Research Methods in

Health Promotion Introduction to

Mixed Methods

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Research

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Prof. (Dr.) Madhumita Dobe
Chairperson, Foundation for Actions
and Innovations Towards Health
Promotion, and

N Former Director Professor and Head,

Dept. of Health Promotion and
Education, AIIH&PH
Email: [email protected]
Lecture # 26
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• Types of research studies

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• How research question determines type of research studies

• When to choose a mixed method study

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RESEARCH STUDIES
Three broad types– Quantitative, Qualitative and Mixed-Method .
Qualitative and quantitative studies are not rigid, distinct categories, or dichotomies - they are
different ends of a continuum. Mixed method studies are in the middle of this continuum and
integrate elements of both qualitative and quantitative studies.
One is not necessarily better than the other, nor more scientific or more rigorous. They are

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compatible and complementary, allowing capture of diverse data for contextually richer, more
complete understanding of the problem.
The decision about which type of study should be used, depends on the nature of the research

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problem, research questions and research designs
Studies that simply combine multiple methods in the data collection or multi-
informant studies are not mixed methods designs.
For the research to be considered a true mixed methods study, there must be

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genuine integration of the data at one or more stages in the process of research.
The core assumption of this approach is that the integration of qualitative and quantitative data
yields additional insight beyond the information provided by either the quantitative or
qualitative data alone.

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 OBJECTIVE - relies specifically on
scientific evidence, such as
experiments and statistic

scientific knowledge is
constructed

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move from data to theory, The researcher studies what others
or from the specific to the have done, reads existing theories of
whatever phenomenon he or she is

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general.
studying, and then tests hypotheses
that emerge from those theories

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identify a problem and view it within its broadest
context

the research process starts with 'surprising facts' or

'puzzles' and the research process is devoted their
explanation

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 RESEARCH QUESTION

What is mixed methods research?

answering research questions through

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a combination ( INTEGRATION) of
qualitative and quantitative data.

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 Problems
•Overweight among young people
•Malnutrition among under 5 children
•Unmet needs of family planning

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•Vaccine hesitancy

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Research questions are based on the aims and objectives

The answer to each research question should provide

information to meet the aim of the research. For example, in
the scenario given before, appropriate research questions

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may include

How do adolescents view the health risks of obesity?

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What are the relevant social or subjective norms regarding
obesity in their social environment?
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When to choose a Mixed Method study?
 Elaboration and clarification of the results from one method with the results from the other and check
the accuracy (validity) of the databases.
 Finding answers for paradoxes and contradictions, new perspectives.
 Using different methods for different inquiries. Quantitative and qualitative research can each answer

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different research questions.
 Qualitative methods can be used to develop Instruments like questionnaire and scale items for
quantitative methods.

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 One method can facilitate the sampling of respondents or cases in the other.
 Qualitative methods can be used to provide contextual understanding for the findings or relationships
among variables uncovered through quantitative survey.

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 Triangulation – convergence ( coming together), corroboration ( confirmation), and correspondence
(similarity) of results from the different methods.
 Both quantitative and qualitative methods have their own strengths and weaknesses so combining them
allows to offset their weaknesses and draw on the strengths of both.

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 N
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PT
EL
• There are three broad types of research studies– Quantitative, Qualitative and Mixed-Method . Mixed
method studies are in the middle of this continuum and integrate elements of both qualitative and
quantitative studies. The decision about which type of study should be used, depends on the nature

EL
of the research problem, research questions and research designs

• Studies that simply combine multiple methods in the data collection or multi-informant

PT
studies are not mixed methods designs.

• For the research to be considered a true mixed methods study, there must be genuine
integration of the data at one or more stages in the process of research to yield
additional insight beyond the information provided by either the quantitative or qualitative data
alone.
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 Mixed method studies are used for elaboration and clarification of the results from one method with
the results from the other and check the accuracy (validity) of the databases,finding answers for
paradoxes and contradictions, new perspectives. – convergence ( coming together), corroboration (
confirmation), and correspondence (similarity) of results from the different methods.

