Browsing by Subject "Mixed Methods"

Now showing 1 - 12 of 12
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    Cities of (In)Difference: A Mixed-Methods Analysis of Place and Wellbeing In Later Life
    (2018-06) Finlay, Jessica
    Where one lives constitutes an important determinant of health and quality of later life. Yet few studies to date focus explicitly on the everyday experiences, contexts, and needs of individuals to age well within their physical and social environments. While aging in place represents a widespread goal of individuals, service providers, and policymakers, it remains an ambiguous, problematic, and uncritical concept. This can have devastating consequences as it is frequently applied with little consideration of the places themselves. This study investigated aging in a harsh continental climate with a strong focus on underrepresented low-income and racially diverse older adults. Three case study areas across the Minneapolis (Minnesota, USA) metropolitan area purposefully contrasted socio-demographic and geographic characteristics. Seated and mobile interviews were conducted with independent-dwelling men and women (n=125, mean age 71 years) from May to October, 2015. A geospatial audit evaluated participants’ homes at the dwelling, street, and neighborhood level. Ethnography with six participants over twelve months (September, 2015 – August, 2016) and semi-structured interviews with ten local policymakers and community service providers (May – October, 2016) deepened understanding. The findings depict how built, social, and natural environments contribute to aging in very particular ways. Older bodies literally express structured advantages and disadvantages of their surrounding contexts. Aging in place efforts can exacerbate the deeply uneven conditions of American cities and the vulnerabilities of those aging ‘in the margins’. Theoretical analyses unpack and unsettle discourses about aging in order to address problematic assumptions, blind spots, and unchallenged and unconsidered modes of thought upon which geography rests. The chapters engage political, economic, feminist, critical race, disability, health, and urban theories to enrich not only geographic scholarship, but also the lives of older adults. The dissertation destabilizes the foundations of age-friendly governance and generates novel possibilities for more just and inclusive modes of urban form. It creates more room for alternative ways of ‘being in the world’ based upon a richer understanding of people, place, and space across the life course.
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    Closing the Divide: Exploring Meaningful Technology Use in the Technology Integration Matrix
    (2024) Seylar, John
    The purpose of this mixed-methods study is to investigate the suitability of Technology Integration Matrix Observations (TIM-O) extensity scores to serve as a quantitative proxy for meaningful technology use in K-12 public school settings across the United States. To do so, correlations between TIM-O extensity scores and various school-level socioeconomic indicators were explored using a Cumulative Link Mixed Model. Questions and observations gathered during the model-building process were then used to inform the development of an interview protocol, which was used to gather the experiences and perspectives of three middle school instructional coaches. My analysis uncovered evidence that TIM-O extensity scores could serve as a useful proxy for meaningful technology use, though improvements and further study will be necessary.
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    Effects of Hope-Based Music Therapy on Hope and Pain in Hospitalized Patients on Blood and Marrow Transplant Unit: A Convergent Parallel Mixed-Methods Pilot Study
    (2016-09) Verstegen, Amanda
    Background: Among continuous improvements in treating cancer as a physical malady, there has been an increased focus on the psychological health of cancer patients. Patients undergoing Blood and Marrow Transplantation (BMT) are particularly susceptible to the deterioration of psychological health due to the demanding nature of BMT procedures. Hope is a multidimensional construct that can impact a patient’s psychological well-being. Extant research on hope with cancer patients has promoted psychological interventions to foster and maintain hope, but has been conducted almost exclusively within the field of oncology nursing. Although researchers have identified that music therapy can be effective in the treatment and psychological care of BMT patients, to date there has been no music therapy literature with a specific focus on hope in the psychological care and support of cancer patients. Objective: The purpose of this convergent parallel mixed-methods pilot study was to target hope by adapting an existing hope intervention to music therapy treatment with patients on a BMT unit. Methods: Patients (N = 10) were randomly assigned to experimental or wait-list control conditions and all patients completed the Herth Hope Index supplemented with an 11-point Likert-Type Pain Scale at pre- and posttest. Experimental participants engaged in a two-session individualized music therapy treatment consisting of patient-preferred live music chosen from a hope-based song menu coupled with therapeutic dialogue that was adapted from the Hope Intervention Program. Experimental participants also participated in an individual semi-structured interview in an attempt to understand their experiences and perceptions of how music therapy may affect hope. The six steps of thematic analysis, as identified by Braun and Clarke (2006), were used to analyze qualitative data. Results: There was no significant between-group difference at pretest. Posttest analyses utilizing Mann-Whitney U tests revealed significant between-group differences in measures of hope with patients in experimental condition demonstrating higher hope. Although not statistically significant, there was a slight tendency for a decrease in pre- to posttest pain for the experimental condition but not for the control condition. Qualitative analyses resulted in three emerging themes: 1. Hope-based music therapy provides opportunities for positive experiences including comfort and interpersonal connection; 2. Hope-based music therapy facilitates personal depth though self-awareness and self-identity; and 3. Hope-based music therapy provides a platform to discuss and confront hope including motivations for and obstacles to hope. Conclusion: Although generalization is limited by a small sample, quantitative results supported hope-based music therapy as an effective intervention with BMT patients in this pilot study. Qualitative data reinforced and provided depth to quantitative results, revealing that hope-based music therapy elicited positive experiences, comfort, and interpersonal connection; acted as a platform to discuss hope; and supported self-awareness and self-identity. Study limitations, implications for clinical practice, and suggestions for future research are provided.
