Mixed Methods Literature Research Articles

“Everyone has the ability actualy to do well in education. It's just the support mechanisms that you give to them…”: A systematic literature review exploring the educational experiences of children in care

The educational outcomes and attainment of children and young people in care (CYPIC) are lower than those of individuals not in care and is a source of international concern (Sebba & Luke, 2019; McNamara et al., 2019). Despite positive shifts in the legislative landscape to increase focus and support for the educational progress of CYPIC, the attainment gap persists. CYPIC are not a homogenous group, and some go on to do well in education. Therefore, it is important not to make assumptions and to inform decisions affecting the educational experiences of CYPIC from their own perspective. A systematic literature review was conducted to explore the educational experiences of CYPIC living in the United Kingdom in qualitative and mixed-methods literature over the last decade. A total of eleven studies were reviewed, incorporating the views of 203 CYPIC. A process of thematic synthesis was used to illuminate the facilitators and barriers to CYPIC’s educational attainment, and four themes were identified: impact of care; support; quality of relationships and agency. The findings of the synthesis are considered with reference to relevant psychological theory and previous research. The limitations of the synthesis are discussed as well as the implications for improvements in service delivery for CYPIC. The review findings are relevant to policy makers and all professionals who work with CYPIC to support their education.

Supporting efficiency improvement in public health systems: a rapid evidence synthesis

BackgroundPublic health systems internationally are under pressure to meet increasing demand for healthcare in the context of increasing financial resource constraint. There is therefore a need to maximise health outcomes achieved with public healthcare expenditure. This paper aims to establish and synthesize the contemporary evidence base for approaches taken at a system management level to improve efficiency.MethodsRapid Evidence Assessment (REA) methodology was employed. A search strategy was developed and applied (PUBMED, MEDLINE) returning 5,377 unique titles. 172 full-text articles were screened to determine relevance with 82 publications included in the final review. Data regarding country, study design, key findings and approaches to efficiency improvement were extracted and a narrative synthesis produced. Publications covering health systems from developed countries were included.ResultsIdentified study designs included policy reviews, qualitative reviews, mixed methods reviews, systematic reviews, literature reviews, retrospective analyses, scoping reviews, narrative papers, regression analyses and opinion papers. While findings revealed no comprehensive frameworks for system-wide efficiency improvement, a range of specific centrally led improvement approaches were identified. Elements associated with success in current approaches included dedicated central functions to drive system-wide efficiency improvement, managing efficiency in tandem with quality and value, and inclusive stakeholder engagement.ConclusionsThe requirement for public health systems to improve efficiency is likely to continue to increase. Reactive cost-cutting measures and short-term initiatives aimed only at reducing expenditure are unlikely to deliver sustainable efficiency improvement. By providing dedicated central system-wide efficiency improvement support, public health system management entities can deliver improved financial, health service and stakeholder outcomes.

Undergraduate Students’ Mental, Emotional and Coping Responses to an Online Environment during the COVID-19 Pandemic in Jamaica: A Mixed Methods Study

The COVID-19 pandemic has affected the lives and livelihoods of people around the world. This study aimed to investigate the mental health and coping response related to the sudden switch to online teaching and learning (OTL) during the pandemic. We also explored the strategies they employed to cope with the online environment’s emotional stress. Participants were recruited from the undergraduate student population of a prominent university in Kingston, Jamaica. In this study, an exploratory sequential mixed methods research design was utilized where findings of the qualitative phase were used to develop a survey instrument for online administration. Focus group discussions (FGDs) with eighty-six students provided qualitative data, and 465 students answered questions on the study topic in the survey. Findings from the sample survey represented those in the qualitative data. In the FGDs, students expressed feelings of anxiety, depression and loneliness about the OTL during the pandemic. In the survey, most students experienced anxiety (87 per cent), some depression symptoms (sadness/crying, 74 per cent), and loneliness (72.1 per cent). In particular, they were generally unaware of the university’s counselling service, which was not dissimilar in the survey findings (54 per cent). There were some statistical associations among mental and emotional outcomes and coping methods between categories: anxiety and missing classes (Φ = 0.264), anxiety and social media (Φ = 0.228), sadness and missing classes (Φ = 0.219) and loneliness and missing classes (Φ = 0.218). The community of practice-learning theory helped to explain these findings. We concluded that these findings highlighted a need for greater awareness of and access to psycho-social services to assist students in managing their mental health, especially during a pandemic. This study contributes to the mixed methods literature as an example of how quantitative findings can help generalize qualitative results to a study sample.