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• Karen Glanz (Editor), Barbara K. Rimer (Editor), K. Viswanath (Editor); Health Behavior:

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Theory, Research, and Practice, 5th Edition ISBN: 978-1-118-62898-0 July 2015 Jossey-
Bass
• Dobe M; Health promotion and Education: Foundations for Changing Health Behavior1st

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Edition 2022 Academic Publishers
• Mixed Methods Research | Definition, Guide & Examples Published on August 13, 2021
by Tegan George. Revised on December 2, 2022
• Mixed Methods Research.https://catalyst.harvard.edu › mmr
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Research Methods in
Health Promotion
The Convergent Design

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PT
Dr. Sweety Suman Jha, MBBS, MD
Senior Resident (Community Medicine)
Dr. B.C. Roy Multi-Speciality Medical

N Research Centre,
Indian Institute of Technology Kharagpur
Email: [email protected]

Lecture # 27
 EL
• Overview of The Convergent Design
• Choice of the Convergent design
• The Convergent design procedures

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• Strengths of the Convergent design
• Challenges in using the Convergent design

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• Convergent
• Quantitative
• Qualitative

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• Point of integration

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Overview of The Convergent Design
• The convergent design is a mixed methods design in which the
researcher collects and analyses two separate databases— quantitative
and qualitative—and then merges the two databases for the purpose of
comparing or combining the results.

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• The intent of the convergent design is to obtain different but
complementary data on the same topic

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• This design is used when the researcher wants to compare quantitative
statistical results with qualitative findings for a complete understanding of
the research problem.

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• Other purposes for this design include corroboration and validation
purposes, illustrating quantitative results with qualitative findings (or vice
versa), or examining relationships among variables.

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Overview of The Convergent Design

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Quantitative
data collection
and analysis Results
merged
Interpretation

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and
compared
Qualitative data
collection and
analysis
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 Choice of the Convergent design

In addition to the intent of comparing results to best understand a problem,

there are other compelling reasons for using the convergent design. It is useful
when:

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• the researcher has limited time for collecting data in the field and must gather both
types of data in one visit,

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• the researcher needs both quantitative and qualitative forms of information from
every participant,
• the researcher has skills in both quantitative and qualitative methods of research,
and

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• the mixed methods team has individuals skilled in both quantitative and qualitative
research.

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The Convergent design procedures

• There are four major steps in the convergent design.

• First, the researcher collects both quantitative data and qualitative data about
the topic of interest.

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• These two types of data collection are concurrent but typically separate—that
is, one does not depend on the results of the other.

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• Second, the researcher analyzes the two data sets separately and
independently from each other using quantitative and qualitative analytic
procedures.

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The Convergent design procedures

• Once the two sets of initial results are in hand, the researcher reaches the point
of interface and works to merge the results of the two data sets in the third step.

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• In the final step, the researcher interprets to what extent and in what ways the
two sets of results converge or diverge from each other, relate to each other,
and/or combine to create a better understanding in response to the study’s

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overall purpose.

• If the results diverge, then the researcher takes further steps to explain this
difference through re examining the results, collecting more data, or reflecting
on the quality of the databases.
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The Convergent design procedures
(Source: Creswell JW, Clark VL. Designing
and conducting mixed methods research.
Sage publications; 2018.)

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The Convergent design procedures

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 Strengths of the Convergent design

• Researchers new to mixed methods often choose this design. It was the design
first discussed in the literature, and it has become a popular approach for thinking
about mixed methods research.

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• It is an efficient design in which both types of data are collected during one phase
of the research at roughly the same time.
• Each type of data can be collected and analyzed separately and independently,
using the techniques traditionally associated with each. This lends itself to team

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research in which the team can include individuals with both quantitative and
qualitative expertise.
• The design facilitates the direct comparison of participants’ perspectives gathered

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in an open-ended questioning format (e.g., semi-structured interview) with the
perspectives drawn from the researchers’ standpoint (e.g., on an instrument such
as a survey chosen by the researcher) in close- ended questioning.

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 Challenges in using the Convergent design

• Issues of different sample sizes—Researchers need to consider the consequences of

having different samples and different sample sizes when merging the two data sets.

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• The need to merge a text and a numeric database—It can be challenging to merge two
sets of very different data and their results in a meaningful way.

• The need to explain divergence when comparing results—Researchers may face the

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question of what to do if the quantitative and qualitative results do not agree.
Contradictions may provide new insights into the topic, but these differences can be
difficult to resolve and may require the collection of additional data.

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 EL
• The convergent design is a mixed methods design in which the researcher collects and
analyses two separate databases— quantitative and qualitative—and then merges the two
databases for the purpose of comparing or combining the results.

