Section 4: Study design

Chapter 4.13 Addressing complexity through mixed methods

WHO guidance on research methods for health emergency and disaster risk management

Authors: O’Sullivan T, Khan Y.


Chapter 4.13 describes the key factors to consider when developing a mixed methods study for research in health emergency and disaster risk management (Health EDRM), including:

  1. The basic principles of mixed methods research.
  2. The relevance of mixed methods design for disaster research.
  3. Systems thinking for use in disaster research.
  4. The basic tenets of complexity theory and their relevance for disaster research.

What is this chapter about? 

The timing, characteristics and non-linear impacts of different types of disaster mean that researchers may need to use both quantitative and qualitative methods to produce findings that will be relevant to disaster health and Health EDRM. Guidance on conducting a mixed methods study can help Health EDRM researchers combine elements of qualitative and quantitative research approaches to improve the breadth and depth of understanding.

This chapter presents various mixed methods research designs and outlines important considerations for the development and implementation of these. It provides examples that illustrate some of the different strategies that can be used to approach complex questions with mixed methods. Alongside outlining the benefits of a mixed methods approach, the chapter also highlights some practical considerations, and challenges and criticisms associated with the approach.

Case studies presented in the chapter: 

  1. Perceptions of earthquake survivors in Amatrice, Italy.
  2. Advancing performance measurement for public health emergency preparedness in Canada.

What are the key messages of this chapter?  

  • Mixed methods, which combines quantitative and qualitative methods, has evolved into a third type of methodology which can provide a more comprehensive explanation for the complexity inherent in disaster research..
  • Systems thinking in disaster health research focuses on the interactions of factors across macro, meso and micro levels of society. .
  • Integration of data, analysis and findings in mixed methods studies is central to the methodology. Many mixed methods studies fall short in the integration process, but this is one of the defining features of mixed methods. .
  • Challenges and practical considerations for designing and implementing mixed method research include theoretical and epistemological differences between methodologies..
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