573209

research-article2015

QHRXXX10.1177/1049732315573209Qualitative Health ResearchPelto

Article

What Is So New About Mixed Methods?

Qualitative Health Research 1­–12 © The Author(s) 2015 Reprints and permissions: sagepub.com/journalsPermissions.nav DOI: 10.1177/1049732315573209 qhr.sagepub.com

Pertti J. Pelto1

Abstract In this article, I dispute claims that mixed methods research emerged only recently in the social sciences. I argue that some anthropologists and sociologists (and others) have used mixed methods in fieldwork for at least 80 years, and there are studies from early in the 20th century that clearly fall within the definition of “mixed methods.” I explore some of the history of the mixing of qualitative and quantitative data in earlier ethnographic works and show that in some sectors of social science research, the “emergence” and proliferation of mixed methods were particularly notable around the middle of the 20th century. Furthermore, concerning issues about “paradigms of research” in the social sciences, I identify some of the types of research in which the mixing of QUAL and QUAN approaches was more likely to occur. I suggest that some of the literature about research paradigms has involved a certain amount of “myth-making” in connection with descriptions of qualitative and quantitative research assumptions and styles. Keywords health care; psychological tests; ecological studies; statistics I was very surprised to read quite recently that “mixed methods” in the social sciences is a new development, as some writers stated that this methodological approach only got going about 25 or 30 years ago. John W. Creswell, in his latest book, A Concise Introduction to Mixed Methods Research, commented about “understanding . . . the basic characteristics of mixed methods research” as follows: “As a field of methodology about 25 years old, this approach has common elements that can easily be identified” (Creswell, 2015, p. 1, emphasis in original). For Creswell and many other recent writers, the defining criterion of “mixed methods research” is the combining of qualitative (QUAL) and quantitative (QUAN) operations and materials to achieve the desired empirical product (research results). That basic definition usually means that both the data-gathering and analysis of those data include the two types of operations. Many writers refer to the QUAL and the QUAN as two separate, basic research “paradigms.” Charles Teddlie and Abbas Tashakkori (2009), in their book, Foundations of Mixed Methods Research: Integrating Qualitative and Quantitative Approaches in the Social and Behavioral Sciences, present the basic idea: “Mixed methods (MM) research has emerged as an alternative to the dichotomy of qualitative (QUAL) and quantitative (QUAN) traditions during the past 20 years” (p. 4). Why was I surprised that this “mixed paradigms” form of research is only 25 or 30 years old? Because I have seen and read many research reports from much earlier times that included both qualitative and quantitative

materials. For example, the topical area earlier referred to as “culture and personality” often involved mixing of ethnographic methods with psychological testing.

Mixed Methods in “Culture and Personality” Studies In 1938, Cora DuBois (anthropologist) went to the Southeast Asian island of Alor to do ethnographic fieldwork. Her research objectives were aimed at understanding personality characteristics and their development in a very different, non-Western traditional society. For about 2 years, she carried out the following data-gathering operations: (a) basic ethnography (participant observation and open-ended qualitative interviewing), (b) Porteus Maze testing (55 informants), (c) word associations (17 males and 19 females), (d) children’s drawings (33 boys and 22 girls), and (e) Rorschach psychological tests (17 males and 20 females), and she collected 8 extensive life histories (4 males and 4 females). In connection with her basic ethnographic observations, she collected 47 instances of serious quarrels, in which she noted that the most frequent quarrels were between persons who were affinal relatives. Her mixed methods study was first 1

University of Connecticut, Storrs, Connecticut, USA

Corresponding Author: Pertti J. Pelto, Professor Emeritus, University of Connecticut, P.O. Box 400, Storrs, CT 06268, USA. Email: [email protected]

