Adopting Mixed Methods in Health Research: A Methodological Approach to Analyze HTA Development

  • Chapter
  • First Online:
Development and Implementation of Health Technology Assessment

Part of the book series: Contributions to Management Science ((MANAGEMENT SC.))

  • 444 Accesses

Abstract

Along with this study, a mixed methods design is adopted, in which both quantitative and qualitative data are captured in order to answer the research questions. The possibility to have a deeper understanding of the complex research problem is conceived as justification for the use of a mixed methods approach. Quantitative data are collected through a web-based survey, while qualitative data are gathered through semi-structured interviews. The analysis of quantitative and qualitative data is done following the triangulation protocol strategy, according to which, after a separate analysis of data coming from both approaches, an interpretation stage is followed to integrate results and to obtain a broader picture of the research problem.

The analysis is conducted in Lombardy Region, in Italy, where a tailored implementation intervention, aimed at diffusing HTA culture at different levels of the healthcare system, was developed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
EUR 29.95
Price includes VAT (Germany)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
EUR 117.69
Price includes VAT (Germany)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
EUR 160.49
Price includes VAT (Germany)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info
Hardcover Book
EUR 160.49
Price includes VAT (Germany)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    CTE and CTD are the two Commissions that are in charge of supporting the evaluation activities related to the Health Technology Assessment Program at Regional level in Lombardy Region (DGR 5671 of 11.10.2016).

  2. 2.

    KEL is a Project of Lombardy Region that has been introduced with the aim of training and educating professionals on the basic principles of HTA and systematically involve them in the evaluation of medical devices. Additional information about the project are provided in Chap. 4.

References

  • Aarons GA, Hurlburt M, Horwitz SM (2011) Advancing a conceptual model of evidence-based practice implementation in public service sectors. Admin Policy Ment Health Ment Health Serv Res 38(1):4–23

    Article  Google Scholar 

  • Amigoni M et al (2005) Health technology assessment: a flexible approach? Experiences in Lombardy. Ital J Public Health 2(2):9–14. https://doi.org/10.2427/5978

    Article  Google Scholar 

  • Andrew S, Halcomb EJ (2009) Mixed methods research for nursing and the health sciences. Wiley, Hoboken, NJ

    Book  Google Scholar 

  • Appleton JV, King L (2002) Journeying from the philosophical contemplation of constructivism to the methodological pragmatics of health services research. J Adv Nurs 40(6):641–648

    Article  Google Scholar 

  • Ary D, Jacobs LC, Razavieh A (1996) Introduction to research in education. Holt, Rinehart, and Winston, Fort Worth

    Google Scholar 

  • Barry CA (1998) Choosing qualitative data analysis software: atlas/ti and nudist compared. In: Sociological research online. Sage, London, 3(3), pp 1–13

    Google Scholar 

  • Berger R (2015) Now I see it, now I don’t: researcher’s position and reflexivity in qualitative research. Qual Res 15(2):219–234

    Article  Google Scholar 

  • Bernauer JA et al (2013) Blending the old and the new: qualitative data analysis as critical thinking and using Nvivo with a generic approach. Qual Rep 18(31):1–10

    Google Scholar 

  • Bhaskar R (2013) A realist theory of science. Routledge, London

    Book  Google Scholar 

  • Biesta G (2010) Pragmatism and the philosophical foundations of mixed methods research. In: Sage handbook of mixed methods in social and behavioral research, vol 2. Sage, Thousand Oaks, CA, pp 95–118

    Chapter  Google Scholar 

  • Boland L et al (2019) Barriers and facilitators of pediatric shared decision-making: a systematic review. Implement Sci 14(1). https://doi.org/10.1186/s13012-018-0851-5.

  • Bradley EH, Curry LA, Devers KJ (2007) Qualitative data analysis for health services research: develo** taxonomy, themes, and theory. Health Serv Res 42(4):1758–1772

    Article  Google Scholar 

  • Brannen J (1992) Mixing methods: qualitative and quantitative research. Routledge, London

    Google Scholar 

  • Brinkmann, S. and Kvale, S. (2015) ‘Interviews: learning the craft of qualitative research interviews 3rd Sage Thousand Oaks, CA

    Google Scholar 

  • Brown ML (1965) Use of a postcard query in mail surveys. Public Opin Q 29(4):635–637

    Article  Google Scholar 

  • Brownson RC, Colditz GA, Proctor EK (2018) Dissemination and implementation research in health: translating science to practice. Oxford University Press, Oxford

    Google Scholar 

  • Bruvold NT, Comer JM (1988) A model for estimating the response rate to a mailed survey. J Bus Res 16(2):101–116

    Article  Google Scholar 

  • Burda MHF et al (2016) Collecting and validating experiential expertise is doable but poses methodological challenges. J Clin Epidemiol 72:10–15