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    Ethno-Epidemiology Of Febrile Illness At The Human Livestock Interface In Uganda
    (2022-01) Mahero, Michael
    Undifferentiated febrile illness is a leading cause of morbidity and mortality in many resource-limited countries. Effective management of febrile illness in areas of limited resources remains a challenge due to delayed recognition and reporting in addition to lack of adequate diagnostic infrastructure. There is increasing evidence linking Non-Malarial Febrile Illness (NMFI) to contact with animals. However, the syndemic human-livestock interactions that drive these illnesses are complex and poorly understood. The overall goal of this dissertation is to improve our understanding of the role that the hu-man-livestock relationship plays in the occurrence of NMFIs in humans. Understanding the cultural context of the human-livestock relationship in Western Uganda, and under-standing its relationship to NMFI occurrence, could help guide development of novel infectious disease prevention and management strategies consequently reducing infectious disease spillover events in areas that lack diagnostic infrastructure. Toward this end, we employed a sequential mixed method ethno-epidemiological approach, comparing and contrasting two culturally different livestock management systems, agro pastoral and pastoral, present in a cultural mosaic in Western Uganda (Hoima and Kasese Districts). Specifically we hypothesize that there are culturally relevant NMFI “syndromic” case definitions that correlate with specific socio-cultural factors associated with livestock ownership and management, which drive NMFI prevalence, and disproportionately contribute to NMFI clustering along the human-livestock inter-face. The study involved an ethnographic study, two cross-sectional surveys and a Brucella sero-survey. It revealed that perception of illness and associated risk factors was heavily influenced by the predominant livelihood activity of the community. The ordinal odds of febrile illness was positively associated with (a) milking, (b) use of bulls for breeding and (c) participating in fishing/hunting livelihood activities; while control of vectors was negatively associated with the ordinal odds of febrile illness (P<0.05). We also noted that among the Brucella positive households, nearly half reported subjective fever in the preceding year. Among the seropositive individuals, 44% reported diagnosis of malaria to explain their fevers and 31% reported no confirmatory diagnosis. Apparent Brucella herd prevalence in cattle was 8.6% (3.7-18.6; 95% CI), while animal level sero-prevalence was 7.1% (3.3-14.6; 95% CI). None of the goats tested positive.
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    Examining the effects of integrated science, engineering, and nonfiction literature on student learning in elementary classrooms
    (2014-06) Tank, Kristina Maruyama
    In recent years there has been an increasing emphasis on the integration of multiple disciplines in order to help prepare more students to better address the complex challenges they will face in the 21st century. Exposing students to an integrated and multidisciplinary approach will help them to better understand the connections between subjects instead of as individual and separate subjects. Science, Technology, Engineering and Mathematics (STEM) Integration has been suggested as an approach that would model a multidisciplinary approach while also offering authentic and meaningful learning experiences to students. However, there is limited research on STEM integration in the elementary classroom and additional research is needed to better define and explore the effects of this integration for both students and science educators. With the recent recommendations for teaching both science and engineering in elementary classrooms (NRC, 2012), two common models include teaching science through inquiry and teaching science through engineering-design pedagogies. This study will explore both of these models as it seeks to better understand one piece of the larger issue of STEM and STEM integration by examining how the integration of science, engineering, and nonfiction literature affects students learning in elementary classrooms. This study employed an embedded mixed methods design to measure the effects of this integration on student learning in four fifth grade classrooms from the same elementary school. The findings revealed that the students who participated in the nonfiction reading instruction that was integrated with their science instruction showed a greater increase in all measures of student learning in both science and reading when compared to the control students. The findings from the integrated science, engineering and nonfiction literature revealed similar findings with the treatment students showing a greater increase in the measures of student learning in all three of the content areas. These results suggest that integrating nonfiction literature with science or science and engineering instruction can be an effective strategy in improving student learning in elementary classrooms.
