TY - JOUR
T1 - Advancing discussion of ethics in mixed methods health services research
AU - Stadnick, Nicole A.
AU - Poth, Cheryl N.
AU - Guetterman, Timothy C.
AU - Gallo, Joseph J.
N1 - Funding Information:
The authors acknowledge with gratitude the participation of MMRTP scholars, faculty and consultants who shared their experiences in a survey that was the primary data source for this study. We also acknowledge the peer reviewers who provided constructive comments that strengthened this manuscript.
Funding Information:
The need for greater focus on practical guidance on ethics in MMR is borne out in our data from the NIH-funded Mixed Methods Research Training Program (MMRTP) for the Health Sciences. The MMRTP is a 1-year fellowship that provides intensive training to competitively selected scholars in MMR through development of a NIH grant proposal [, , ]. First, the need for additional training beyond the fellowship on ‘how’ ethical strategies are applied to MMR was noted by MMRTP scholars via a structured pre/post survey evaluation. Scholars reported a need to improve skills related to the ethical principles of consent and recruitment before program participation. However, scholars reported no change in their self-reported ability to “define or explain” or “apply to practical problems” the ethical principles of consent nor of recruitment following MMRTP participation []. Scholars’ self-ratings offer initial support for enhanced attention to MMR ethical training in the MMRTP. Second, we analyzed NIH summary statements from grants submitted by MMRTP scholars and faculty and identified three inductive themes that emerged from the study section reviewer comments regarding ethical concerns. These included: (1) subject burden of participating in both qualitative and quantitative data collection; (2) participant confidentiality and anonymity, particularly risk of participant identification during the qualitative phase of the project or if video recordings were a data source; and (3) informed consent procedures that may require more explanation and thus be time-intensive []. Thus, our previous work with the MMRTP motivated our current study focus on understanding ethical considerations derived from practical experience in carrying out MMR.
Funding Information:
This work was supported by NIMH K23 MH110602 (PI: Stadnick). The Mixed Methods Research Training Program (MMRTP) is supported by the Office of Behavioral and Social Sciences Research and the National Institute of Mental Health under Grant R25MH104660 (PI: Gallo). This work was supported by NIMH K23 MH110602 (PI: Stadnick) and NIMH R34 MH120190 (PI: Stadnick).
Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - 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.
AB - 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.
KW - Health services research
KW - Mixed methods
KW - Research ethics
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U2 - 10.1186/s12913-021-06583-1
DO - 10.1186/s12913-021-06583-1
M3 - Article
C2 - 34126980
AN - SCOPUS:85107908504
VL - 21
JO - BMC Health Services Research
JF - BMC Health Services Research
SN - 1472-6963
IS - 1
M1 - 577
ER -