    Article  Google Scholar 

  • Caretta MA (2016) Member checking: a feminist participatory analysis of the use of preliminary results pamphlets in cross-cultural, cross-language research. Qual Res 16(3):305–318

    Article  Google Scholar 

  • Castillo-Montoya M (2016) Preparing for interview research: the interview protocol refinement framework. Qual Rep 21(5):811–831

    Google Scholar 

  • Chan ZCY, Fung Y, Chien W (2013) Bracketing in phenomenology: only undertaken in the data collection and analysis process. Qual Rep 18(30):1–9

    Google Scholar 

  • Checkland P (1999) Systems thinking, Rethinking management information systems: an . Available at http://books.google.com/books?hl=en&lr=&id=rEDSNVV2SDAC&oi=fnd&pg=PA45&dq=system+thinking&ots=SZvu6iRMH9&sig=TeZ_nuf04qMyO9GkAL4oDMzfOXI%5Cnpapers2://publication/uuid/C73A1A15-14E9-4F8D-B6DD-E498A5DDA597

  • Churchman CW (1970) Operations research as a profession. Manag Sci 17(2):B-37

    Article  Google Scholar 

  • Ciani O, Tarricone R, Torbica A (2012) Diffusion and use of health technology assessment in policy making: what lessons for decentralised healthcare systems? Health Policy 108(2–3):194–202. https://doi.org/10.1016/j.healthpol.2012.09.017

    Article  Google Scholar 

  • Clark AM, Lissel SL, Davis C (2008) Complex critical realism: tenets and application in nursing research. Adv Nurs Sci 31(4):E67–E79

    Article  Google Scholar 

  • Cobanoglu C, Moreo PJ, Warde B (2001) A comparison of mail, fax and web-based survey methods. Int J Market Res 43(4):1–15

    Article  Google Scholar 

  • Cohen D et al (2014) The population health approach: a qualitative study of conceptual and operational definitions for leaders in Canadian healthcare. SAGE Open Med. https://doi.org/10.1177/2050312114522618

  • Collins KMT, Onwuegbuzie AJ, Jiao QG (2006) Prevalence of mixed-methods sampling designs in social science research. Eval Res Educ 19(2):83–101

    Article  Google Scholar 

  • Collins KMT, Onwuegbuzie AJ, Jiao QG (2007) A mixed methods investigation of mixed methods sampling designs in social and health science research. J Mixed Methods Res 1(3):267–294

    Article  Google Scholar 

  • Connors JJ, Elliot J (1994) Teacher perceptions of agriscience and natural resources curriculum. J Agric Educ 35(4):15–19

    Article  Google Scholar 

  • Couper MP, Traugott MW, Lamias MJ (2001) Web survey design and administration. Public Opin Q 65(2):230–253

    Article  Google Scholar 

  • Coyle CE et al (2018) Federal funding for mixed methods research in the health sciences in the United States: recent trends. J Mixed Methods Res 12(3):305–324

    Article  Google Scholar 

  • Crawford S, McCabe SE, Pope D (2005) Applying web-based survey design standards. J Prev Interv Community 29(1–2):43–66

    Google Scholar 

  • Creswell JW (2007) Research design: qualitative, quantitative and mixed method approaches. Sage, Thousands Oaks, CA, pp 203–223. https://doi.org/10.4135/9781849208956.

    Book  Google Scholar 

  • Creswell JW et al (2003) Advanced mixed methods research designs. In: Handbook of mixed methods in social and behavioral research, vol 209. Sage, Thousand Oaks, CA, p 240

    Google Scholar 

  • Creswell JW et al (2011) Best practices for mixed methods research in the health sciences. National Institutes of Health, Bethesda, MD, pp 541–545

    Google Scholar 

  • Cruickshank J (2012) Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation. Nurs Inq 19(1):71–82

    Article  Google Scholar 

  • Denzin NK, Lincoln YS (2011) The SAGE handbook of qualitative research. Sage, Thousand Oaks, CA

    Google Scholar 

  • Dillman DA (2000) Procedures for conducting government-sponsored establishment surveys: comparisons of the Total Design Method (TDM), a traditional cost-compensation model, and tailored design. Washington State University, Pullman, WA, pp 343–372

    Google Scholar 

  • Dobbins M, DeCorby K, Twiddy T (2004) A knowledge transfer strategy for public health decision makers. Worldviews Evid Based Nurs 1(2):120–128. https://doi.org/10.1111/j.1741-6787.2004.t01-1-04009.x.

