Mixed Methods Investigation Research Articles

Commercialisation fears and preferred forms of governance: a mixed methods investigation to identify a trusted Australian genomics repository

Commercialisation fears and preferred forms of governance: a mixed methods investigation to identify a trusted Australian genomics repository

Transforming assessment policy: improving student outcomes through an immersive block model

ABSTRACT This paper describes how one Australian university achieved deep assessment reform through transition to the Southern Cross Model: a 6-week, immersive block learning approach. There are few studies that explicitly discuss the governance, policy and people changes required to effect whole-of-institution shift. Addressing this gap, this case study draws on a mixed-method investigation of policy reform and student achievement data. It outlines the tenets underpinning the university’s new assessment approach, and how these were translated into practice. A principles-based approach was developed, providing the foundation for pedagogical change. Analysis of the quantitative data demonstrates a significant increase in student pass rates and, over time, student satisfaction with assessment, workload and skills development. The findings underscore how essential whole-of-institution assessment reform is in transitioning to an immersive block model. Implications and recommendations are offered for other institutions seeking to transform assessment and drive enhanced learning and teaching outcomes through institution-wide change.

Adult Diagnosis of ADHD in Women: A Mixed Methods Investigation.

The goal of this study was to examine the experiences of women diagnosed with ADHD in adulthood. Benefits and costs associated with obtaining the diagnosis were examined in two focus groups conducted virtually. Factors hindering and facilitating the identification, assessment, and subsequent treatment of ADHD were also explored. Focus groups were conducted virtually and together included 14 women (Mage = 39.43, SD = 6.37) who were diagnosed with ADHD in adulthood. The majority of women described numerous benefits of receiving a diagnosis of ADHD, including validation/self-compassion, adaptive coping, and social support. Negative aspects of the diagnosis, including difficulties accessing care, the burden of care, limitations to existing evidence-based treatments, and stigma were also identified by some women. Furthermore, women described variable diagnostic experiences, with many indicating that they had not recognized their own symptoms of ADHD, as well as diagnostic complexity and other factors that masked identification of ADHD. Women described a range of diagnostic assessment procedures, as well as considerable self-advocacy to convince their providers to consider the diagnosis of ADHD. These lived experiences of women diagnosed with ADHD provide critical insight into improving clinical care for ADHD in women. Recommendations to increase accurate and timely identification of ADHD in women and advance efforts toward effective and equitable care are discussed.

Strategies for resolving challenging psychedelic experiences: insights from a mixed-methods study

Psychedelic substances are garnering renewed interest for their potential therapeutic applications, yet the mechanisms by which challenging experiences during psychedelic use contribute to positive outcomes remains poorly understood. Here we present a mixed-methods investigation into the strategies individuals employ to navigate difficult psychedelic experiences and their relationship to emotional breakthrough. Qualitative analysis of accounts from psilocybin retreat participants (n = 16) informed the development of the Responses to Challenging Psychedelic Experiences Inventory (ReCiPE). In a subsequent online survey (n = 529), exploratory factor analysis of the ReCiPE revealed three primary response strategies: Acceptance and Reappraisal, Sensory Regulation and Physical Interaction, and Social Support and Disclosure. Exploratory correlation and multiple regression analyses demonstrated significant relationships between different types of challenges, response strategies and emotional breakthrough. Notably, Acceptance and Reappraisal, and Social Support and Disclosure strategies were positively associated with greater emotional breakthrough. Fear-related challenges were negatively associated with emotional breakthrough and involved fewer adaptive coping strategies. These findings elucidate the complex interplay between challenging experiences and adaptive responses in psychedelic contexts, offering insights for optimising therapeutic protocols and enhancing safety in both clinical and non-clinical settings.

Expressed emotion and help-seeking behaviours among elderly adults with depression symptoms in northeast Malaysia: qualitative findings from a mixed methods investigation.

