Mixed Methods Research

Mixed Methods


Current Studies

Mi Health Mi Choice study logo

Mi Health Mi Choice: Improving Contraceptive Care for Women With Medical Conditions

Justine P. Wu, M.D., M.P.H., Principal Investigator

Funded by National Institutes of Health (read more on Dr. Wu's award)

Adult women with chronic conditions have a higher rate of unintended pregnancy than adult women without chronic conditions. Chronic conditions and unintended pregnancy are both associated with pregnancy-related complications and adverse maternal and child health outcomes. Prior studies show that women with chronic conditions are not receiving adequate contraceptive counseling, particularly regarding highly effective contraceptive methods. There is an urgent need to improve contraceptive counseling and services for women with chronic conditions in order to decrease the rate of unintended pregnancy and improve reproductive health outcomes among this population. 

This mixed methods, multi-phase study will first 1.) identify key factors on the patient-, provider-, and practice-level that are critical to the design of a contraceptive intervention for women with chronic conditions in primary care. The research team, led by Wu, will then develop an interactive, web-based contraceptive decision aid for women with chronic conditions, their PCPs, and implementation in primary care. Finally, a pilot randomized controlled trial (RCT) will be conducted to measure the feasibility of the decision aid as a potential large-scale intervention.

Protocol Citation: Wu JP, Damschroder LJ, Fetters MD, et al. A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study. JMIR Research Protocols. 2018;7(4). doi:10.2196/resprot.9249.

Modeling Professional Attitudes and Teaching Humanistic Communication in Virtual Reality (MPathic VR)

Michael D. Fetters, M.D., M.P.H., M.A., Principal Investigator
Timothy C. Guetterman, PhD

Funded by The National Institutes of Health

The M-Pathic VR II project will rigorously evaluate the extent that the newly successful "virtual reality" software program (developed in Phase I) can enhance medical school curricula in professionalism, empathy, and in patient-centeredness (using verbal and non-verbal communication skills) as well as the ACGME competencies when treating a terminally ill cancer patient.

Telemonitoring Enhanced Support for Depression Self-Management

James E. Aikens, Ph.D., Principal Investigator

Funded by The National Institutes of Health

The goal of this study is to develop a telephone-based system called CarePartners to improve depression outcomes by training a family member or close friend to support the depressed person from long distance. This project will determine whether CarePartners is more effective than usual care at improving the patient’s depression symptoms and other key outcomes.

Telemonitoring Enhanced Informal Caregiving to Support Diabetes Self Management

James E. Aikens, Ph.D., Principal Investigator
Ananda Sen, Ph.D., Co-Investigator

Funded by National Institutes of Health

We propose a community-based RCT to test the hypothesis that providing formal support to "CarePartners" (CPs) (non-household family members) improves glycemic control, diabetes mellitus (DM)-related distress, and DM self-management.

Early Audiology Referral in Primary Care (EAR-PC): Improving Detection of Hearing Loss

Philip Zazove, M.D., Principal Investigator

Funded by the National Institutes of Health, National Institute on Deafness and Other Communication Disorders, Department of Health and Human Services ($1,624,469)

Dr. Zazove is lead investigator of this R21/R33 study, which seeks to increase hearing loss screenings for patients 55 and older by utilizing electronic clinical management tools in primary care setting and multimedia. The MiChart research team has designed a Best Practice Alert (BPA) which notifies primary care providers (PCPs) of HL assessment opportunities and allows clinicians to refer directly and efficiently to audiology specialists. The multimedia project, guided by Micheleen Hashikawa, M.D., also created a video to address physicians’ mental models of hearing loss. The investigation has expanded to look at patients’ decision-making around hearing testing and adoption of hearing aids. The EAR-PC study has partnered with the Beaumont Family Medicine network and Elie Mulhem, M.D., Associate Professor, Oakland University William Beaumont School of Medicine to successfully include 5,500 patients in the pilot study. Dr. Zazove anticipates over 20,000 patients in the R33 phase.

The research is guided by three aims, to:

  • Evaluate whether the EAR-PC program increases PCP identification of patients with mild to moderate HL compared to baseline data.

  • Evaluate whether the EAR-PC program increases appropriate PCP referral of patients with mild to moderate HL to audiology specialists.