A Mixed Methods Literature Review and Framework for Decision Factors That May Influence the Utilization of Managed Wildfire on Federal Lands, USA

There is increasing discussion in the academic and agency literature, as well as popular media, about the need to address the existing deficit of beneficial fire on landscapes. One approach allowable under United States federal wildland fire policy that could help address this condition is by deliberately managing wildfire with a strategy other than full suppression (hereafter referred to as ‘managed wildfire’). To improve the understanding of the managed fire decision-making process, we conducted a mixed methods review of the existing literature. This review spanned 1976 to 2013 and used thematic coding to identify key factors that affect the decision to manage a wildfire. A total of 110 descriptive factors categories were identified. These were classified into six key thematic groups, which addressed specific decision considerations. This nexus of factors and decision pathways formed what we describe as the ‘Managed Fire Decision Framework’, which contextualizes important pressures, barriers, and facilitators related to managed wildfire decision-making. The most prevalent obstacles to managing wildfire were operational concerns and risk aversion. The factor most likely to support managing a fire was the decision maker’s desire to see the strategy be implemented. Ultimately, we found that the managed fire decision-making process is extremely complex, and that this complexity may itself be a barrier to its implementation.

Navigating the caregiving abyss: A metasynthesis of how family caregivers manage end-of-life care for older adults at home

Background: Demographic changes (global aging, decreased fertility, increased home deaths) will present a critical need for end-of-life family caregivers of older adults at home. In order to support these family caregivers, we need to better understand their experiences, struggles, and needs. Aim: To describe and explain the process of end-of-life caregiving as experienced by family caregivers of older adults residing in the home setting. Design: The Preferred Reporting Items for Systematic Reviews and Metaanalysis (PRISMA) guidelines and Sandelowski and Barroso’s procedural steps for a metasynthesis review guided this study. Data sources: Qualitative and mixed methods literature from CINAHL, Medline, PsycINFO, and EMBASE databases and information from professional organizations were reviewed for studies that focused on family caregivers providing end-of-life care to older adults residing in the home setting. Results: A total of 24 studies were identified. Family caregivers engaged in the process of “navigating a caregiving abyss” when providing and managing end-of-life-care for older adults at home. The “caregiving abyss” consisted of four phases: (1) managing multiple roles, (2) encountering challenges, (3) mobilizing resources, and (4) acknowledging death is near. During the process family caregivers strived to “live day by day” and “maintain normalcy” to achieve the goals of honoring life’s final wishes and provide home death. Conclusion: Family caregivers of older adults at the end of life navigate a variety of challenges. The findings provide a conceptual framework to help guide the development of education, interventions, and health policy to meet family caregivers’ needs in providing quality end-of-life care.

Behaviour in sustainability transitions: A mixed methods literature review

Sustainability transitions require changing many behaviours embedded in production and consumption systems. Simultaneously, behavioural public policy is now a significant site of research-policy translation globally. Links between behaviour and system change are underdeveloped in both fields. Systematic review of current transitions literature found ∼4% of papers focused on behaviour. Two prominent perspectives on behaviour (labelled: ‘everyday’ and ‘strategic’) are critical of a focus on individuals, preferencing broader analysis. Two additional perspectives were identified - ‘automatic’ and ‘reflective’ - which highlight immediate and local influences on behaviour but underemphasise context. All four perspectives on behaviour draw on different conceptualisations, causality, methods and disciplinary foundations, and yet all have value and application to transitions. We argue that a complimentary and flexible approach to behaviour would benefit the field, considering the diversity of phases, scales and contexts of sustainability transitions. Transitions’ own behavioural perspectives could also help address behavioural public policy's challenges.