2 published in 1944 with the title The People of Alor: A Social Psychological Study of an East Indian Island (DuBois, 1961). Cora DuBois’s extensive collection of different kinds of psychological materials produced a longer list of “methods” than many other similar studies, but especially around the middle of the 20th century the so-called “culture and personality” studies were quite common among anthropologists and social psychologists as well as some other social scientists, and almost always included quantitative psychological materials along with the usual “core ethnographic” descriptive data. In the two volumes of The People of Alor (DuBois, 1961), we do not find any hypothesis-testing statistics. The analyses of the various psychological tests were mainly qualitative assessments, except for the more refined quantitative scoring system for the Porteus Maze test. Thus, the numerical materials, especially from the various psychological tests, were presented as frequencies, usually showing differences between males and females. A particularly interesting mixing of qualitative and quantitative research was described by Hortense Powdermaker (1956) in an article titled “Social Change Through Imagery and Values of Teen Age Africans in Northern Rhodesia.” Powdermaker was studying the relationships between Africans and Europeans in the context of social and economic change and development. In addition to extensive qualitative ethnographic data, she collected essays written by African school students. The students were in fifth and sixth grade levels, and her sample had 53 boys and 58 girls. Each student wrote four essays as regular classroom assignments. The quantitative data that Powdermaker (1956) extracted from the essays (content analysis) were presented in six tables mainly devoted to comparing boys’ and girls’ responses. For example, Table 5 (p. 792) presents data on the topic “Self-Imagery: Interpersonal Relations and Personality,” and Table 6 is “Imagery of Europeans: Their Interpersonal Relations and Personality.” In that Table 6 (p. 793), the fourth item concerning the Europeans is “men’s respect for women” (boys = 38% “yes,” girls = 19% “yes”) and the fifth item of content is “education and intelligence” (boys = 23%, girls = 45%). In Powdermaker’s (1956) discussion about the African students’ attitudes, she wrote, “About a quarter of the boys but none of the girls thought Europeans treated Africans well; another quarter of the boys and a third of the girls thought that Europeans treated Africans badly” (p. 793). Powdermaker’s study included a wide range of other data from observations, informal interviews, and other qualitative and quantitative data. This “imbedded mixed method sub-study” presents a good deal of quantitative data, in the form of frequencies. Like the study

Qualitative Health Research  by DuBois, there are no statistical tests of hypothesized relationships in this article, but qualitative, descriptive data were used to support and explain some of the quantitative differences between boys’ and girls’ essays. Use of statistics to examine relationships among variables tended to occur more often in studies of psychological aspects of culture change in mid-20th century mixed methods research. The Spindlers (Louise and George) used chi-square tests of significance in their studies of Menomini acculturation. For example, in their article on “Male and Female Adaptations in Culture Change,” the Spindlers (1958) used Rorschach tests and other materials to compare the “psychocultural centers of gravity” of 68 males and 61 females. The respondents ranged from “native-oriented” to “elite acculturated” on the Spindlers’ 5-point acculturation scale. The “native-oriented” Menomini were described as having plenty of knowledge of “native lore” and “use of Indian medicines,” and almost all of these individuals had full knowledge of Menomini language. At the acculturated end of their culture change scale were 21 individuals with very low scores concerning those elements of traditional Menomini culture. The quantitative data showed that the females were much more likely to be “native-oriented,” and their psychological profiles differed significantly from those of the males. The Spindlers concluded, Menomini women do not encounter the sharply disjunctive role expectations in acculturation that the en do, as long as they continue to play the feminine, expressive roles. Even when they move into the arena of instrumental roles in acculturation . . . the traditional flexibility of the feminine position probably helps make it possible for them to adapt to new expectations without much disturbance . . . (pp. 230–231)

In contrast, they reported that the conflicts in role expectations for males were “ . . . mirrored in the anxiety, tension, constriction, and breakdown in emotional controls characterizing the modal Menomini male in acculturation” (Spindler & Spindler, 1958, pp. 230–231).