    Article  Google Scholar 

  • Doody O, Noonan M (2013) Preparing and conducting interviews to collect data. RCN Publishing, London

    Book  Google Scholar 

  • Dowden AR et al (2014) A phenomenological analysis of invisibility among African-American males: implications for clinical practice and client retention. Prof Counselor Res 4(1):58

    Article  Google Scholar 

  • Doyle L, Brady AM, Byrne G (2009) An overview of mixed methods research – revisited. J Res Nurs 14(2):623–635. https://doi.org/10.1177/1744987116674257.

    Article  Google Scholar 

  • Driedger SM et al (2010) If you build it, they still may not come: outcomes and process of implementing a community-based integrated knowledge translation map** innovation. Implement Sci 5(1):1–13. https://doi.org/10.1186/1748-5908-5-47.

    Article  Google Scholar 

  • Duan N et al (2015) Optimal design and purposeful sampling: complementary methodologies for implementation research. Admin Policy Ment Health Ment Health Serv Res 42(5):524–532

    Article  Google Scholar 

  • Dusenbury L et al (2003) A review of research on fidelity of implementation: implications for drug abuse prevention in school settings. Health Educ Res 18(2):237–256

    Article  Google Scholar 

  • Ekstrom M, Danermark B (2002) Explaining society: an introduction to critical realism in the social sciences. Routledge, London

    Google Scholar 

  • Elo S et al (2014) Qualitative content analysis. SAGE Open 4(1). https://doi.org/10.1177/2158244014522633

  • Erzberger C, Prein G (1997) Triangulation: validity and empirically-based hypothesis construction. Qual Quant 31(2):141–154

    Article  Google Scholar 

  • Estabrooks CA et al (2006) A guide to knowledge translation theory. J Contin Educ Heal Prof 26(1):25–36. https://doi.org/10.1002/chp.48.

    Article  Google Scholar 

  • Farmer T et al (2006) Develo** and implementing a triangulation protocol for qualitative health research. Qual Health Res 16(3):377–394. https://doi.org/10.1177/1049732305285708.

    Article  Google Scholar 

  • Favaretti C et al (2009) Health technology assessment in Italy. Int J Technol Assess Health Care 25(S1):127–133. https://doi.org/10.1017/S0266462309090539

    Article  Google Scholar 

  • Fielding NG, Fielding JL (1986) Linking data: qualitative research methods, vol 4. Sage, Beverly Hills

    Book  Google Scholar 

  • Fletcher AJ (2017) Applying critical realism in qualitative research: methodology meets method. Int J Soc Res Methodol 20(2):181–194

    Article  Google Scholar 

  • Flick U (1992) Triangulation revisited: strategy of validation or alternative? J Theory Soc Behav 22(2):175–197

    Article  Google Scholar 

  • Flick U (2002) Qualitative research-state of the art. Soc Sci Inform 41(1):5–24

    Article  Google Scholar 

  • France G (2000) Health technology assessment in Italy. Int J Technol Assess Health Care 16(2):459–474. Available at http://www.ncbi.nlm.nih.gov/pubmed/10932419

    Article  Google Scholar 

  • Gale NK et al (2013) Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 13(1):117. https://doi.org/10.1186/1471-2288-13-117.

    Article  Google Scholar 

  • Galesic M, Bosnjak M (2009) Effects of questionnaire length on participation and indicators of response quality in a web survey. Public Opin Q 73(2):349–360. https://doi.org/10.1093/poq/nfp031.

    Article  Google Scholar 

  • Gehringer EF (2010) Daily course evaluation with Google forms. In: ASEE, American Society for Engineering Education Annual Conference & Exposition

    Google Scholar 

  • Gibbs G (2002) Qualitative data analysis: explorations with NVivo (understanding social research). Open University Press, Buckingham

    Google Scholar 

  • Gifford WA et al (2008) A mixed methods pilot study with a cluster randomized control trial to evaluate the impact of a leadership intervention on guideline implementation in home care nursing. Implement Sci 3(1):51

    Article  Google Scholar 

  • Glasow PA (2005) Fundamentals of survey research methodology. Accessed 18 January 2013

    Google Scholar 

  • Graham ID, Logan J (1998) Toward a comprehensive interdisciplinary model of health care research use. Sci Commun 20(2):227–246

    Article  Google Scholar 

  • Graham I, Logan J (2004) Ottawa model of research use: a framework for adopting innovations relevance for public health implementing the tool steps for using tool. Can J Nurs Res 36(2):89–103. Available at http://www.nccmt.ca/resources/search/65

  • Graham ID et al (1998) Toward a comprehensive interdisciplinary model of health care research use. Sci Commun 20(2):227–246

    Article  Google Scholar 

  • Greene JC (2007) Mixed methods in social inquiry. Wiley, Hoboken, NJ

    Google Scholar 

  • Greene JC, Caracelli VJ, Graham WF (1989) Toward a conceptual framework for mixed-method evaluation designs. Educ Eval Policy Anal 11(3):255–274

