Aplicación de la propuesta y análisis de los resultados

Over the last two decades there has been an increased interest in mixed methods research, which has grown to become one of the major approaches used in social science and increasingly in healthcare research. It is often used to address complex research questions (Brannen, 2005; Dixon-Woods et al., 2004;

CHAPTER 3: METHODOLOGY

64

multiple perspectives (Clarke and Yaros, 1988 cited in Sale et al., 2002). A mixed methods research design or approach (Creswell, 2003; Tashakkori and Teddlie, 2003), also called a multi-method or multi-strategy approach (Dixon-Woods et al., 2004; Bryman, 2001), at its simplest level, involves mixing both qualitative and quantitative methods of data collection and analysis in a single study, in order to provide a comprehensive understanding of the research problem. It involves the planned mixing of qualitative and quantitative methods at a predetermined stage of the research process – during the initial study planning, during the process of data collection or at the data analysis or data reporting stage (Halcomb, Andrew and Brannen in Andrew and Halcomb, 2009). Although a challenging approach (need for extensive data collection, the time-consuming nature of analysing both numeric and verbatim text), the mixed methods design aims to capture the best of both quantitative and qualitative approaches and diminish the limitations of each (Tashakkori and Teddlie, 2003; Bryman, 2001).

Over the last few decades there has been an ongoing debate in social sciences research over the choice of using quantitative or qualitative research methods and mixed methods approaches. Authors have previously criticised the use of mixed methods as it combines methods founded on different theoretical

paradigms i.e. different epistemological and ontological assumptions (Tashakkori and Teddlie, 2003; Blaikie, 1991). The quantitative paradigm is based on

positivism, while the qualitative paradigm is based on interpretivism and

constructivism. According to the quantitative paradigm, an objective reality exists independently of, and can be studied by the investigator without any influence between the investigator and the investigated phenomenon. Within the qualitative

CHAPTER 3: METHODOLOGY

paradigm, the reality is based on one’s construction of it; the investigator and the investigated phenomenon are actively interconnected. Other authors have argued towards the combination of quantitative and qualitative research methods in a single study for complementary purposes. The two research methods can be specifically employed, simultaneously or sequentially, to study different phenomena within the same study (Sale et al., 2002). Pragmatists prioritise

practical issues over theoretical issues; fundamental to the pragmatic approach to methodology is the belief that the choice of research design should be informed by the research question and not by a paradigm (Halcomb, Andrew and Brannen in Andrew and Halcomb, 2009). Researchers have previously based mixed methods health research studies on pragmatic principles (Cawley, unpublished thesis; Robertson, unpublished thesis).

This study was based on pragmatic principles: the impetus for choosing the research design was not a paradigm but the research question (Halcomb, Andrew and Brannen in Andrew and Halcomb, 2009). The mixed methodology was not theoretically or philosophically driven as ‘one cannot be both a positivist and an interpretivist or constructivist’ (Sale et al., 2002, page 47).

A mixed methods approach was selected in order to explore the research topic in both breadth and depth, gathering and converging quantitative (numbers,

frequencies) and qualitative (detailed views of children and their parents/carers) findings, in order to inform the methodology of a future larger-scale study. Quantitative data on the type, severity and frequency of reported exhibited

CHAPTER 3: METHODOLOGY

66

Qualitative data on sources of watching aggression and participants’ views shed a different light on any such associations. Both components provided data that enabled the identification of potential third variables and feasible sampling strategies for the future study.

According to Tashakkori and Teddlie (2003) a mixed methods study involves ‘the collection or analysis of both quantitative and/or qualitative data in a single study in which the data are collected concurrently or sequentially, are given a priority, and involve the integration of the data at one or more stages in the process of research’. Different strategies/procedures/models/designs have been developed within the mixed methods approach and authors have yet to reach consensus on their types, names and characteristics. In helping to distinguish between the various designs, two fundamental issues have been identified:

 Whether the sequence of collecting quantitative and qualitative data is concurrent (i.e. data gathered at the same time) or sequential (i.e. data gathered in phases).

 Whether either quantitative or qualitative data is given priority or whether they are weighted equally (Tashakkori and Teddlie, 2003).

In this mixed methods study a concurrent strategy of data collection was adopted (Creswell, 2003; Tashakkori and Teddlie, 2003) in order to overcome challenges, previously reported by others researching a similar population, e.g. in participant recruitment (National CAMHS Support Service and YoungMinds, 2005; Laws, 1998) and data collection (Ford, Tingay and Wolpert, 2006; Johnston and Gowers, 2005).

CHAPTER 3: METHODOLOGY

This study adopted a facilitation approach to mixed methods research, in which one research method facilitates the other (Hammersley, 1996 in Bryman, 2001). The data analysis was sequential: the quantitative data analysis preceded the qualitative data analysis. The quantitative findings were used

 To purposively select the qualitative research sample with regard to intensity of exhibited aggression and in order to produce maximum variation in terms of age, gender, ethnicity and family income level.  To facilitate the qualitative data analysis (through provision of

attribute data such as age, gender, ethnicity, family income level and intensity of exhibited aggression).

Following this, a further quantitative data analysis was conducted based on issues that arose from the qualitative findings.

In this project I aimed to give equal priority to the quantitative and qualitative research methods as they were used to address particular research questions. Each research question is related to specific study component(s) (see repetition of Table 1.5 below) and each study component is related to specific research question(s) (see repetition of Table 1.6 below).

CHAPTER 3: METHODOLOGY

68

Table 1.5 Mapping of research questions and study components related to each question

Research question Study

component

Q1 – What are the type, severity and frequency of reported aggression exhibited

by children aged 7-11 years with BED attending Tier 2/3 CAMHS? Survey component

Q2 – Where do children aged 7-11 years with BED attending Tier 2/3 CAMHS

see aggression in their lives? Qualitative component

Q3 – What are the views of children aged 7-11 years with BED attending Tier 2/3 CAMHS and their parents/carers on any association between exhibited

aggression and viewed aggression?

Qualitative component Q4 – What is an appropriate methodology for a future study to test for any

association between aggression exhibited by these children and their seeing aggression in television programmes and video games?

Survey and qualitative components

Q4a – What is an appropriate sampling strategy for such a study? Survey

component

Q4b –What is an appropriate sample size for such a study? Survey

component Q4c – What are the potential third variables and sources of bias in such

a study? Survey and qualitative

components

Table 1.6 Mapping of study components, research questions related to each component and methodology of each component

Study

component Research question Methodology

Study design Measures Sampling strategy Analysis

Survey

component Q1, Q4a, Q4b, Q4c Cross-sectional survey of reported exhibited aggression MAVRIC, CAS-P, SDQ, Brief questionnaire Use of data management systems for CAMHS and approaching case managers to identify children who fulfil inclusion criteria

Descriptive statistics

Qualitative

component Q2, Q3, Q4c Qualitative study of views of children and their parents/carers on any association between exhibited aggression and viewed aggression Semi- structured interview schedule

Child and carer participants in survey sample invited to be interviewed. Purposively selected 20 interviews for analysis Qualitative data analysis using the Framework analysis approach

CHAPTER 3: METHODOLOGY