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• This design is used when the researcher wants to compare quantitative statistical results
with qualitative findings for a complete understanding of the research problem.

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 RESOURCES

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• Creswell JW, Clark VL. Designing and conducting mixed methods research. Sage publications; 2018.

• Saha I, Paul B. Essentials of Biostatistics & Research Methodology. 3rd Edition 2021 Academic Publishers

PT
• Dobe M; Health promotion and Education: Foundations for Changing Health Behavior.1st Edition 2022 Academic
Publishers

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Research Methods in
Health Promotion
The Explanatory
Sequential Design

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PT
Dr. Sweety Suman Jha, MBBS, MD
Senior Resident (Community Medicine)
Dr. B.C. Roy Multi-Speciality Medical

N Research Centre,
Indian Institute of Technology Kharagpur
Email: [email protected]

Lecture # 28
 EL
• Overview of The Explanatory Sequential Design
• Choice of the explanatory sequential design
• The explanatory sequential design procedures

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• Strengths of the explanatory sequential design
• Challenges in using the explanatory sequential design

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 EL
• Explanatory
• Qualitative strand
• Quantitative

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• Point of integration

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 Overview of The Explanatory Sequential Design
• The explanatory sequential design is a mixed methods design in which the researcher
begins by conducting a quantitative phase and follows up on specific results with a
subsequent qualitative phase to help explain the quantitative results.

• It involves a two-phase data collection project in which the researcher collects quantitative

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data in the first phase, analyzes the results, and then uses the results to plan (or build on
to) the second, qualitative phase. The key idea is that the qualitative data collection builds
directly on the quantitative results.

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• The qualitative phase is implemented for the purpose of explaining the initial results in more
depth, and the name of the design—explanatory—reflects how the qualitative data help
explain the quantitative results.
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• The primary intent of this design is to use a qualitative strand to explain initial quantitative
results. It can be used to explain the mechanisms through qualitative data that shed light on
why the quantitative results occurred and how they might be explained.

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Overview of The Explanatory Sequential Design

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Quantitative data Results Qualitative data
collection and connected to collection and Interpretation
analysis and analysis
explained by

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 Choice of the explanatory sequential design

The explanatory sequential design is most useful when:

• the researcher and the research problem are more quantitatively oriented and thus it

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makes sense to start the procedures with a quantitative phase,
• the researcher knows the important variables and has access to quantitative
instruments for measuring the constructs of primary interest,

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• the researcher has the ability to return to participants for a second round of
qualitative data collection,
• the researcher has the time to conduct the research in two phases, and
• the researcher has limited resources (perhaps the researcher is the sole

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investigator) and needs a design in which only one type of data is being collected
and analyzed at a time.

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The explanatory sequential design procedures

• During the first step, the researcher designs and implements a

quantitative phase that includes collecting and analyzing quantitative
data.

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• In the second step, the researcher connects to a second phase—the
point of integration for mixing—by identifying specific quantitative results

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that call for additional explanation and using these results to guide the
development of the qualitative strand.

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The explanatory sequential design procedures

• Specifically, the researcher develops or refines the qualitative research

questions, purposeful sampling procedures, and data collection protocols
so they follow from the quantitative results. As such, the qualitative

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phase is connected to and depends on the quantitative results.

• In the third step, the researcher implements the qualitative phase by

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collecting and analyzing qualitative data. Finally, the researcher
interprets to what extent and in what ways the qualitative results explain
and add insight into the quantitative results and what overall is learned in
response to the study’s purpose.

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The explanatory sequential design procedures

(Source: Creswell JW, Clark VL. Designing

and conducting mixed methods research.
Sage publications; 2018.)

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PT
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The explanatory sequential design procedures

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 Strengths of the explanatory sequential design
The many advantages of the explanatory design make
it the most straightforward of the mixed methods
designs. These advantages include the following:

• This design appeals to quantitative researchers because it often begins with a

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strong quantitative orientation.
• Its structure makes it straightforward to implement because the researcher
conducts the two phases—quantitative, then qualitative—separately and collects

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only one type of data at a time. This means single researchers can find this to be a
manageable design to conduct.
• The final report can be written with a quantitative section followed by a qualitative
section, making it straightforward to write and providing a clear delineation for
readers.
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• This design lends itself to emergent approaches in which the second phase can be
designed based on what is learned from the initial quantitative phase.