    Article  Google Scholar 

  • Griffiths D (1997) The case for theoretical pluralism. Educ Manag Admin 25(4):371–380

    Article  Google Scholar 

  • Hanson JL, Balmer DF, Giardino AP (2011) Qualitative research methods for medical educators. Acad Pediatr 11(5):375–386

    Article  Google Scholar 

  • Harper M, Cole P (2012) Member checking: can benefits be gained similar to group therapy? Qual Rep 17(2):510–517

    Google Scholar 

  • Heath G et al (2012) Paediatric “care closer to home”: stake-holder views and barriers to implementation. Health Place 18(5):1068–1073

    Article  Google Scholar 

  • Heberlein TA, Baumgartner R (1978) Factors affecting response rates to mailed questionnaires: a quantitative analysis of the published literature. Am Sociol Rev 43:447–462

    Article  Google Scholar 

  • Heiervang E, Goodman R (2011) Advantages and limitations of web-based surveys: evidence from a child mental health survey. Soc Psychiatry Psychiatr Epidemiol 46(1):69–76

    Article  Google Scholar 

  • Hogan DL, Logan JO (2004) The Ottawa model of research use: a guide to clinical innovation in the NICU. Clin Nurse Special 18(5):255–261

    Article  Google Scholar 

  • Houghton C et al (2013) Rigour in qualitative case-study research. Nurse Res 20(4)

    Google Scholar 

  • Howe KR (1988) Against the quantitative-qualitative incompatibility thesis or dogmas die hard. Educ Res 17(8):10–16

    Article  Google Scholar 

  • Hudon C et al (2018) Case management in primary care for frequent users of health care services: a mixed methods study. Ann Family Med 16(3):232–239

    Article  Google Scholar 

  • Hunt B (2011) Publishing qualitative research in counseling journals. J Couns Dev 89(3):296–300. https://doi.org/10.1002/j.1556-6678.2011.tb00092.x.

    Article  Google Scholar 

  • ISPOR Asia Consortium (2015) HTA principles survey questionnaire. Available at https://www.ispor.org/consortiums/asia/documents/ISPOR_HTA_Principles_Survey.pdf. Accessed 25 October 2017

  • Italian Ministry of Health (2007) Istituti di Ricovero e Cura a Carattere Scientifico - IRCCS. Available at http://www.salute.gov.it/portale/temi/p2_6.jsp?id=794&area=Ricercasanitaria&menu=ss. Accessed 22 August 2018

  • Jacob SA, Furgerson SP (2012) Writing interview protocols and conducting interviews: tips for students new to the field of qualitative research. Qual Rep 17(42):1–10

    Google Scholar 

  • Jacobs K (2012) Making sense of social practice: theoretical pluralism in public sector accounting research. Financ Account Manag 28(1):1–25

    Article  Google Scholar 

  • Johnson RB, Onwuegbuzie AJ (2004) Mixed methods research: a research paradigm whose time has come. Educ Res 33(7):14–26

    Article  Google Scholar 

  • Kaplan B (2001) Evaluating informatics applications—some alternative approaches: theory, social interactionism, and call for methodological pluralism. Int J Med Inform 64(1):39–56

    Article  Google Scholar 

  • Karsh BT (2004) Beyond usability: designing effective technology implementation systems to promote patient safety. BMJ Qual Saf 13(5):388–394

    Article  Google Scholar 

  • Kash BA et al (2014) Success factors for strategic change initiatives: a qualitative study of healthcare administrators’ perspectives. J Healthcare Manag 59(1):65–81

    Article  Google Scholar 

  • Kelly SE (2010) The SAGE handbook of qualitative methods in health research. Sage, London. https://doi.org/10.4135/9781446268247

    Book  Google Scholar 

  • Krueger RA, Casey MA (2014) Focus groups: a practical guide for applied research. Sage, Thousands Oaks, CA

    Google Scholar 

  • Landsverk J et al (2012) Design and analysis in dissemination and implementation research. Dissemination and implementation research in health: translating science to practice, vol 225. Oxford University Press, New York, NY, p 260

    Google Scholar 

  • Lefever S, Dal M, Matthiasdottir A (2007) Online data collection in academic research: advantages and limitations. Br J Educ Technol 38(4):574–582

    Article  Google Scholar 

  • Lewin S, Glenton C, Oxman AD (2009) Use of qualitative methods alongside randomised controlled trials of complex healthcare interventions: methodological study. BMJ 339:b3496

    Article  Google Scholar 

  • Lewis S (2015) Qualitative inquiry and research design: choosing among five approaches. Health Prom Pract 16(4):473–475

    Article  Google Scholar 

  • Lewis EF, Hardy M, Snaith B (2013) Estimating the effect of nonresponse bias in a survey of hospital organizations. Eval Health Prof 36(3):330–351. https://doi.org/10.1177/0163278713496565

    Article  Google Scholar 

  • Lincoln YS, Lynham SA, Guba EG (2011) Paradigmatic controversies, contradictions, and emerging confluences, revisited. In: The Sage handbook of qualitative research, vol 4. Sage, Thousand Oaks, CA, pp 97–128

    Google Scholar 

  • Lindner JR, Murphy TH, Briers GE (2001) Handling nonresponse in social science research. J Agric Educ 42(4):43–53. https://doi.org/10.5032/jae.2001.04043.