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    A Factorial Mixed-Methods Inquiry to Engage Latino Participants in Parenting Programs
    (2016-09) Garcia-Huidobro Munita, Diego
    Parents are important for healthy child development. Parenting programs help mothers and fathers improve their parenting practices; however, reduced participation diminishes the impact of these interventions. Using mixed methods and a factorial approach, this study examined the needs and preferences for an ideal parenting program for Latino families. Participants included Latino fathers and mothers with low and high attendance to a prior parenting program, and those without previous experience in parenting education. Evaluated domains included intervention characteristics, promotion, recruitment, and retention strategies, and places for program delivery. Mothers and fathers with adolescents aged 10-14 years (n=36) completed a semi-structured individual interview and a survey in Spanish. Data were collected until reaching qualitative data saturation. Qualitative data were analyzed in the original language following the procedures of Content Analysis. Quantitative data were summarized using descriptive statistics. Qualitative and quantitative data were merged using side-by-side comparisons. Subgroup analyses compared responses based on parent role (mother or father) and program enrollment/attendance status (low attendance, high attendance, and no contact with the program). Results showed that participants wanted an engaging program that covers a variety of topics. Ideally, the intervention would include individual and group components, target the whole family, and be facilitated by involved Latino leaders. Subgroup analyses revealed different needs and preferences among participants. Implications for practice and future research are discussed.
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    Inclusive Evaluation: Conducting Program Evaluations With Individuals With Cognitive Disabilities
    (2015-07) Maynard, Amelia
    Individuals with cognitive disabilities (IWCD), such as developmental disabilities, traumatic brain injuries and dementia, make up over 4% of our population in the United States. This number is expected to grow as our population ages, particularly in the cases of disability caused by dementia and stroke. IWCD have been historically marginalized through the suppression of their voices and a lack of power over their own lives. While the advocacy movement has helped IWCD achieve self-empowerment and abolish the inhumane research practices of the past, the inclusion of IWCD in program evaluations has been limited. Exclusion from evaluation means that IWCD have less influence over the programs and services on which they rely. This study examined the extent to which and in what ways IWCD have been included in evaluations, the common obstacles to inclusion, and why evaluators do or do not include IWCD in their evaluations. Using a mixed-method approach, the researcher conducted over 500 surveys and 12 interviews with evaluators, primarily with members of the American Evaluation Association, who have a wide range of experience working with IWCD. The results show that evaluators believe including IWCD in evaluations is an ethical necessity, but many evaluators do not know how to identify or accommodate IWCD. Many evaluators have not considered including IWCD in their evaluations as participants or on their evaluation teams. Additionally, concern over resources, ethical review, and validity limit inclusive practice. Evaluators who have conducted evaluation projects with IWCD have faced these challenges and offer solutions and reassurances. The dissertation concludes with several recommendations for increasing inclusion in the evaluation field.