  • Utilize both qualitative and quantitative inquiry to investigate how successful PCPs implement the intervention, identifying processes and tools that will allow this project to successfully scale

Media and Infographics

Publication video trailer series #2: 

Verma BA, Nichols LPPlegue MA, Moniz MH, Rai M, Chang T. Advice given by community members to pregnant women: a mixed methods study. BMC Pregnancy Childbirth. 2016 Nov 9;16(1):349. DOI: 10.1186/s12884-016-1146-y - Read More


What is Mixed Methods Research? Mini lecture from Adjunct Professor John D. Creswell, Ph.D.




Recent Publications

  1. Rahtz E, Child S, Knight S, Warber SL, Dieppe P. Clients of UK healers: A mixed methods survey of their demography, health problems, and experiences of healing. Complementary Therapies in Clinical Practice. 2019;35:72-77. doi:10.1016/j.ctcp.2019.01.012.
  2. Alwashmi MF, Hawboldt J, Davis E, Fetters MD. The Iterative Convergent Design for Mobile Health Usability Testing: Mixed-Methods Approach. JMIR mHealth and uHealth. 2019;7(4). doi:10.2196/11656.
  3. Tipirneni R, Kullgren JT, Ayanian JZ, et al. Changes in Health and Ability to Work Among Medicaid Expansion Enrollees: a Mixed Methods Study. Journal of General Internal Medicine. December 2018. doi: 10.1007/s11606-018-4736-8.
  4. Hou S-I, Fetters MD. Mixed methods in public health research in Taiwan – Using visual diagrams to communicate complex design procedures. Health Care for Women International. November 2018:1-12. doi:10.1080/07399332.2018.1516769.
  5. Goodrich DE, Lowery JC, Burns JA, Richardson CR. The Phased Implementation of a National Telehealth Weight Management Program for Veterans: Mixed-Methods Program Evaluation. JMIR Diabetes. 2018;3(3). doi:10.2196/diabetes.9867.
  6. Agbozo F, Colecraft E, Jahn A, Guetterman T. Understanding why child welfare clinic attendance and growth of children in the nutrition surveillance programme is below target: lessons learnt from a mixed methods study in Ghana. BMC Nursing. 2018;17(1). doi:10.1186/s12912-018-0294-y.
  7. Goold SD, Tipirneni R, Kieffer E, Haggins A, Salman C, Szymecko L, Chang T, et al. Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study. Journal of General Internal Medicine. December 2018. doi:10.1007/s11606-018-4487-6
  8. Tsui J, Hudson SV, Rubinstein EB, et al. A mixed-methods analysis of the capacity of the Patient-Centered Medical Home to implement care coordination services for cancer survivors. Translational Behavioral Medicine. 2018;8(3):319-327. doi:10.1093/tbm/ibx059.

See More

  1. Guetterman TC, Chang T, Dejonckheere M, Basu T, Scruggs E, Vydiswaran VV. Augmenting Qualitative Text Analysis with Natural Language Processing: Methodological Study. Journal of Medical Internet Research. 2018;20(6). doi:10.2196/jmir.9702.
  2. Goold SD, Tipirneni R, Kieffer E, Haggins A, Salman C, Szymecko L, Chang T, et al. Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study. Journal of General Internal Medicine. December 2018. doi:10.1007/s11606-018-4487-6.
  3. Guetterman TC, Fetters MD. Two Methodological Approaches to the Integration of Mixed Methods and Case Study Designs: A Systematic Review. American Behavioral Scientist. 2018;62(7):900-918. doi:10.1177/0002764218772641.
  4. Lisinskiene A, Guetterman T, Sukys S. Understanding Adolescent–Parent Interpersonal Relationships in Youth Sports: A Mixed-Methods Study. Sports. 2018;6(2):41. doi:10.3390/sports6020041.
  5. Wu JP, Damschroder LJ, Fetters MD, et al. A Web-Based Decision Tool to Improve Contraceptive Counseling for Women With Chronic Medical Conditions: Protocol For a Mixed Methods Implementation Study. JMIR Research Protocols. 2018;7(4). doi:10.2196/resprot.9249.
  6. Runaas L, Hoodin F, Munaco A, et al. Novel Health Information Technology Tool Use by Adult Patients Undergoing Allogeneic Hematopoietic Cell Transplantation: Longitudinal Quantitative and Qualitative Patient-Reported Outcomes. JCO Clinical Cancer Informatics. 2018;(2):1-12. doi:10.1200/cci.17.00110.
  7. Piil K, Jakobsen J, Christensen K, Juhler, M, Guetterman, TC, Fetters MD, Jarden, M. Needs and preferences among patients with high-grade glioma and their caregivers - A longitudinal mixed methods study. European Journal of Cancer Care. January 2018. doi:10.1111/ecc.12806.
  8. Moseholm E, Fetters MD. Conceptual models to guide integration during analysis in convergent mixed methods studies. Methodological Innovations. 2017;10(2):205979911770311. doi:10.1177/2059799117703118.
  9. DeJonckheere M, Nichols LP, Moniz MH, Sonneville KR, Vydiswaran VGV, Zhao X, Guetterman TC, Chang T. MyVoice National Text Message Survey of Youth Aged 14 to 24 Years: Study Protocol. JMIR Res Protoc. 2017 Dec 11;6(12):e247. doi: 10.2196/resprot.8502.
  10. Creswell JW, Sinley RC. Developing a culturally-specific mixed methods approach to global research. KZfSS Kölner Zeitschrift für Soziologie und Sozialpsychologie. 2017 October. 69(suppl 2): 87-105. doi: 10.1007/s11577-017-0453-2
  11. Guetterman TC, Fetters MD, Mawocha S, Legocki LJ, Barsan WG, Lewis RJ, Berry DA, Meurer WJ. The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project. SAGE Open Medicine. ePub ahead of print online 2017 October 16. Volume 5. DOI: 10.1177/2050312117736228
  12. Guetterman TC. Designing a Rigorous Mixed Methods Research Study. Qualitative Research. 2017;18(1):1-16. doi:10.22284/qr.2017.18.1.1.
  13. Fetters MD and Molina-Azorin JF. The Journal of Mixed Methods Research Starts a New Decade: The Mixed Methods Research Integration Trilogy and Its Dimensions. Journal of Mixed Methods Research. 1(3) 291–307, June 2017. DOI: 10.1177/1558689817714066