    Article  Google Scholar 

  • Litwin MS (1995) How to measure survey reliability and validity. Sage, Thousand Oaks, CA

    Book  Google Scholar 

  • Liu M, Cernat A (2018) Item-by-item versus matrix questions: a web survey experiment. Soc Sci Comput Rev 36(6):690–706. https://doi.org/10.1177/0894439316674459

    Article  Google Scholar 

  • Logan JO, Graham ID (1998) Toward a comprehensive interdisciplinary model of health care research use. Sci Commun 20(2):227–246

    Article  Google Scholar 

  • Logan J, Graham ID (2010) The Ottawa model of research use. In: Models and frameworks for implementating evidence-based practice: evidence to action. Wiley-Blackwell, Oxford

    Google Scholar 

  • Logan J et al (1999) Evidence-based pressure-ulcer practice: the Ottawa model of research use. Can J Nurs Res Arch 31(1):37

    Google Scholar 

  • Lohr KN, Steinwachs DM (2002) Health services research: an evolving definition of the field. Health Serv Res 37(1):15

    Article  Google Scholar 

  • Longhurst R (2003) Semi-structured interviews and focus groups. In: Key methods in geography. Sage, London, pp 117–132

    Google Scholar 

  • Low J (2013) Unstructured and semi-structured interviews in health research. In: Researching health: qualitative, quantitative and mixed methods. Sage, London, pp 87–105

    Google Scholar 

  • Macintyre K (1999) Rapid assessment and sample surveys: trade-offs in precision and cost. Health Policy Plan 14(4):363–373

    Article  Google Scholar 

  • Marshall B et al (2013) Does sample size matter in qualitative research? A review of qualitative interviews in IS research. J Comput Inform Syst 54(1):11–22

    Google Scholar 

  • Mason J (1996) Qualitative researching. Sage, London

    Google Scholar 

  • Mason WS, Dressel RJ, Bain RK (1961) An experimental study of factors affecting response to a mail survey of beginning teachers. Public Opin Q 25:296–299

    Article  Google Scholar 

  • Maxwell JA, Mittapalli K (2010) Realism as a stance for mixed methods research. In: Handbook of mixed methods in social & behavioral research. Sage, Thousand Oaks, CA, pp 145–168

    Chapter  Google Scholar 

  • McEvoy P, Richards D (2006) A critical realist rationale for using a combination of quantitative and qualitative methods. J Res Nurs 11(1):66–78

    Article  Google Scholar 

  • Menon D, Marshall D (1990) Technology assessment in teaching hospitals. Dimens Health Serv 67(2):26

    Google Scholar 

  • Merriam S, Tisdell ET (2009) Qualitative research: a guide to design and implementation. Wiley, San Fransisco

    Google Scholar 

  • Midgley G (2011) Theoretical pluralism in systemic action research. Syst Pract Action Res 24(1):1–15. https://doi.org/10.1007/s11213-010-9176-2.

    Article  Google Scholar 

  • Miller LE, Smith KL (1983) Handling nonresponse issues. J Ext 21:45

    Google Scholar 

  • Mingers J (2001) Combining IS research methods: towards a pluralist methodology. Inform Syst Res 12(3):240–259

    Article  Google Scholar 

  • Modell S (2009) In defence of triangulation: a critical realist approach to mixed methods research in management accounting. Manag Account Res 20(3):208–221

    Article  Google Scholar 

  • Moffatt S et al (2006) Using quantitative and qualitative data in health services research–what happens when mixed method findings conflict? BMC 6(1):28

    Google Scholar 

  • Moharra M et al. (2008) Survey report on HTA organisations Espallargues M on behalf of work package 8, EUnetHTA project. Catalan Agency for Health Technology Assessment and Research (CAHTA), Work Package Catalan Health Service. Department of Health. Autonomous Government of Catalonia, 8

    Google Scholar 

  • Moustakas C (1994) Phenomenological research methods. Sage, Thousand Oaks, CA

    Book  Google Scholar 

  • Müller N, Damico JS (2002) A transcription toolkit: Theoretical and clinical considerations. Clin Linguist Phonetics 16(5):299–316