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 Challenges in using the explanatory sequential design

Although the explanatory design is straightforward,

researchers choosing this approach still need to
anticipate challenges specific to it. These challenges
include the following:

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• Extended time needed for completion—This design requires a lengthy amount of time
for implementing the two phases, and participants must be accessible over an

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extended period.

• The qualitative phase cannot be fully specified in advance—It can be difficult to secure
institutional review board (IRB) approval for studies using this design because the

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researcher cannot specify with precision the participants to be selected for the second
phase or the questions that will be asked in the follow-up qualitative phase until the
initial quantitative findings are obtained.

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 Challenges in using the explanatory sequential design

Although the explanatory design is straightforward,

researchers choosing this approach still need to
anticipate challenges specific to it. These challenges
include the following:

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• Quantitative results to follow up on must be identified—The researcher must decide
which quantitative results need to be further explained. Although this cannot be

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determined precisely until after the quantitative phase is complete, options such as
selecting significant results and strong predictors can be considered as the study is
being planned.

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• The need to specify who can best provide the explanation—The researcher must
decide who to sample in the second phase and what criteria to use for participant
selection.

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• The explanatory sequential design is a mixed methods design in which the researcher

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begins by conducting a quantitative phase and follows up on specific results with a
subsequent qualitative phase to help explain the quantitative results.

• The primary intent of this design is to use a qualitative strand to explain initial quantitative

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results.

• The many advantages of the explanatory design make it the most straightforward of the
mixed methods designs.
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 RESOURCES

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• Creswell JW, Clark VL. Designing and conducting mixed methods research. Sage publications; 2018.

• Saha I, Paul B. Essentials of Biostatistics & Research Methodology. 3rd Edition 2021 Academic Publishers

PT
• Dobe M; Health promotion and Education: Foundations for Changing Health Behavior.1st Edition 2022 Academic
Publishers

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Research Methods in
Health Promotion
The Exploratory
Sequential Design

EL
PT
Dr. Sweety Suman Jha, MBBS, MD
Senior Resident (Community Medicine)
Dr. B.C. Roy Multi-Speciality Medical

N Research Centre,
Indian Institute of Technology Kharagpur
Email: [email protected]

Lecture # 29
 EL
• Overview of The Exploratory Sequential Design
• Choice of the Exploratory sequential design
• The Exploratory sequential design procedures

PT
• Strengths of the Exploratory sequential design
• Challenges in using the Exploratory sequential design

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2
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• Exploratory
• Quantitative
• Qualitative

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• Point of integration

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3
 Overview of The Exploratory Sequential Design

• The exploratory sequential design is a three-phase mixed methods

design in which the researcher starts with the collection and analysis of
qualitative data that is then followed by a development phase of

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translating the qualitative findings into an approach or tool that is tested
quantitatively.

• This means that the approach or tool will be grounded in the views of

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participants. This emphasis on exploring before the development phase is
reflected in the design name.

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• In many applications of this iterative design, the researcher develops an
instrument as an intermediate step between the phases that builds on the
qualitative results and is used in the subsequent quantitative data
collection.

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 Overview of The Exploratory Sequential Design

• Alternatively, researchers may design new variables, new measures (or a

survey), new experimental activities, or an app or digital tool during the
development phase.

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• Specifically, the primary intent of the exploratory design is to develop and
apply a quantitative measure, survey, intervention, digital tool, or new
variables that are grounded in the qualitative data.

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• By this we mean that the quantitative feature is based on the culture or
setting of participants. With the culture-specific development of the

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measure or instrument, the likelihood increases that it will be seen as
relevant to the group being studied.

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 Overview of The Exploratory Sequential Design

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Qualitative data Results Quantitative measure,
Tested or Quantitative data
collection and connected Instrument, Intervention,
applied by collection and
analysis to and build App, or Website analysis
to

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Interpretation

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 Choice of the exploratory sequential design

The exploratory sequential design is most useful when:

• the researcher and the research problem are more qualitatively oriented and

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therefore it makes sense to start with a more inductive approach;
• the researcher needs to develop a product (e.g., an instrument, intervention
materials, or a digital tool) that is substantively relevant and culturally sensitive;

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• the researcher has the necessary time to conduct the research in three phases:
qualitative, development, and quantitative;
• the researcher is interested in the transferability and generalizability of a newly
developed product; and

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• the researcher identifies new emergent research questions based on small-
sample qualitative results that can be best tested with a large quantitative sample.