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    Is Explainable Medical AI a Medical Reversal Waiting to Happen? Exploring the Impact of AI Explanations on Clinical Decision Quality
    (2023-05) Clement, Jeffrey
    Medical AI systems generate personalized recommendations to improve patient care, but to have an impact, the system recommendation must be different from what the clinician would do on their own. This impact might be beneficial (in the case of a high-quality recommendation), and clinicians should follow the system; on the other hand, AI will be wrong occasionally and clinicians should override it. Resolving conflict between their own judgment and the system’s is crucial to optimal AI-augmented clinical decision-making. To help resolve such conflict, there have been recent calls to design AI systems that provide explanations for the reasoning behind their recommendations, but it is unclear how system explanations affect how clinicians incorporate AI recommendations into care decisions. This dissertation explores this issue against the history of medical reversals—technologies and treatments that were initially thought beneficial but ultimately were ineffective or even harmful to patients. Ideally, AI explanations are helpful; however, practicing evidence-based medicine requires that we validate this normative statement to ensure that explanations are not either ineffective or worse, actively harmful. We employ mixed methods, combining semi-structured interviews and three computer-based experiments to examine factors posited to support proper system use. To ground the findings, Study 1 interviews with clinicians highlighted that disclosing the confidence level and explanations for AI recommendations might create new conflicts between the system and clinician. To evaluate this within the clinical context, we conducted a trio of experiments where clinical experts were faced with drug dosing decision tasks. In Study 2, participants received AI recommendations for drug dosing and were shown (or not) the confidence level and an explanation. In Study 3, participants were shown explanations (or not) and received two patient cases each with either a high- or low-quality AI recommendation. Contrary to theoretical predictions, providing explanations did not uniformly increase the influence of AI or improve clinical decision quality. Instead, explanations increased the influence of low-quality AI recommendations and decreased the influence of high-quality recommendations. In Study 4, participants were shown one of four types of explanations along with either a high- or low-quality recommendation. Again, explanations did not optimally improve the influence of AI or improve decision-quality. Two relevant findings help explain why. First, the initial disagreement between the users’ a priori judgment and the AI recommendation, along with the quality of the recommendation, were much more influential than any of our explanation formats. And second, the qualitative and mediation analyses indicate that clinicians do carefully consider explanations, but the way that explanations impact overall perceptions of explanation detail and helpfulness of the explanation or decision conflict do not necessarily explain the observed effects. We see indications that the individual information cues in the explanations are compared against the users’ own knowledge and experience, and the way discrepancies between the users’ own opinion about these cues and the conclusions the system purports to draw from them can influence use of the recommendation. Further work is needed to understand exactly how the information from explanations is shaping use of AI advice.
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    The language learning motivation of early adolescent French and Spanish elementary immersion program graduates.
    (2009-06) Wesely, Pamela Mary
    This mixed methods study focuses on the transition between elementary and middle/junior high school in one-way immersion programs in the United States. Understanding more about this transition is important to creating immersion programs that provide the maximum benefits to students, schools, and the community. An exploration of students' language learning motivation at this point of their education can help with this understanding. The primary goal of this study is thus to investigate the L2 learning motivation of elementary immersion school graduates, with a particular focus on issues vital to the unique context of immersion education. Three hundred fifty-eight (358) students who had graduated from five public elementary immersion schools in one metropolitan area were the target population. The secondary target population was their parents. One hundred thirty-one (131) students and their parents responded to surveys, and 33 students were interviewed. Data analysis procedures included a theme analysis of the interview data, a statistical analysis of the survey data, and an integrated consideration of the qualitative and quantitative findings. Findings were organized around two topical frameworks in immersion education: persistence and attrition in immersion programs, and developing cross-cultural understanding in immersion students. This study found that the participating immersion graduates' decisions to persist in the immersion program were more based on peer influence and their assessments of the school environment of the immersion continuation program than any other factor. Additionally, students who demonstrated the most cross-cultural understanding had experienced increased exposure to other cultures, languages, and individuals outside of the immersion classroom. Other findings reflected the respondents' understandings of the nature of language and culture, their relationships with their parents and teachers, and their many reasons and uses for learning a language. The conclusion includes suggestions and implications for district-level administrators, school administrators, and teachers in immersion programs.
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    Pragmatic and dialectic mixed method approaches: an empirical comparison
    (2008-12) Betzner, Anne E.
