Mixed methods research has gained visibility within the last few years, although limitations persist regarding the scientific caliber of certain mixed methods research designs and methods. The need exists for rigorous mixed methods designs that integrate various data analytic procedures for a seamless transfer of evidence across qualitative and quantitative modalities. Such designs can offer the strength of confirmatory results drawn from quantitative multivariate analyses, along with “deep structure” explanatory descriptions as drawn from qualitative analyses. This article presents evidence generated from over a decade of pilot research in developing an integrative mixed methods methodology. It presents a conceptual framework and methodological and data analytic procedures for conducting mixed methods research studies, and it also presents illustrative examples from the authors' ongoing integrative mixed methods research studies.
This study sought to determine whether select pretreatment demographic and in-treatment clinical variables predict premature treatment discharge at 6 and 12 months among patients receiving methadone maintenance treatment (MMT). Data were abstracted from electronic medical records for 1,644 patients with an average age of 34.7 years (SD = 11.06) admitted to 26 MMT programs located throughout the United States from 2009 to 2011. Patients were studied through retrospective chart review for 12 months or until treatment discharge. Premature discharge at 6- and 12-month intervals were the dependent variables, analyzed in logistic regressions. Clinical predictor variables included average methadone dosage (mg/d) and urinalysis drug screen (UDS) findings for opioids and various nonopioid substances at intake and 6 months. Pretreatment demographic variables included gender, race/ethnicity, employment status, marital status, payment method, and age at admission. UDS findings positive (UDS+) for cocaine at intake and 6 months were found to be independent predictors of premature discharge at 12 months. UDS+ for opioids at 6 months was also an independent predictor of premature discharge at 12 months. Higher average daily methadone dosages were found to predict retention at both 6 and 12 months. Significant demographic predictors of premature discharge at 6 months included Hispanic ethnicity, unemployment, and marital status. At 12 months, male gender, younger age, and self-pay were found to predict premature discharge. Select demographic characteristics may be less important as predictors of outcome after patients have been in treatment beyond a minimum period of time, while others may become more important later on in treatment.
INTRODUCTION This study examined the ability of family cohesion, parental control, and parent-child attachment to prevent adolescents with a history of drug or alcohol use from experiencing subsequent problems related to their use. METHODS Data came from Wave I and Wave II of the National Longitudinal Study of Adolescent Health and included Mexican heritage and White adolescents who reported alcohol use (n = 4,894, 25% prevalence) or any other drug use (n = 2,875, 14% prevalence) in their lifetime. RESULTS Logistic regression results indicate greater parent-child attachment predicted lower risk of experiencing drug use problems (OR = 0.87, 95% CI = 0.77 – 0.98) while stronger family cohesion predicted lower odds of experiencing drug- (OR = 0.82, 95% CI = 0.70 – 0.97) or alcohol-related (OR = 0.74, 95% CI = 0.65 – 0.84) problems. Parental control was also negatively associated with odds of problems related to drug use (OR = 0.93, 95% CI = 0.86 – 0.99) or alcohol use (OR = 0.94, 95% CI = 0.90 – 0.99). Results also indicated family cohesion was the only protective factor for Mexican heritage youth while family cohesion and parent-child attachment were protective among White youth. Parental control protected White female adolescents from drug use problems more than males. Mexican heritage male adolescents experienced more protection from drug problems compared to females. CONCLUSION Findings highlight the need for prevention interventions to emphasize parent-child attachment for White youth and family cohesion for both Mexican-heritage and White youth to decrease adolescent substance users’ drug- and alcohol-related problems.
This study examined interactive relationships among ethnic identity, gender, time in the US, and changes in substance use outcomes among a school-based sample of 1,731 Mexican-heritage preadolescents (ages 9–13). Residual change multilevel models adjusting for school clustering and using multiply imputed data assessed changes from beginning to end of fifth grade in use of alcohol, cigarettes, marijuana and inhalants, and four substance use antecedents. Effects of ethnic identity were conditional on time in the US, and in opposite directions by gender. Among males living longer in the US, stronger ethnic identity predicted desirable changes in all but one outcome (substance offers). Among females living longer in the US, stronger ethnic identity predicted undesirable changes in alcohol use, pro-drug norms, and peer substance use. Interpretations focus on differential exposure to substance use opportunities and the erosion of traditional gender role socialization among Mexican-heritage youth having lived longer in the US.
Studies show that positive family factors help protect adolescents from engaging in risky sexual activities, but do they continue to protect adolescents as they transition to late adolescence/early adulthood? Using data from the National Longitudinal Study of Adolescent Health, we examined whether family support, parent–child closeness, parental control/monitoring of adolescent behaviors and parent–child communication about sex, assessed in adolescence, were related to condom use in late adolescence/early adulthood among African American (n = 1,986), Chinese American (n = 163), Mexican American (n = 1,011) and White (n = 6,971) youth. Controlling for demographic variables and number of sex partners, the results showed that family support was positively related and parent-child communication was negatively related to condom use for the sample as a whole and for the white sample, but not for the other groups. Parent–child communication about sex and parental control were negatively related to condom use in the Chinese American sample. None of the family factors was related to condom use in the African American or Mexican American samples. Overall, parents talked more with daughters than sons about sexual matters. Condom use was most common among African Americans and among males. Greater attention to cultural expectations regarding sex and gender roles, as well as the causal ordering of effects, are important directions for future research.
The link between drug use and crime has been broadly described, but little detail is known about the contributions of alcohol and drug dependence to different types of offending. Data were drawn from the 2010 Arrestee Drug Abuse Monitoring II (ADAM II) program to examine the relationships between dependence, offense type, and severity among recent male arrestees ( N = 3,006). A substantial proportion (ranging from 15% to 39%) of arrestees across all offense types and severity levels endorsed drug-dependent items. Smaller proportions (between 5% and 16%) of arrestees endorsed alcohol-dependent items. Drug dependence was associated with higher odds of receiving felony charges and higher probability of being charged with a substance-related offense. Alcohol dependence was associated with lower odds of felony charges, but greater probability of being charged with a violent offense. Assessment and treatment provisions need to be systematically implemented to reduce these types of offenses.
The incarcerated population in the United States is disproportionately African American and many inmates are parents of children under the age of 18. Recent reports show that African American children were significantly more likely than White children to have a parent in prison. Emerging research has also begun to investigate some of the effects that parental incarceration can have on children, but little has focused exclusively on the population of African American youth. This study draws on the National Longitudinal Study of Adolescent to Adult Health to examine how having a father, a mother, or both parents incarcerated may be associated with an array of adverse life circumstances (i.e., criminal justice contact, drug use, and depression) for African American children. Differences were examined among children who had (a) an imprisoned mother, (b) an imprisoned father, (c) both parents imprisoned, and (d) neither parent imprisoned. Results indicated that having different parents imprisoned early in life was differentially associated with negative outcomes during emerging adulthood. These findings have important implications for the development of prevention and intervention programs for African American children of incarcerated parents.
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