Mixing a Grounded Theory Approach with a Randomized Controlled Trial Related to Intimate Partner Violence: What Challenges Arise for Mixed Methods Research?
Little is known about how to systematically integrate complex qualitative studies within the context of randomized controlled trials. A two-phase sequential explanatory mixed methods study was conducted in Canada to understand how women decide to disclose intimate partner violence in emergency department settings. Mixing a RCT (with a subanalysis of data) with a grounded theory approach required methodological modifications to maintain the overall rigour of this mixed methods study. Modifications were made to the following areas of the grounded theory approach to support the overall integrity of the mixed methods study design: recruitment of participants, maximum variation and negative case sampling, data collection, and analysis methods. Recommendations for future studies include: (1) planning at the outset to incorporate a qualitative approach with a RCT and to determine logical points during the RCT to integrate the qualitative component and (2) consideration for the time needed to carry out a RCT and a grounded theory approach, especially to support recruitment, data collection, and analysis. Data mixing strategies should be considered during early stages of the study, so that appropriate measures can be developed and used in the RCT to support initial coding structures and data analysis needs of the grounded theory phase. 1. Introduction Mixed methods research uses both quantitative and qualitative data to improve understanding of a research problem beyond what is possible with either approach alone [1]. Mixed methods studies are challenging for health researchers to plan and implement due to their design complexity and difficulties related to appropriate integration of data and results [2–4]. There is acknowledgement among health researchers about the value of mixed methods, but concerns regarding a lack of formal education and skills in using mixed methods [5]. While many investigators have received formal graduate training in either quantitative methods or qualitative methods, few had been exposed to the specifics of mixed methods designs and the process for mixing and integration of data [5]. There continues to be a gap in our understanding of how mixed methods can be used in health research, especially when combining two methods in a single study. While mixing two methods can offer a more comprehensive investigation of a research problem, there are unique challenges to integrating two methods. 1.1. Study Aim Our goal is to describe the process of implementing a sequential explanatory mixed methods study involving a randomized, controlled trial
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