The role of local radio in promoting creative engagement for healthy ageing

ObjectivesTo identify and critique literature on the links between public service local radio promoting creative engagement for healthy ageing in order to better understand the potential for public health agendas. MethodsThis communication draws on preliminary learning from Up for Arts (UfA), a partnership initiative between BBC local radio and the UK charity Voluntary Arts. As part of the development of a logic model for the national roll-out of UfA, a scoping review of literature was undertaken. Eight search engines were searched systematically using four main search terms, ‘older people’, ‘participatory arts’, ‘mass media’ and ‘public health’. Journals and websites were also opportunistically searched for outlying material. The inclusion criteria were qualitative, quantitative and mixed method studies and literature reviews published in English, between 2009 and 2018, wherein public service local radio was involved in promoting arts and crafts activities in local communities. Both formal activities, such as singing in a choir, and informal activities, such as a home-based knitting circle, were included. Art therapy, music therapy and other clinical interventions were excluded. ResultsOf 708 papers, articles and reports identified through title, 37 were retained for primary screening. None met the criteria for inclusion. However, results on the individual search topics indicate that improved public health outcomes might result by including the promotion of creative engagement for healthy ageing. ConclusionPublic Service Local Radio partnership initiatives, such as UfA, could have a role in supporting the development of creative engagement as a positive healthy ageing activity. This may be of interest and relevance to policymakers seeking novel ways to address health behaviours among people approaching old age.

Design method validation – an investigation of the current practice in design research

Validation of design methods is a challenge in design research, as there is a lack of common methodology. This contribution investigates how validation of design methods is currently conducted in order to clarify this issue and identify approaches that might be suitable as best practices. A mixed-methods literature study including the years 2010–2020 is conducted. Systematic mapping structures the identified literature in an overview. The following state-of-the-art review focuses on challenges in validation and on how researchers address them. The overview of 54 identified studies shows a preponderance of non-comparative studies conducted in laboratory environment. Challenges arising in conducting experiments and field studies are caused by a lack of common metrics and established study designs. In success evaluation, the challenge is to objectively measure the effects of method application on the design outcome. Based on the identified examples, possible strategies to overcome the challenges are proposed.

A Fully Longitudinal Mixed Methods Case Study Design: An Example Based on the Illness Trajectory of a Person With Chronic Conditions in Home-Monitoring-Based Telenursing During the COVID-19 Pandemic

A challenge for mixed methods researchers concerns integration in the methodological dimension. Employing a fully longitudinal mixed methods case study design, we examined the physical and psychological changes in a chronically ill older person via telenursing video consultations. We collected daily measures of his physical state and conducted clinical interviews before and during the COVID-19 pandemic. Our two-step approach integrated mixed data types, first, by making meta-inferences at five time frames during his illness trajectory and, second, by developing “global meta-inferences,” or interpretations across the meta-inferences from each of the five time frames using joint display analysis. We contribute to the mixed methods literature by illustrating integration in the methodological dimension through a fully longitudinal mixed methods case study.

Evidence\u2010based priorities of under\u2010served pregnant and parenting adolescents: addressing inequities through a participatory approach to contextualizing evidence syntheses

PurposeThis study describes an interdiscursive evidence-based priority setting process with pregnant and parenting adolescents and their services providers.MethodsA mixed methods literature review identified studies reporting on perinatal outcomes and experiences of adolescents during pregnancy to 12 months post-partum published in Canada after 2000. We also calculated relative risks for common perinatal risk factors and outcomes for adolescents compared to adult populations from 2012 to 2017 based on data from a provincial database of maternal and newborn outcomes. Two trained peer researchers identified outcomes most relevant to their peers. We shared syntheses results with four service providers and 13 adolescent mothers accessing services at a community service organization, who identified and prioritized their areas of concern. We repeated the process for the identified priority issue and expanded upon it through semi-structured interviews.ResultsAdolescent mothers face higher rates of poverty, abuse, anxiety and depression than do adult mothers. Adolescents prioritized the experience of judgment in perinatal health and social services, particularly as it contributed to them being identified as a child protection risk. Secondary priorities included loss of social support and inaccessibility of community resources. The experience of judgment in adolescent perinatal health literature was summarized around: being invisible, seen as incapable and seen as a risk. Adolescent mothers adapted these categories, emphasizing organizational and social barriers.ConclusionsYoung marginalized women are disproportionately affected by inequities in perinatal outcomes, yet their perspectives are rarely centered in efforts to address these inequities. This research addresses health inequities by presenting a robust, transparent and participatory approach to priority setting as a way to better represent the perspectives of those who carry the greatest burden of health inequities in evidence syntheses. In our work, marginalized adolescent parents adapted published literature around the experience and consequences of social stigma on perinatal outcomes, shifting our understanding of root causes and possible solutions.