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The exploratory sequential design procedures

• This design starts with the collection and analysis of qualitative data to explore
a phenomenon.

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• In the next step, which represents the point of integration in mixing, the
researcher identifies the results on which the quantitative feature will be built.

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• The researcher undertakes a development phase by developing an instrument,
identifying variables, designing intervention (experimental) activities, or coming
up with an app or website intervention to test.

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The exploratory sequential design procedures

• These developments connect the initial qualitative phase to the subsequent

quantitative strand of the study.

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• In the third step, the researcher implements the quantitative strand of the study
to examine the salient variables using the developed instrument or intervention
with a new sample of participants.

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• Finally, the researcher interprets in what ways and to what extent the
quantitative results generalize or extend the initial qualitative findings.

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The exploratory sequential design procedures
(Source: Creswell JW, Clark VL. Designing
and conducting mixed methods research.
Sage publications; 2018.)

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PT
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The exploratory sequential design procedures

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PT
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 Strengths of the exploratory sequential design

• Separate phases make the exploratory sequential design straightforward to

describe, implement, and report.

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• Although this design typically emphasizes the qualitative aspect, the inclusion of a
quantitative component can make the qualitative approach more acceptable to
quantitative-biased audiences.

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• This design is useful when the need for a second, quantitative phase emerges
based on what is learned from the first, qualitative phase.

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• The researcher can produce a new instrument (or measure, variable, set of
intervention activities, or digital tool) as one of the potential products of the
research process.

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 Challenges in using the exploratory sequential design

• The researcher must plan for extended time to complete—This sequential approach
requires considerable time to implement, potentially including time for a third phase to
develop a feature (e.g., new instrument). Researchers need to recognize this factor

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and build time into their study’s plan.

• The quantitative phase must be tentatively specified in advance—It is difficult to

specify the procedures of the quantitative phase when applying for initial IRB approval

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for the study.

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Challenges in using the exploratory sequential design

• Two different samples might need to be identified—Researchers should

consider using a small, purposeful sample in the first phase and a large
sample of different participants in the second phase to enhance the
generalization of the quantitative results.

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• The researcher must determine which qualitative results to use—When
developing a new feature after the qualitative phase, the researcher needs to

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decide which results to use from the qualitative phase to build the quantitative
feature and how to use these results to generate quantitative measures or
materials.

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• The researcher must be skilled—This design requires expanded skills on the
part of the researcher because proficiency in qualitative research, quantitative
research, mixed methods research, and instrument development (or digital
tool development) will be needed.

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• The exploratory sequential design is a three-phase mixed methods design in which the

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researcher starts with the collection and analysis of qualitative data that is then followed by
a development phase of translating the qualitative findings into an approach or tool that is
tested quantitatively.

PT
• Specifically, the primary intent of the exploratory design is to develop and apply a
quantitative measure, survey, intervention, digital tool, or new variables that are grounded in
the qualitative data.

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 RESOURCES

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• Creswell JW, Clark VL. Designing and conducting mixed methods research. Sage publications; 2018.

• Saha I, Paul B. Essentials of Biostatistics & Research Methodology. 3rd Edition 2021 Academic Publishers

PT
• Dobe M; Health promotion and Education: Foundations for Changing Health Behavior.1st Edition 2022 Academic
Publishers

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Research Methods in
Health Promotion
The Embedded Design

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Dr. Sweety Suman Jha, MBBS, MD
Senior Resident (Community Medicine)
Dr. B.C. Roy Multi-Speciality Medical

N Research Centre,
Indian Institute of Technology Kharagpur
Email: [email protected]

Lecture # 30
 EL
• Overview of The Embedded Design
• Choice of the Embedded design
• The Embedded experimental model

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• Strengths of the Embedded design
• Challenges in using the Embedded design

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• Embedded
• Quantitative
• Qualitative

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• Experimental

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 Overview of The Embedded Design

• The Embedded Design is a mixed methods design in which one data set
provides a supportive, secondary role in a study based primarily on the
other data type.

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• The premises of this design are that a single data set is not sufficient, that
different questions need to be answered, and that each type of question
requires different types of data.

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Choice of the Embedded design

• Researchers use this design when they need to include qualitative or

quantitative data to answer a research question within a largely quantitative or
qualitative study.