    Article  Google Scholar 

  • Nicol ED, Mohanna K, Cowpe J (2014) Perspectives on clinical leadership: a qualitative study exploring the views of senior healthcare leaders in the UK. J R Soc Med 107(7):277–286

    Article  Google Scholar 

  • O’Cathain A, Murphy E, Nicholl J (2007) Integration and publications as indicators of “yield” from mixed methods studies. J Mixed Methods Res 1(2):147–163

    Article  Google Scholar 

  • O’Cathain A, Murphy E, Nicholl J (2010) Three techniques for integrating data in mixed methods studies. BMJ 341:c4587

    Article  Google Scholar 

  • O’Reilly M, Parker N (2013) “Unsatisfactory saturation”: a critical exploration of the notion of saturated sample sizes in qualitative research. Qual Res 13(2):190–197

    Article  Google Scholar 

  • Oliver DG, Serovich JM, Mason TL (2006) Constraints and opportunities with interview transcription: towards reflection in qualitative research. Soc Forces 84(2):1273–1289. https://doi.org/10.1353/sof.2006.0023

    Article  Google Scholar 

  • Palinkas L, Aarons G et al (2011a) Mixed method designs in implementation research. Adm Policy Ment Health Ment Health Serv Res 38(1):44–53. https://doi.org/10.1007/s10488-010-0314-z

    Article  Google Scholar 

  • Palinkas L, Ell K et al (2011b) Sustainability of collaborative care interventions in primary care settings. J Soc Work 11(1):99–117

    Article  Google Scholar 

  • Palinkas LA et al (2011c) Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study. Implement Sci 6:1–11

    Article  Google Scholar 

  • Palinkas L et al (2015) Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Admin Policy Ment Health Ment Health Serv Res 42(5):533–544

    Article  Google Scholar 

  • Parkinson S et al (2016) Framework analysis: a worked example of a study exploring young people’s experiences of depression. Qual Res Psychol 13(2):109–129. https://doi.org/10.1080/14780887.2015.1119228.

    Article  Google Scholar 

  • Parlour R, McCormack B (2012) Blending critical realist and emancipatory practice development methodologies: making critical realism work in nursing research. Nurs Inq 19(4):308–321

    Article  Google Scholar 

  • Patton MQ (2002) Qualitative research and evaluation methods, Sage, Thousand Oaks, CA

    Google Scholar 

  • Peredaryenko MS, Krauss SE (2013) Calibrating the human instrument: understanding the interviewing experience of novice qualitative researchers. Qual Rep 18(43):1–17

    Google Scholar 

  • Pilgrim D (2017) Critical realism and mental health research. In: Routledge International handbook of critical mental health. Routledge, London

    Google Scholar 

  • Pope C, Ziebland S, Mays N (2000) Qualitative research in health care. Analysing qualitative data. BMJ 320(7227):114–116

    Article  Google Scholar 

  • Proctor EK et al (2009) Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Admin Policy Ment Health Ment Health Serv Res 36(1):24–34

    Article  Google Scholar 

  • Proctor E et al (2011) Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Admin Policy Ment Health Mental Health Serv Res 38(2):65–76. https://doi.org/10.1007/s10488-010-0319-7.

    Article  Google Scholar 

  • Rabin BA et al (2008) A glossary for dissemination and implementation research in health. J Public Health Manag Pract 14(2):117–123

    Article  Google Scholar 

  • Rabionet SE (2011) How I learned to design and conduct semi-structured interviews: an ongoing and continuous journey. Qual Rep 16(2):563–566

    Google Scholar 

  • Radaelli G et al (2014) Implementation of EUNETHTA core model® in Lombardia: the VTS framework. Int J Technol Assess Health Care 30(01):105–112. https://doi.org/10.1017/S0266462313000639

    Article  Google Scholar 

  • Rashidian A, Eccles MP, Russell I (2008) Falling on stony ground? A qualitative study of implementation of clinical guidelines’ prescribing recommendations in primary care. Health Policy 85(2):148–161

    Article  Google Scholar 

  • Reason P (1988) Human inquiry in action: developments in new paradigm research. Sage, London

    Google Scholar 

  • Regione Lombardia (2001) DGR n. 7197 del 3/12/2001

    Google Scholar 

  • Regione Lombardia (2006) Piano Socio Sanitario Regionale 2007-2009

    Google Scholar 

  • Regione Lombardia (2008) DGR n. 7856 of 30/07/2008

    Google Scholar 

  • Regione Lombardia (2009) Decreto del Direttore Generale n. 11858 del 12/11/2009