Abuse-to-Prison Pipeline: A Call for A Human Rights Approach

ABSTRACT This Special Issue is applying a human rights framework to address risk and vulnerability, as well as the implications of trauma across the lifespan from a trauma-informed lens with applied intersectional theory. The intention of this special issue is to identify mixed methods research and literature reviews on the collective impact of trauma and how trauma may be a pathway for justice-involvement. Authors utilized diverse sampling and methodologies with applied psychological, sociological, and criminological theories with particular attention to polyvictimization, and/or history of child abuse and/or history of domestic violence (DV)/interpersonal violence (IPV), and involved with one or multiple institutions. Recommendations encompassed next steps in research among community samples and justice-involved participants, policy, and best practices within our justice and community-based systems to create sustainable programs that are trauma-responsive, culturally sensitive, and gendered interventions to reflect the populations being served.

A Novel Mixed Methods Approach Combining Geospatial Mapping and Qualitative Inquiry to Identify Multilevel Policy Targets: The Focused Rapid Assessment Process (fRAP) Applied to Cancer Survivorship.

Multi-level perspectives across communities, medical systems and policy environments are needed, but few methods are available for health services researchers with limited resources. We developed a mixed method health policy approach, the focused Rapid Assessment Process (fRAP), that is designed to uncover multi-level modifiable barriers and facilitators contributing to public health issues. We illustrate with a study applying fRAP to the issue of cancer survivorship care. Through this multi-level investigation we identified two major modifiable areas impacting high-quality cancer survivorship care: 1) the importance of cancer survivorship guidelines/data, 2) the need for improved oncology-primary care relationships. This article contributes to the mixed methods literature by coupling geospatial mapping to qualitative rapid assessment to efficiently identify policy change targets.

Use of Services by People Living Alone With Cognitive Impairment: A Systematic Review.

Background and ObjectivesFormal supports and social services are essential to people living alone with cognitive impairment (PLACI) because they are at risk of negative health outcomes and lack cohabitants who may support them with cognitively demanding tasks. To further our understanding of this critical and worldwide issue, we conducted a systematic review to understand whether, and how, PLACI access and use essential formal supports and services.Research Design and MethodsWe searched 6 databases (PubMed, Embase, PsycINFO, CINAHL, Web of Science, and Sociological s) to identify quantitative and mixed-method literature on formal service use among PLACI. The initial search was conducted in 2018 and updated in 2020.ResultsWe identified 32 studies published between 1992 and 2019, representing 13 countries, that met our criteria: 16 reported on health services and 26 on social services. Most studies compared PLACI with people with cognitive impairment living with others. Health service use was lower or similar among PLACI, as opposed to counterparts living with others. Most studies reported a higher use of social services (e.g., home services) among PLACI than those living with others. Overall use of essential home service among PLACI was higher in Europe than in the United States, a country where large portions of PLACI were reported receiving no formal services.Discussion and ImplicationsWe identified wide variability among countries and major gaps in service use. Results for use of health services were mixed, although our findings suggest that PLACI may have fewer physician visits than counterparts living with others. Our findings suggest that varying policies and budgets for these services among countries may have affected our findings. We encourage researchers to evaluate and compare the influence of social policies in the well-being of PLACI. We also encourage policy makers to prioritize the needs of PLACI in national dementia strategies.

Quantitative and Qualitative Analysis of an Emerging Topic: A Mixed Method Approach on Sustainable Development Goals Discourse

An unprecedented growth in academic publication has led to a deluge of information also the challenge of absorbing the knowledge desired. Our focus is on quantitative and qualitative methods that explore the evolutionary pattern of an emerging discussion in academic discourse. As a case study, we use the United Nations 2030 Agenda of Sustainable Development Goals (SDGs);a topic that gained momentum in academic discourse as well as business and management literature. We argue that both quantitative and qualitative approaches should be utilized when reviewing literature on emerging, complex and multidisciplinary topics, such as the SDGs. To obtain an accurate, holistic perspective on development and challenges surrounding this topic, a mixed-method literature review approach identified significant discussion clusters. While applying each methodological approach separately and clustering the topical areas, we made an effort to combine the results of both quantitative and qualitative literature review assessments to observe the overlaps and differences.

