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The Use of “Mixing” Procedure of Mixed Methods in Health Services Research

Zhang, Wanqing MD, PhD*; Creswell, John PhD

doi: 10.1097/MLR.0b013e31824642fd
Applied Methods

Background: Mixed methods research has emerged alongside qualitative and quantitative approaches as an important tool for health services researchers. Despite growing interest, among health services researchers, in using mixed methods designs, little has been done to identify the procedural aspects of doing so.

Purpose: To describe how mixed methods researchers mix the qualitative and quantitative aspects of their studies in health services research.

Data Source: We searched the PubMed for articles, using mixed methods in health services research, published between January 1, 2006 and December 30, 2010.

Study Selection: We identified and reviewed 30 published health services research articles on studies in which mixed methods had been used. We selected 3 articles as illustrations to help health services researcher conceptualize the type of mixing procedures that they were using.

Results: Three main “mixing” procedures have been applied within these studies: (1) the researchers analyzed the 2 types of data at the same time but separately and integrated the results during interpretation; (2) the researchers connected the qualitative and quantitative portions in phases in such a way that 1 approach was built upon the findings of the other approach; and (3) the researchers mixed the 2 data types by embedding the analysis of 1 data type within the other.

Conclusions: “Mixing” in mixed methods is more than just the combination of 2 independent components of the quantitative and qualitative data. The use of “mixing” procedure in health services research involves the integration, connection, and embedding of these 2 data components.

*Department of Health Services Research & Administration, College of Public Health, University of Nebraska Medical Center, Omaha

Department of Educational Psychology, University of Nebraska Lincoln, Lincoln, NE

The authors declare no conflict of interest.

Presented at the 2011 Academy Health Annual Research Meeting in Seattle.

Reprints: Wanqing Zhang, MD, PhD, Department of Health Services Research & Administration, College of Public Health, 984350 University of Nebraska Medical Center, Omaha, NE 68198-4350. E-mail:

© 2013 by Lippincott Williams & Wilkins.