    Google Scholar 

  • Regione Lombardia (2016) DGR X/5671 del 11.10.2016

    Google Scholar 

  • Regione Lombardia (2018) DGR n. XI/1046 of 17/12/2018

    Google Scholar 

  • Regione Lombardia (2019a) Programma Regionale HTA Dispositivi Medici. Available at https://htadm-lombardia.ats-pavia.it/index.php/linee-guida/g-analisi-decisionale-a-criteri-multipli-adcm.html. Accessed 3 September 2019

  • Regione Lombardia (2019b) RELAZIONE SCIENTIFICA PROGETTO KEL - key evidence leaders. Available at https://htadm-lombardia.ats-pavia.it/index.php/formazione/progetto-kel-2018/2721-risorse-metodologiche-2.html

  • Ricciardi W et al. (2010) Primo Libro Bianco sull’Health technology assessment in Italia. Progetto ViHTA. Valore in Health Technology Assessment

    Google Scholar 

  • Richards TJ, Richards L (1994) Using computers in qualitative research. In: Handbook of qualitative research. Sage, Thousand Oaks, CA, pp 445–462

    Google Scholar 

  • Rider GN et al (2018) Youth and provider perspectives on improving health care experiences for transgender and gender nonconforming adolescents: a mixed methods study. J Adolesc Health 62(2):S4

    Article  Google Scholar 

  • Risjord M (2011) Nursing knowledge: science, practice, and philosophy. Wiley, Hoboken, NJ

    Google Scholar 

  • Ritchie J, Spencer L (1994) Qualitative data analysis for applied policy research. In: Bryman B, Burgess R (eds) Analyzing qualitative data. Routledge, London and New York

    Google Scholar 

  • Ritchie J et al (2013) Qualitative research practice: a guide for social science students and researchers. Sage, Thousand Oaks, CA

    Google Scholar 

  • Robins CS et al (2008) Dialogues on mixed-methods and mental health services research: anticipating challenges, building solutions. Psychiatr Serv 59(7):727–731

    Article  Google Scholar 

  • Robinson L et al (2013) A qualitative study: professionals’ experiences of advance care planning in dementia and palliative care, “a good idea in theory but…”. Palliat Med 27(5):401–408

    Article  Google Scholar 

  • Rowley J (2012) Conducting research interviews. Manag Res Rev 35(3/4):260–271

    Article  Google Scholar 

  • Rubin HJ, Rubin IS (2011) Qualitative interviewing: the art of hearing data. Sage, Thousand Oaks

    Google Scholar 

  • Salant P, Dillman I, Don A (1994) How to conduct your own survey

    Google Scholar 

  • Saleem JJ et al (2013) You and me and the computer makes three: variations in exam room use of the electronic health record. J Am Med Inform Assoc 21(e1):e147–e151

    Article  Google Scholar 

  • Sandelowski M (2000) Focus on research methods combining qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method studies. Res Nurs Health 23(3):246–255. https://doi.org/10.1002/1098-240X(200006).

    Article  Google Scholar 

  • Sayer A (2000) Realism and social science. Sage, Thousand Oaks, CA

    Book  Google Scholar 

  • Schiller CJ (2016) Critical realism in nursing: an emerging approach. Nurs Philos 17(2):88–102

    Article  Google Scholar 

  • Schleyer TKL, Forrest JL (2000) Methods for the design and administration of web-based surveys. J Am Med Inform Assoc 7(4):416–425

    Article  Google Scholar 

  • Seidman I (2013) Interviewing as qualitative research: a guide for researchers in education and the social sciences. Teachers College Press, New York

    Google Scholar 

  • Sheard L et al (2013) Barriers to the diagnosis and treatment of venous thromboembolism in advanced cancer patients: a qualitative study. Palliat Med 27(4):339–348

    Article  Google Scholar 

  • Sheehan KB (2001) E-mail survey response rates: a review. J Comput Mediat Commun. https://doi.org/10.1111/j.1083-6101.2001.tb00117.x

  • Silverman D (2013) Doing qualitative research

    Google Scholar 

  • Solomon DJ (2001) Conducting web-based surveys. Pract Assess Res Eval 7:19

    Google Scholar 

  • Srivastava A, Thomson SB (2009) Framework analysis: a qualitative methodology for applied policy research

    Google Scholar 

  • Stacey D et al (2006) Adoption and sustainability of decision support for patients facing health decisions: an implementation case study in nursing. Implement Sci 1(1):17

    Article  Google Scholar 

  • Tashakkori A, Teddlie C (1998) Mixed methodology: combining qualitative and quantitative approaches. Sage, Thousand Oaks

    Google Scholar 

  • Teddlie C, Tashakkori A (2010) Overview of contemporary issues in mixed methods research. In: Handbook of mixed methods in social and behavioral research. Sage, Thousand Oaks, CA, pp 1–41

    Google Scholar 

  • Tesch R (2013) Qualitative research: analysis types and software. Routledge, London

    Book  Google Scholar 

  • Thomas DR (2006) A general inductive approach for analyzing qualitative evaluation data. Am J Eval 27(2):237–246. https://doi.org/10.1177/1098214005283748.