Toward Culturally Tailored Advance Care Planning for the Chinese Diaspora: An Integrative Systematic Review.

Background: The Chinese diaspora experiences disparate end-of-life (EOL) care outcomes. Advance care planning (ACP) may be an effective intervention to improve EOL care, but its reception and uptake in the Chinese diaspora are unknown. Objective: Review and synthesize current literature to develop a culturally tailored ACP framework for the Chinese diaspora. Design: A systematic integrative review framed by Whittemore and Knafl's method was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Data Sources: PubMed, Embase, CINAHL, Web of Science, Cochrane Library, and University of York Center for Reviews and Dissemination were systematically searched for articles published before February 2020. All English, peer-reviewed quantitative, qualitative, and mixed-method literature studying ACP in Chinese adults living outside China and Taiwan were included. A mixed-method appraisal tool was utilized for quality assessment. Results: The search yielded 836 unique articles, from which we included 30. Integrative synthesis resulted in a novel framework to guide culturally tailored ACP among the Chinese diaspora. The framework highlights the importance of an authority-initiated, indirect approach to ACP that maximizes individual and collective harmony. Furthermore, due to evolving sociodemographic and acculturation factors, the perception of harmony may differ between individuals and generations. Conclusion: The Chinese diaspora population is willing to engage in ACP. An individualized, culturally sensitive approach that captures and maximizes harmony will be central to the success of ACP in this population. Further work is required to understand the influence of serious illness, spirituality, and family on ACP.

Integrating data in a complex mixed‐methods classroom interaction study

Mixed‐methods (MM) designs have gained increasing interest in educational research. Still, many studies collect quantitative and qualitative data but report these data separately and do not attempt to integrate them in practice. The aim of this article is to discuss the purposes and processes of integrating qualitative and quantitative data in an MM classroom interaction study. Issues regarding mixing and integration, including how to overcome integration barriers, are discussed. Based on this outline, the study then presents details about the various integration processes adopted in a recent MM study on classroom interaction in Norway. The possibilities and challenges of integration to produce new knowledge and a deeper understanding throughout the research process in classroom studies are illustrated with a specific focus on points of interface. A key issue is whether the new knowledge obtained in an MM study is more than the sum of the individual quantitative and qualitative parts. Using selected questions from the MM alphabet proved a helpful heuristic for guiding the iterative processes of integration and provided richer explanations and an enhanced understanding of the implementation and impact of a complex classroom intervention initiative. The study provides a new methodological contribution to the MM literature by examining the integration processes and challenges faced in a specific study.

Health Literacy in people with intellectual disabilities – is there a need for an adapted concept?

Abstract Background Health literacy (HL) is a crucial factor in terms of health and health-related outcomes. HL refers to personal and social resources as well as the abilities to access, understand, appraise and apply health information to make self-determined health decisions. Due to reduced resources including cognitive abilities it is assumed that HL in people with intellectual disabilities (PWID) is low. Up to 3% of the general population have an ID (IQ < 70). Methods Current state of the art is presented via a mixed-method literature review published in 2019. Against that, results from 5 target group orientated groups are presented (n = 50). Results Literature Review (12 studies incl.): HL does not go beyond a purely functional understanding. Studies assume that the HL level of PWID is very low, but fail to mention a reference source. Overall, studies are mainly from the health professionals' perspective and exceptions directly questioned or focused people with ID. People with ID still seems to be a 'hidden' population in HL research. Group discussions: An introducing quiz about health-related topics turns into a discussion within the group of PWID. Topics were physical activity, nutrition and health advices from health professionals like GPs. Instructions of physicians were discussed; a critical view of health advices were taken. Bassed on experiences own health decisions are described. Trained caregivers like nurses are stated as an own professional HL resource. Communicative and critical HL have been demonstrated. Conclusions There is only little knowledge about HL in PWID. Promoting HL could be highly beneficial for managing health information with a positive impact on PWID themselves (empowerment), their (family) caregivers, and the health care system (reducing health costs). A debate to conceptualize HL for PWID is mandatory. This must be based on valid data, consider the perspectives of PWID and have to respect the resources of PWID. Future directives will be discussed. Key messages People with ID communicative and critical health literacy is is available but not yet explored how it can be increased. A target-adapted health literacy of people with intellectual disabilities is beneficial, it it takes the perspectives of this target group into account.