Stressful life events greatly increase the risk of depression, which affects about 22% of older persons in northeast Malaysia. But how emotional distress manifests itself in reaction to these stressful events differs from person to person. Therefore, this study aims to delve into the nuances of emotional expression among older adults with depression symptoms in northeast Malaysia, alongside their help-seeking behaviours and utilisation of professional support. Using a qualitative interpretative phenomenological approach, we conducted in-depth face-to-face interviews with participants, guided by Kleinman's explanatory model of illness. Nineteen older adults who screened positive for depression were included in the research. None of the participants explicitly acknowledged experiencing depression. However, they articulated their distress through three primary themes: 'Life is miserable,' 'Depression is a sign of weakness,' and 'Belief in pre-determination.' Remarkably, despite screening positive for depression, participants demonstrated a lack of awareness regarding available professional mental health services. Moreover, they expressed a reluctance to seek such services, citing reasons related to stigma and misconceptions. The predominant themes that emerged concerning help-seeking behaviours were 'Self-efficacy,' 'Social support,' and 'Formal assistance from non-mental healthcare professionals.' The expression of emotion among older adults is restricted by socio-cultural influences. Thus, there is a need to improve mental health literacy among older adults in Malaysia, and their preferred source of support such as religious leaders and non-mental healthcare physicians.

A Mixed-Methods Investigation of First-Year Medical Students’ Professionalism Competency Development over the Gross Anatomy Course

Abstract Background While competency-based medical education (CBME) and competency assessment in clinical training are well documented, they are less commonly included in preclinical medical education. The gross anatomy laboratory is an opportune setting to incorporate competency assessment and reflection during preclinical medical education. This mixed-methods study determined how first-year medical student assessments of professionalism skills in the gross anatomy lab change over time and analyzed student reflections to contextualize the experiences they had developing the Professionalism competency. Methods First-year medical students at the University of Louisville completed self- and peer-assessments using the Professionalism Assessment Scale (PAS) at the beginning and end of their gross anatomy course (n = 83). The students also completed three competency development portfolio (CDP) entries throughout the course (n = 83). Qualitative thematic analysis with grounded theory was used to analyze comments related to professionalism skill development in the CDP reflections during the course. Results There was no statistical difference in PAS self-assessment scores from Time 1 (M = 4.81, SD = .209) to Time 2 (M = 4.85, SD = .217), p = .108. There was a statistically significant increase in PAS-peer-assessment scores from Time 1 (M = 4.89, SD = .165) to Time 2 (M = 4.93, SD = .127), p = .005. Thematic analysis of CDPs revealed that students believed they developed interpersonal relations/social skills, responsibility skills, and gross anatomy lab-specific skills over the gross anatomy course. Conclusions The Professionalism competency is inherently present and able to be assessed in the gross anatomy lab context for first-year medical students.

The Private Life of QAnon: A Mixed Methods Investigation of Americans' Exposure to QAnon Content on the Web

The QAnon movement has been credited with spreading disinformation and fueling online radicalization in the United States and around the globe. While some research has documented publicly-visible communications and engagements with the QAnon movement, little work has examined individuals' actual exposure to QAnon content. In this paper, we investigate the extent to which Americans are exposed to QAnon websites, in what contexts, and to what effect. We employ a mixed methods review of 21 million website visits collected from a nationally representative sample of 1,238 American adults across laptops, smartphones, and tablets during the 2020 U.S. presidential election. Quantitative techniques reveal overall levels of exposure to QAnon and who is more likely to be exposed, and qualitative techniques provide rich information about how participants came to be exposed to QAnon and how it fit within their broader media diets. We find that: (1) exposure to QAnon websites is limited and stratified by political ideology and news consumption; (2) exposure tends to occur within right-wing media ecosystems that align with QAnon beliefs; and (3) mixed methods approaches to analyzing digital trace data can provide rich insights that contextualize quantitative techniques. We discuss the implications of our findings for the design of interventions to lessen exposure to problematic material online and future research on the spread of disinformation and extremist content.

Utilisation of New Zealand Rugby's concussion management pathway: A mixed methods investigation.