    Mixed methods are increasingly used in the fields of evaluation, health sciences, and education in order to meet the diverse information needs of funders and stakeholders. However, a consensus has yet to develop on the theoretical underpinnings of the methodology. A side-by-side assessment of two competing theoretical approaches to mixed methods, the dialectic and pragmatic, can assist researchers to optimize their use of mixed methods methodology and contribute to the growth of mixed methods theory. This study empirically compares the dialectic and pragmatic approaches to mixed methods and probes key issues underlying the methodology, including unique yield from mixed method studies, the importance of paradigmatic divergence between methods, and the financial demands of mixed method studies. A secondary analysis of a real-world evaluation, this study explores five research questions regarding the convergence, divergence and uniqueness of single method findings; the extent to which mixed methods produce unique findings over and above single methods presented side-by-side; the extent to which studies meet key criteria for validity; stakeholders' perceptions of the utility and credibility of the studies; and the cost of single methods. The pragmatic mixed method study was developed by integrating a post-positivistic telephone survey with weakly interpretive focus groups at the point of interpretation using pragmatic criteria. The dialectic study mixed the same post-positivistic telephone survey with strongly interpretive phenomenological interviews using a Hegelian-inspired dialectic format. All three single methods were examined by a method expert in the field who affirmed the methodologies used. Findings suggest that both mixed method approaches produced unique conclusions that would not have been available by presenting single methods side-by-side. However, the dialectic method produced more complex convergence and more divergence, leading it to be more generative than the pragmatic method. The use of stronger as compared to weaker interpretive methods contributed to the generative quality of the dialectic approach. Overall, the dialectic method appears more suitable to exploring more complex phenomenon as compared to the pragmatic approach. However, these conclusions are drawn from one study of one real-world evaluation. Much more scholarship is needed to explore the issues raised here.
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    Understanding Students’ Self-Regulation in Asynchronous Online Learning
    (2019-05) North, Sarah
    Despite rapid growth in online enrollment within higher education, persistence and completion rates remain lower for online courses than face-to-face courses. This discrepancy between the two modalities indicates a need to better understand students’ self-regulated learning (SRL) within online learning environments. Students with higher SRL skills demonstrate higher academic achievement than those who do not, and so it is critical to investigate the topic of SRL because it is so closely tied with achievement online. This study used a sequential, explanatory mixed methods approach to better understand the experience and actions of undergraduate students in an asynchronous online course who possess varying levels of self-regulation. In the quantitative phase, participants completed the Motivated Strategies for Learning Questionnaire which gave a self-reported snapshot into students’ motivation, self-regulating skills, and learning strategies. Trace log data from the learning management system (LMS) was additionally collected during four weeks of the semester. During an interim phase, three focal participants were selected and a semi-structured interview protocol was developed for the qualitative phase. The qualitative phase consisted of data collected through interviews with each of the focal participants, and observations of the three participants throughout the semester. Results suggest that while students appreciate the flexibility of an online course, flexibility can also lead to challenges. The flexible nature of a course appeared most challenging during online group work, when taking an online class for the first time, or when time management was poor. It was also found that students with higher levels of SRL strategies tend to dedicate specific time and places to work on coursework, and demonstrated a propensity to log in to the course LMS earlier and more frequently during each course week. Conversely, it was found that a student with lower SRL abilities did not dedicate a specific time or place to studying for the course, and tended to miss group discussion deadlines. Finally, it was found that an online instructors’ presence, frequent communication, use of video posts and discussions, and outlining weekly expectations were helpful teaching strategies which encouraged students to maintain motivation and SRL within the course.
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    Yoga for chronic pain in veterans: A mixed methods study
    (2018-05) Donaldson, Melvin
    Yoga is an increasingly common practice used in the management of chronic pain, largely due to its safety and demonstrated effectiveness as an adjunctive treatment. There are important challenges to understanding the effect of yoga on chronic pain, notably yoga is rarely used in isolation and the specific content of yoga interventions varies widely between studies. Additionally, yoga and complementary practices in general are under-described in veteran populations even though veterans are more highly engaged with complementary practices than civilians. This dissertation seeks to inform the evidence base of veterans who practice yoga in three ways. First, I estimate the cross-sectional association between yoga practice and disability among veterans with pain using propensity score-matching. Yoga practice is not associated with a difference in prevalence of disability. Second, I identify differences in yoga practice between veterans with chronic pain and veterans without chronic pain. A mixed methods approach is employed with a qualitative strand that builds upon the quantitative strand to explain the differences observed. This analysis shows that yoga practitioners with chronic pain are regularly using self-directed practices more frequently than yoga practitioners without chronic pain. Interviews with study participants identify convenience as a facilitator of self-directed practice and feeling self-conscious as a barrier to instructor-led group practice among practitioners with chronic pain. Finally, I describe patterns of use of 19 different non-pharmacological health approaches among all members of the sample to show how modalities are being used in integrated ways. This dissertation makes several important contributions. I piloted of a self-report instrument for describing yoga practice, the Essential Properties of Yoga Questionnaire, and a self-report instrument of use of non-pharmacologic therapies, the Health Practices Inventory. Both instruments are ready for use by others. Also, I provide a detailed description of how veterans with pain are using and experiencing yoga.