high level of commitment to Christian approaches to education, the participants’ relationship to constructivist pedagogy across the corpus is less clear. The results contribute to the empirical literature on faith integration and notions of constructivism in Christian education.