Concerns around concussion highlight the need for strategies to improve the implementation and translation of concussion guidelines in community sports. This study assessed players' utilisation and compliance with New Zealand Rugby's Concussion Management Pathway (CMP). This pragmatic, mixed methods study comprised of concussion injury surveillance and mapping of players' healthcare touchpoints through the CMP. Semi-structured interviews were conducted to understand stakeholders' experiences. Over the season, 27 different healthcare pathways were identified with 28% of players progressing through all phases of the CMP (ideal pathway). Of the 206 suspected concussions reported over the season, 70% were logged in the CMP phone App, and 89% of these had an associated valid baseline concussion assessment. Prior to returning to contact training, 64% of players obtained a medical clearance. One theme, 'belief in the value of pathway' was identified as a facilitator across all CMP components. Themes such as 'concussion knowledge and the nature of concussion'; 'communication between stakeholders and sufficient information on the process'; and 'strong relationships and clarity around responsibilities' were identified as facilitators across several pathway components. Other facilitators included 'ease and timing of general practitioner access'; 'the phone App as facilitator to logging'; and 'spotting for concussion as a team'. Additionally, the findings signify baseline testing as a potential pre-cursor to overall CMP compliance. Strategies that support the facilitators identified in this study may further enhance compliance.

Effects of Qualitative Interview Participation on Muslim American Identity Integration: A Mixed-Method Investigation

ABSTRACT Participation in research studies about one’s identity has been found to act as a form of counseling intervention. This mixed-method convergent parallel design study sought to examine whether participating in a 45-minute one-on-one semi-structured interview on Muslim American identity integration affected participants’ views of their identity one year later. Participants included 29 ethnically diverse second-generation Muslim Americans residing in the U.S. Midwest who were retained at one-year follow-up from a semi-structured identity interview of 53 participants. Participants completed a survey with measures of identity, identity integration, and open-ended questions inquiring how the study influenced them. Descriptive quantitative analyses and thematic analysis of qualitative data were used to examine the participants’ perceptions of the interview. Qualitative responses displayed five themes (Self-Understanding and Reflection, Affirmation, Connecting With In-Group, “Normal” Conversation Topic, and No Change) aligning with the three primary domains incorporated in ethnic identity development. The blendedness of the participants’ Muslim and American identities, American centrality, and participants’ self-reported positive private regard toward their American identity were lower at Time 2 compared to Time 1. More research is needed regarding the influence of participating in identity-based mixed-methods studies on Muslim American identity formation.

A Mixed Methods Investigation of Trends in COVID-19 Pandemic-Specific Positive Changes Across Three Academic Years Following Pandemic Onset

Abstract: This study sought to identify levels and types of positive changes experienced during the pandemic and determine whether different patterns of positive changes existed across academic years. In this repeated cross-sectional mixed methods study, different samples of undergraduate students at a large, public university were recruited in Fall 2020–Spring 2021 (N = 719), Fall 2021–Spring 2022 (N = 1,243), and Fall 2022–Spring 2023 (N = 1,102). Participants completed an online survey that included the Stress-Related Growth Scale-Short Form-Revised (SRGS-SF-R) and an open-ended question about positive change due to the pandemic. Based on SRGS-SF-R scores, 41–45% reported low growth, 11–21% moderate growth, and 3–4% high growth across samples; means were significantly higher each subsequent academic year while remaining low. Common qualitative categories across years were enhanced social relationships (32–35%), personal development (24–28%), and enhanced academics (11–16%). Quantitative and qualitative analyses resulted in 15 overarching domains of positive change, including areas of psychological (e.g., change in perspective) and non-psychological (e.g., technology) change. Most students experienced some pandemic-specific positive change in each of the three academic years following the pandemic onset. Certain types of positive change may reflect specific impacts of particular phases of the pandemic.