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• This design is particularly useful when a researcher needs to embed a
qualitative component within a quantitative design, as in the case of an
experimental design.

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• In the experimental design, the investigator includes qualitative data for several
reasons, such as to develop a treatment, to examine the process of an
intervention, or to follow up on the results of an experiment.

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 The embedded experimental model
• This model is defined by having qualitative data embedded within an
experimental design (such as a true experiment or a quasi experiment).

• The priority of this model is established by the quantitative, experimental

methodology, and the qualitative dataset is subservient within that

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methodology.

• This design adds qualitative data collection into an experiment or

intervention so that the personal experiences of participants can be

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included in the research. Thus the qualitative data become a secondary
source of data embedded in the experiment.

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• This design can either be used as a one-phase or a two-phase approach,
in which the timing reflects the purpose for including the qualitative data.

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The embedded experimental model

• The researcher must decide at what point in the experimental study to

collect the qualitative data (before, during, or after the intervention). This
decision should be made based on the intent for including the qualitative
data (e.g., to shape the intervention, to explain the process of

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participants during treatment, or to follow up on results of the
experimental trial).

• In a one- phase approach, qualitative data can be embedded during the

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intervention phase , such as when a researcher wants to qualitatively
examine the process of the intervention in addition to the quantitative
outcomes. When investigators gather qualitative data during the

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experiment, they often ask process questions to identify how participants
experience the intervention.

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The embedded experimental model

• For before-intervention approaches, the researcher needs to decide which qualitative

results will be used in the quantitative phase. Again, the qualitative data collection should
be carefully designed to match the intent for including qualitative data, such as to

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develop an instrument or shape the intervention. Researchers collect qualitative data
prior to an experiment, so that they can use that information to plan specific intervention
activities that will be appealing or useful to the participants.

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• For after-intervention approaches, decisions must be made about which aspects of the
trial will be further explored, and the researcher must specify the criteria used to select

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the participants for the follow- up data collection. Researchers may want to follow up in
depth only with participants who received the treatment or with select cases based on
positive and negative treatment outcomes. Researchers collect qualitative data after the
intervention, such information helps explore in more detail the outcome results and
explain why the intervention may or may not have worked.

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The embedded experimental model

(Source:Creswell JW, L. PCV.

Designing and conducting mixed
methods research. Thousand
Oaks, CA: SAGE Publications;
2006.)

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PT
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The embedded experimental model

(Source:Creswell JW, Clark VL.

Designing and conducting mixed
methods research. Sage publications;
2018.)

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PT
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 Strengths of the Embedded design

• It can be used when a researcher does not have sufficient time or resources to
commit to extensive quantitative and qualitative data collection because one data
type is given less priority than the other.

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• This design may be logistically more manageable for students because one method
requires less data than the other method.

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• This design may be appealing to funding agencies because the primary focus of the
design is traditionally quantitative, such as an experimental trial.

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 Challenges in using the Embedded design

• The researcher must specify the purpose of collecting qualitative (or quantitative) data
as part of a larger quantitative (or qualitative) study.

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• Determining the appropriate point in the experimental study to collect the qualitative
data.

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• Researchers need expertise in experimental research as well as qualitative research.

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• Few examples exist and little has been written about embedding quantitative data
within traditionally qualitative designs.

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• The Embedded Design is a mixed methods design in which one data set provides a

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supportive, secondary role in a study based primarily on the other data type.

• Researchers use this design when they need to include qualitative or quantitative data to

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answer a research question within a largely quantitative or qualitative study.

• This Embedded experimental model is defined by having qualitative data embedded within
an experimental design (such as a true experiment or a quasi experiment).

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 RESOURCES
• Creswell JW, Creswell JD. Research design qualitative, quantitative, and mixed methods approaches. 5th ed.

EL
Thousand Oaks, CA: SAGE; 2018.

• Creswell JW, Clark VL. Designing and conducting mixed methods research. Sage publications; 2018.

• Creswell JW, L. PCV. Designing and conducting mixed methods research. Thousand Oaks, CA: SAGE Publications;

PT
2006.

• Saha I, Paul B. Essentials of Biostatistics & Research Methodology. 3rd Edition 2021 Academic Publishers

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• Dobe M; Health promotion and Education: Foundations for Changing Health Behavior.1st Edition 2022 Academic
Publishers

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PT
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