Key Publications

  1. Fetters MD, Curry LA, Creswell JW. Achieving integration in mixed methods designs-principles and practices. Health Services Research. 2013 Dec;48(6 Pt 2):2134-56. DOI: 10.1111/1475-6773.12117
  2. Creswell JW1, Fetters MD, Ivankova NV. Designing a mixed methods study in primary care. Annals of Family Medicine. 2004 Jan-Feb;2(1):7-12. PMID: 15053277
  3. Designing and Conducting Mixed Methods Research by John W. Creswell
  4. A Concise Introduction to Mixed Methods Research by John W. Creswell


Collaborative Partners and External Affiliations

michigan mixed methods research and scholarship program logo




In the News

image of melissa dejonckheere, Ph.D.

December 19, 2017:  MyVoice explained two ways, in TED talk and a new protocol publication

A fresh approach to longitudinal, mixed methods research design, MyVoice harnesses the power of mobile SMS technology and rapid algorithmic text analysis toward their goal of “strategic science.”

Dr. Michael Fetters

December 12, 2017:  A new way to consume research--video abstracts come to family medicine

Two family medicine faculty have produced short web videos, with support from the department and Michigan Medicine


August 6, 2017:  Study examines use of grounded theory in mixed methods research

A new publication from methodologist and assistant professor Timothy Guetterman offers a grant-writing “checklist” for researchers who employ grounded theory methods

Advice to pregnant women about smoking

December 2, 2016: New research examines health advice given by friends and family to pregnant women

A new mixed methods study used text message surveys to tap into community conversations about pregnancy health norms and health literacy.

Image of Assistant Professor Dr. Timothy Guetterman

November 10, 2016: How to train health professionals in mixed methods research 

A recent publication by Timothy Guetterman, PHD, evaluates the first national mixed methods training program for the health sciences (MMRTP), a project partnership between the University of Michigan, Johns Hopkins University, and Harvard University.

image of Timothy Guetterman PhD

September 7, 2016: New faculty spotlight: Timothy C. Guetterman, Ph.D.

Welcome Timothy Guetterman, Ph.D., our newest research faculty member.

photo of Dr. Michael Fetters

August 29, 2016: Dr. Fetters heads to China for cross-cultural Fulbright work

 An interview with Dr. Michael Fetters on his recent Fulbright achievement and plans for research, teaching, and collaboration at Peking University Health Science Center.

Image of Assistant Professor Dr. Timothy Guetterman

August 4, 2016: University of Michigan Experts Awarded at International Mixed Methods Conference

Family Medicine research faculty share their expertise, Dr. Guetterman awarded at the 2016 Mixed Methods International Research Association (MMIRA) conference.

Principal Investigators