Exploring the role of packaging in the formation of brand images: a mixed methods investigation of consumer perspectives

Purpose This study aims to explore consumers’ perspectives on how packaging plays a role in their consumption experience and how it contributes to the formation of brand images. By adopting a consumer’s perspective, the authors identify the criteria that consumers apply to evaluate packaging and reveal how packaging relates to consumers’ overall brand associations. Design/methodology/approach Through a sequential exploratory mixed methods design, the authors explore brand packaging of chocolate bars as emotionally laden, well-known fast-moving consumer goods. First, the authors conduct a qualitative focus group study to explore how consumers perceive package design, and how it relates to their brand impressions. Second, the authors test the constructs and attributes with an independent sample through a quantitative survey. Findings The qualitative findings reveal the different roles of packaging and highlight how packaging provides value for consumer experiences not only at the point-of-sale but also during later consumption. More specifically, the authors identify 12 main criteria that consumers use to evaluate packaging. The authors unwrap how packaging is embedded in consumers’ brand image networks by mapping out its connections to other brand associations pertaining to product attributes, the brand itself and personality impressions. The quantitative findings confirm the importance of practical and symbolic packaging criteria and the brand image comparisons. Originality/value Taking a consumer’s perspective, this study contributes to a more holistic understanding of how packaging supports brand building as we reveal the various ways in which packaging relates to consumers’ overall brand image associations. This study further directs attention to the roles that consumers themselves assign to packaging and how they evaluate packaging based on its practical, symbolic and social value.

Access to transition-related health care among transmasculine people in India: A mixed-methods investigation.

Little research has examined the health care experiences of transmasculine people in India, where government initiatives to improve access to transition-related (also called gender-affirmative) care have recently been announced. We draw on data from 'Our Health Matters', a mixed-methods community-based participatory research project, to characterize the transition-related care experiences of transmasculine people in India. Peer researchers conducted 40 virtual qualitative interviews in Hindi or Marathi from July to September 2021. Between November 2022 and January 2023, 377 transmasculine people participated in a multi-mode survey available in five languages. Qualitative data were analysed with a combination of framework analysis and grounded theory techniques. Data were mixed using a convergent parallel approach. Transmasculine persons' care journeys began with information-seeking, relying on peers and internet searches. In choosing between the public and private healthcare systems, they weighed issues of quality and affordability: the public system was perceived as lower-quality and difficult to access but most could not afford private care, leading to delays in care. Indeed, unmet need was common; 36.4% of survey participants were planning but had not begun to receive transition-related care and 80.2% wanted at least one transition-related surgery. Although some participants encountered stigma and refusal of care when seeking hormones, survey participants reported largely positive experiences with their hormone prescribers, which may reflect the influence of peer referrals. Participants underwent psychological assessments prior to transition-related care, which some experienced as disempowering and a barrier to disclosing mental health challenges. Finally, participants who were able to access care reported improved well-being, although surgical dissatisfaction was not uncommon (26.2%). Trans-inclusive medical training and continuing education are critical to enhancing access to high-quality transition-related care. Transmasculine people generally relied on peers and grassroots organizations for information, system navigation, and financial assistance. Strengthening these existing community resources may improve access to care.

Examining generative AI–mediated informal digital learning of English practices with social cognitive theory: a mixed-methods study

Abstract This study explores the integration of generative artificial intelligence (GenAI) in informal digital learning of English (IDLE) practices, focusing on its potential to enhance language learning outcomes and addressing the technological challenges language teachers face in utilising AI-based tools to facilitate second language acquisition. Based on the research context of IDLE and holistic learning ecology and drawing on the theoretical frameworks of technological pedagogical and content knowledge and social cognitive theory, we performed a mixed-methods investigation with an empirical experiment to assess the effectiveness of GenAI followed by semi-structured interviews. The results suggest that the GenAI-mediated IDLE practices effectively improve college students’ oral proficiency in English from both technological and humanistic perspectives. However, results also indicate that the GenAI conversational partner alone is not adequate to provoke continuous extramural GenAI-mediated IDLE practices. We discuss the theoretical and pragmatic significance of GenAI-mediated IDLE in educational equity and reformation.