Interprofessional collaboration in hospitals: a critical, broad-based review of the literature

ABSTRACT Interprofessional collaboration (IPC) is a common term applied in the healthcare literature, with suggestions it contributes to improved quality and safety of patient care across the globe. Despite worldwide implementation of models of IPC, past systematic or meta-reviews on this topic have concluded that the evidence is mixed. However, these reviews are yet to adequately consider the qualitative and mixed-methods literature on this topic. In this critical review, we synthesize the outcomes and key findings of IPC in hospitals, taking a broader approach by including diverse study designs. A total of 4,776 abstracts were screened from three major databases (Medline, CINAHL, Embase). Thirty-four studies fulfilled inclusion criteria. Although outcomes and key findings (e.g., staff turnover, error rates) were mostly positive, there were inconsistencies in the results. The included studies reflected a variety of study designs and different methodological approaches. Overall, our review revealed moderate evidence that IPC can positively influence patient, staff and organizational factors in hospitals, and that inconsistent findings may be due to variation in context (e.g., the cohort of patients). Recommendations from the review are to incorporate qualitative- and mixed-methods approaches to studying IPC in healthcare and tailor evaluations of IPC outcomes specific to the context.

Culture, socio-economic status, and religious coping as predictors of happiness: a review

Happiness importance cannot be overemphasized this has been confirmed by many researches and world happiness report 2012—2018. As a result, factors predicting happiness have been employed by researchers and scholars in various studies on Muslim women. Thus, this study examined and found out the factors predicting happiness such as culture, socio-economic status (SES) and religious coping as well as identified the foremost and majorpredictor and research design used by these scholars. A systematic review of the literature on culture, socio-economic status and religious coping as predictors of happiness among Muslim women was carried out. A total of number of 30 articles from different disciplines has been examined. The factors and research design found were divided in to those that belong to happiness predicted by culture, by socio-economic status, by religious coping and by culture, socio-economic status and religious coping, happiness related to culture, happiness related to culture, to socio-economic status, to religious coping and related to culture, socio-economic status and religious coping. The research designs were quantitative, qualitative, mixed method and systematic literature review (SLR). Quantitative research design was found to be the leading research design.The studies were also examined based on countries of study; Iran, Turkey, Palestine, Oman, Qatar, New Zealand, England, Bangladesh, Algeria, Jordan, Indonesia, Malaysia and Lebanon. Iran was the leading country. But no model of happiness was found in the studies analysed. It is hoped that findings from this study will be beneficial to Muslims in women centre for continuing education and counsellors especially in sub-Sahara Africa (Nigeria).

Green walking groups: A mixed-methods review of the mental health outcomes for adults with mental health problems

Introduction Evidence suggests group walking in natural environments is more beneficial to the general population’s mental health than walking indoors, in urban environments, and alone. Such ‘green walking groups’ have been suggested as an occupational therapy intervention that could be suitable for adults with mental health problems. However, there have been no reviews of the mental health outcomes of participating in green walking groups for this population. Method A mixed-methods literature review was conducted. A range of databases was systematically searched electronically. Papers that met pre-defined inclusion criteria were selected, critically appraised, and qualitative and quantitative data were extracted. Thematic analysis was used to identify key qualitative outcomes. Findings Six papers were included and eight mental health outcomes identified. The evidence suggests participants can experience connections with other people, connections with nature, and a sense of freedom. There is some limited evidence to support improvements to mood, self-esteem, reflection on life tasks, and symptoms of depression, with mixed evidence for experiencing a sense of achievement. Conclusion This review can be used to build the evidence base for the link between occupation and mental health, and inform the clinical decision-making of occupational therapists, who are well-placed to design and implement green walking groups.