Advancing discussion of ethics in mixed methods health services research

Abstract

Background To describe the ethical issues and experiences of scientists conducting mixed methods health services research and to advance empirical and conceptual discussion on ethical integrity in mixed methods health research. Methods The study was conducted with 64 scholars, faculty and consultants from the NIH-funded Mixed Methods Research Training Program (MMRTP) for the Health Sciences. This was a cross-sectional study. Survey results were analyzed using descriptive statistics to characterize responses and open coding to summarize strategies about eight ethical mixed methods research issues. Respondents completed an online survey to elicit experiences related to eight ethical issues (informed consent, confidentiality, data management, burden, safety, equitable recruitment, communication, and dissemination) and strategies for addressing them. Results Only about one-third of respondents thought their research ethics training helped them plan, conduct, or report mixed methods research. The most frequently occurring ethical issues were participant burden, dissemination and equitable recruitment (> 70% endorsement). Despite occurring frequently, < 50% of respondents rated each ethical issue as challenging. The most challenging ethical issues were related to managing participant burden, communication, and dissemination. Strategies reported to address ethical issues were largely not specific or unique to mixed methods with the exception of strategies to mitigate participant burden and, to a lesser degree, to facilitate equitable recruitment and promote dissemination of project results. Conclusions Mixed methods health researchers reported encountering ethical issues often yet varying levels of difficulty and effectiveness in the strategies used to mitigate ethical issues. This study highlights some of the unique challenges faced by mixed methods researchers to plan for and appropriately respond to arising ethical issues such as managing participant burden and confidentiality across data sources and utilizing effective communication and dissemination strategies particularly when working with a multidisciplinary research team. As one of the first empirical studies to examine mixed methods research ethics, our findings highlight the need for greater attention to ethics in health services mixed methods research and training.

Pragmatism and Methodology

“…Worryingly, studies have found that many mixed methods investigators do not consider their ethics training useful for planning, conducting, and reporting their research (Stadnick et al, 2021). These findings raise the important issue of how to prepare mixed methods researchers to recognize, seize, and address ethical dilemmas.…”

Integrating Mixed Method Research in Palliative Care of Cancer Patients: Enhancing Holistic Understanding and Patient-Centered Care

“…In MMR, the ethical dilemmas that posed the greatest challenges revolved around addressing participant burden, communication, and dissemination. 10 Hence, emphasis to be placed on the necessity to ensure the well-being of participants, uphold privacy and confidentiality, and approach sensitive subjects with empathy and respect.…”

Operationalizing and Expanding the Rigorous Mixed Methods Framework for Systematic Reviews: The Case of Inclusive Education

“…First, we provide conceptual arguments for their inclusion. Second, drawing from seminal literature (Cain et al, 2019;Creswell & Plano Clark, 2007;Hall, 2013;Hesse-Biber, 2010;Poth, 2018;Shannon-Baker, 2016;Stadnick et al, 2021;Teddlie & Tashakkori, 2009), we developed criteria for the additional elements. As with the original elements, we independently reviewed all 66 documents and met to compare responses and resolve discrepancies.…”

“…Research ethics has been a major consideration since the late 1970s when the Belmont Report was issued. This also applies to mixed methods research (Hesse-Biber, 2010;Poth, 2018;Stadnick et al, 2021). Since ethical considerations should inform the steps taken by researchers and are important for reporting quality (Fàbregues & Molina-Azorín, 2017;Howell Smith & Shanahan Bazis, 2021), a demonstration of ethical inquiry is needed in high-rigor methodological practice (Cain et al, 2019).…”