Applying to Lead: A Mixed-Methods Investigation of Prospective Principals’ Job Application Strategies in Two Urban Districts

Purpose: Urban school districts often face challenges in filling principal vacancies with effective leaders, especially in high-needs schools. Prospective principals’ engagement with the job application process may contribute to these challenges. The goal of this study is to better understand the job search strategies and behaviors of prospective principals and how their approaches might contribute to leadership staffing challenges in high-needs schools. Research Design and Methods: We employ a convergent mixed-methods design that draws on data from two urban school systems. We pair analysis of interviews of 36 principals who have recently navigated the districts’ hiring systems with multiple years of applications and other administrative data provided by the two districts. We explored how patterns and themes that emerged from each data source were confirmed or disconfirmed with the other source. Findings: Guided by a job-search model, our analysis uncovers three main findings. First, the typical principal applicant conducted a targeted rather than a wide search, reflecting multiple strategies, preferences, and relational factors. Second, elementary educators showed a strong propensity to apply to the same grade level. Third, leaders applied to schools serving larger proportions of historically marginalized students at similar rates as other schools, reflecting their motivations to work with underserved students. Implications for Research and Practice: Considerations informing prospective principals’ job searches are multifaceted. High-needs schools are desirable to many principal candidates. Identifying and strategically recruiting candidates with preferences for working in such schools can be a strategy for districts seeking to overcome challenges in filling principal vacancies.

A mixed-method investigation of faculty perspectives on the benefits and challenges of engaging in student partnership activities in science

There is a growing interest within higher education to engage with students as partners to reposition students from consumers to producers of knowledge. The purpose of this study was to gather insights into the benefits, barriers/challenges, and best practices for engaging in student-faculty partnership activities for science faculty members. Supervising or working with graduate teaching assistants, working with students on university committees, collaborating with undergraduate or graduate students on a new or existing research project, and co-authoring manuscripts with graduate students were regarded as the most impactful partnership activities. Common benefits of student partnership activities included: collaboration and relationship building, broadening perspectives and gaining feedback, personal satisfaction, and institutional and career-related benefits. Common barriers/challenges reported were interpersonal dynamics and maintaining relationships, student management, and external influences. Best practices consisted of planning and setting expectations, developing students’ agency, using open communication, and facilitating peer-to-peer collaboration and peer mentoring.

"Wow another fake game from YouTube ad": Unpacking Fake Games Through a Mixed-Methods Investigation

Mobile games have become highly popular and profitable. While much work has been done to understand deceptive patterns of games and some unethical practices they apply, little is known about fake games, an emergent phenomenon in mobile gaming. To answer this question, we conducted two studies: a walkthrough method to characterize fake games, and a thematic analysis of user reviews to gain understanding from the user perspective. We found five types of misalignments that render a game fake and identified four primary facets of player experience with fake games. These misalignments act as realization points in the users' decision-making to define games as being fake. We discuss the fakeness of fake games, how the formation of an ecosystem helps with the circulation of fakeness, as well as challenges to governing fake games. Lastly, we propose implications for research and design on how to mitigate and identify fake games.

Racial and Gender Disparities in Community Mental Health Center Diagnoses of Adolescent ADHD and Comorbidities: A Mixed Methods Investigation

Racial and Gender Disparities in Community Mental Health Center Diagnoses of Adolescent ADHD and Comorbidities: A Mixed Methods Investigation

Inclusion of Individuals With Lived Experiences in the Development of a Digital Intervention for Co-Occurring Depression and Cannabis Use: Mixed Methods Investigation.