    Article  Google Scholar 

  • Tufford L, Newman P (2012) Bracketing in qualitative research. Qual Soc Work 11(1):80–96

    Article  Google Scholar 

  • Tuffrey-Wijne I, Rose T (2017) Investigating the factors that affect the communication of death-related bad news to people with intellectual disabilities by staff in residential and supported living services: an interview study. J Intellect Disabil Res 61(8):727–736. https://doi.org/10.1111/jir.12375

    Article  Google Scholar 

  • Vaismoradi M, Turunen H, Bondas T (2013) Content analysis and thematic analysis: implications for conducting a qualitative descriptive study. Nurs Health Sci 15(3):398–405

    Article  Google Scholar 

  • Wainwright SP (1997) A new paradigm for nursing: the potential of realism. J Adv Nurs 26(6):1262–1271

    Article  Google Scholar 

  • Ward DJ et al (2013) Using framework analysis in nursing research: a worked example. J Adv Nurs 69(11):2423–2431

    Article  Google Scholar 

  • Wei Y et al (2017) Perceptions of health technology assessment knowledge translation in China: a qualitative study on HTA researchers and policy-makers. Int J Healthcare Technol Manag 16(1/2):44. https://doi.org/10.1504/IJHTM.2017.10008509.

    Article  Google Scholar 

  • Weiss RS (1994) Learning from strangers. The Free Press, New York

    Google Scholar 

  • Welsh E (2002) Dealing with data: using NVivo in the qualitative data analysis process. Forum, pp 1–7. Available at http://www.qualitative-research.net/index.php/fqs/article/view/865/1880

  • Wensing M et al (2011) Tailored implementation for chronic diseases (TICD): a project protocol. Implement Sci 6(1):2–9. https://doi.org/10.1186/1748-5908-6-103

    Article  Google Scholar 

  • Weston C et al (2001) Analyzing interview data: the development and evolution of a coding system. Qual Sociol 24(3):381–400

    Article  Google Scholar 

  • Widodo HP (2014) Methodological considerations in interview data transcription. Int J Innov Eng Lang Teach Res 3(1):101–107

    Google Scholar 

  • Wisdom JP et al (2012) Methodological reporting in qualitative, quantitative, and mixed methods health services research articles’. Health Serv Res 47(2):721–745. https://doi.org/10.1111/j.1475-6773.2011.01344.x

    Article  Google Scholar 

  • World Health Organization (2015) 2015 Global Survey on Health Technology Assessment by National Authorities. Available at www.who.int/about/licens-ing/copyright_form/en/index.html. Accessed 25 October 2017

  • World Health Organization (WHO) (2012) Knowledge translation framework for ageing and health, April, p 65

    Google Scholar 

  • World Medical Association (1964) Declaration of Helsinki serves as guide to physicians. JAMA 189:33–34

    Article  Google Scholar 

  • Yammarino FJ, Skinner SJ, Childers TL (1991) Understanding mail survey response behavior a meta-analysis. Public Opin Q 55(4):613–639

    Article  Google Scholar 

  • Yin RK (2009) Case Study Research: design and methods. Essential guide to qualitative methods in organizational research. Sage, Thousand Oaks, CA. https://doi.org/10.1097/FCH.0b013e31822dda9e

    Book  Google Scholar 

  • Zachariadis M, Scott SV, Barrett MI (2013) Methodological implications of critical realism for mixed-methods research. MIS Q 37(3):855–879

    Article  Google Scholar 

  • Zamawe FC (2015) The implication of using NVivo software in qualitative data analysis: evidence-based reflections. Malawi Med J 27(1):13–15

    Article  Google Scholar 

  • Zecevic AA et al (2017) Improving safety culture in hospitals: facilitators and barriers to implementation of systemic falls investigative method (SFIM). Int J Qual Health Care 29(3):371–377. https://doi.org/10.1093/intqhc/mzx034

    Article  Google Scholar 

  • Zhang Y, Wildemuth BM (2009) Qualitative analysis of content. In: Applications of social research methods to questions in information and library science, vol 308. Springer, New York, p 319

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Beretta, V. (2021). Adopting Mixed Methods in Health Research: A Methodological Approach to Analyze HTA Development. In: Development and Implementation of Health Technology Assessment . Contributions to Management Science. Springer, Cham. https://doi.org/10.1007/978-3-030-70308-0_3

Download citation

Publish with us

Policies and ethics

Navigation