Existing interventions for co-occurring depression and cannabis use often do not treat both disorders simultaneously and can result in higher rates of symptom relapse. Traditional in-person interventions are often difficult to obtain due to financial and time limitations, which may further prevent individuals with co-occurring depression and cannabis use from receiving adequate treatment. Digital interventions can increase the scalability and accessibility for these individuals, but few digital interventions exist to treat both disorders simultaneously. Targeting transdiagnostic processes of these disorders with a digital intervention-specifically positive valence system dysfunction-may yield improved access and outcomes. Recent research has highlighted a need for the inclusion of individuals with lived experiences to assist in the co-design of interventions to enhance scalability and relevance of an intervention. Thus, the purpose of this study is to describe the process of eliciting feedback from individuals with elevated depressed symptoms and cannabis use and co-designing a digital intervention, Amplification of Positivity-Cannabis Use Disorder (AMP-C), focused on improving positive valence system dysfunction in these disorders. Ten individuals who endorsed moderate to severe depressive symptoms and regular cannabis use (2-3×/week) were recruited online via Meta ads. Using a mixed methods approach, participants completed a 1-hour mixed methods interview over Zoom (Zoom Technologies Inc) where they gave their feedback and suggestions for the development of a mental health app, based on an existing treatment targeting positive valence system dysfunction, for depressive symptoms and cannabis use. The qualitative approach allowed for a broader investigation of participants' wants and needs regarding the engagement and scalability of AMP-C, and the quantitative approach allowed for specific ratings of intervention components to be potentially included. Participants perceived the 13 different components of AMP-C as overall helpful (mean 3.9-4.4, SD 0.5-1.1) and interesting (mean 4.0-4.9, SD 0.3-1.1) on a scale from 1 (not at all) to 5 (extremely). They gave qualitative feedback for increasing engagement in the app, including adding a social component, using notifications, and being able to track their symptoms and progress over time. This study highlights the importance of including individuals with lived experiences in the development of interventions, including digital interventions. This inclusion resulted in valuable feedback and suggestions for improving the proposed digital intervention targeting the positive valence system, AMP-C, to better match the wants and needs of individuals with depressive symptoms and cannabis use.

A mixed-methods investigation into complex components of multilingual international students' self-regulated learning in English as a foreign language context: A social cognitive perspective

Self-regulated learning serves as a fundamental framework for understanding the cognitive, motivational, and emotional dimensions of learning. Recently, a growing body of studies on such cognitive processes appears in multilingual populations. Applying a mixed-methods approach, this study examined the key components of the self-regulated learning process among 233 multilingual international students in China, specifically within the context of English as a Foreign Language learning. Qualitative data was analyzed through Pearson's correlation analysis, structural equation modeling, and path analysis, while semi-structured interviews were conducted to further confirm the results of the qualitative data analysis. 15 students were purposefully selected through purposive sampling to participate in follow-up interviews. Within the framework of social cognitive theory, the findings revealed that metacognition, motivation, self-efficacy, and feedback loops are the primary components of self-regulated learning. Additionally, path analysis confirmed that the four factors are positive predictors of self-regulated learning proficiency of multilingual international students in China. The interview outcomes further validated the integral role of these primary components in the self-regulated learning process within the context of multilingual study. This study underscores the significance of incorporating translanguaging backgrounds into teaching strategies and language policy. Findings may offer some insights for multilingual international students, language teachers, and language policymakers in the field of Chinese language instruction.

Current and Future Implementation of Digitally Delivered Psychotherapies: An Exploratory Mixed-Methods Investigation of Client, Clinician, and Community Partner Perspectives.

Following the initial outbreak of the COVID-19 pandemic, mental health clinicians rapidly shifted service delivery from in-person to digital. This pivot was instrumental in maintaining continuity of care and meeting increased mental health service demands. Many mental health services have continued to be offered via digital delivery. The long-term implications of delivering services via digital media remain unclear and need to be addressed. This study aimed to identify current micro (i.e., clinician-patient interactions), meso (i.e., clinician-clinic manager interactions), and macro (i.e., government-policy maker interactions) level issues surrounding the use of digital mental health interventions (DMHI). Such integrated assessments are important for optimizing services to improve treatment outcomes and client satisfaction. Participants were recruited between January 2022 and April 2023. Quantitative data were collected using a survey informed by the Hexagon Tool. Qualitative data were collected from online semi-structured interviews and focus groups and analyzed using rapid thematic analysis. Survey data were collected from 11 client and 11 clinician participants. Twenty-six community partner participants were interviewed for this study. Client and clinician participants expressed satisfaction with the implementation of DMHI. Community partner participants generally agreed, reporting that such services will play an integral role in mental healthcare moving forward. Community partners shared that certain issues, such as uncertainty surrounding policies and regulations related to digital delivery, must be addressed in the future. Participants in this study supported the use of DMHI despite difficulties implementing these programs, asserting that such services are not a temporary fix but a pivotal cornerstone in the future of mental healthcare service delivery.