Economic and Ecological Studies The mixture of qualitative and quantitative data in ethnographic studies is not only in connection with “culture and personality” studies. Anthropologists, sociologists, and geographers who focused on economic development, or general “ecological adaptations” usually included plenty of quantified information about environmental features, working times; monetary expenditures; and other counting and tabulating. The book, Chan Kom: A Maya Village (Redfield & Rojas, 1962), includes a table of amounts of land cultivated (54 farmers), and different crops planted (p. 53), tabulation of amounts of different items purchased in the local store (p. 60), numbers of

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Pelto days spent in different kinds of farming tasks (p. 80), tabulation of differences in household composition (numbers of persons and relationships), and a few other smallscale tabulations (p. 91). These data, from 1930 and 1931, are not rich in numerical treatment, but the several smallscale quantitative materials present quite concrete examples and “portraits” concerning quantifiable aspects of daily life. Many other studies of this type contain a great deal of counting and descriptive quantification, with little or no statistical testing of hypotheses concerning relationships among background variables and “outcomes.” For example (just picked at random from my bookshelf), C. Gregory Knight’s (1974) book, Ecology and Change: Rural Modernization in an African Community (based on “ethnogeographical” research in Tanzania), is a “typical” ecological case study, particularly in the extensive use of maps and photographs to present salient features of the physical environment. In his preface, Knight commented, The ecological point of view causes us to focus on scientifically understandable processes in the environment, including the very basic mustering of energy resources for life. Data presented in this study are only indicative of the basic flow of matter and energy that composes any ecological system. (p. xvii)

In the next paragraph, he wrote, The ethnogeographic point of view asks that we treat the cognitive component of this human mustering of environmental resources as a culture specific system of knowledge and beliefs concerning the environment and its human organization and use. (Knight, 1974, p. xvii)

The combination of “the ecological with the ethnogeographic research model” (which he likens to ethnoscience in anthropology) requires a great deal of quantitative description of the plant and animal species of the area. Those data are followed by quantitative and qualitative descriptions of “Contemporary Agricultural Patterns” (Chap. 5), which include several maps, photographs, and six quantitative tables, imbedded in 28 pages of textual description. The remaining chapters focus on “sources of change,” “models of change,” and “implications of change.” Although he identified the study as “geography,” he included statements suggesting the closeness to anthropological-ecological studies. John W. Bennett’s (1967) ethnographic study of the Hutterian Brethren, with the subtitle The Agricultural Economy and Social Organization of a Communal People is another example of an ecological study, in which a large amount of quantitative data was used to give concrete contents to the ethnographic descriptions. The work includes 20 quantitative tables, and like Knight’s (1974) study, does not engage in statistical hypothesis-testing.

Mixed Methods in Medical and Health Care Studies Medical anthropology is another topical area in which the mixing of quantitative and qualitative research has a quite long history. In the early 1970s, anthropologist Gananath Obeyesekere carried out research to describe main features of Ayurvedic medical ideas and practices in urban settings of Sri Lanka. Dr. Obeyesekere examined Ayurvedic literature (classic Vedic medical literature from India) and carried out key informant interviewing with a small number of trained Ayurvedic practitioners. Under the heading “Statistical Data,” he described results from a questionnaire administered to 58 final-year students at the College of Ayurveda in Colombo (national capital). Some of his statistical tables are “Five diseases which the finalyear students . . . believe could most effectively be treated by Ayurvedic Medicine” (Obeyesekere, 1998, p. 218), “Summary of 275 cases admitted to the Government Ayurvedic Hospital in Colombo” (p. 220), and “Types of diseases for which 13 Western-trained doctors in Kandy (city), thought Ayurvedic treatment could be effective” (p. 221). Like many other such descriptive ethnographic studies, Obeyesekere did not use any statistical tests of hypotheses or other complex statistical calculations. In 1967 to 1969, Edward Montgomery carried out research on practitioners, health care practices, and ecological aspects of disease in North Arcot district of Tamil Nadu (India). In studying medical practitioners, Montgomery contacted 77 practitioners in Vellore city and carried out interviews in which he explored their styles of practice, the backgrounds of training, experiences of apprenticeship, and other characteristics. He found that 29 of these practitioners “ . . . had fathers who practiced one of the indigenous traditions: 8 Ayurveda, 13 Siddha, and 8 Unani. Of these, 28 recalled a period of filial apprenticeship . . . ” (Montgomery, 1998, pp. 275– 276). His ethnographic data-gathering included a broad range of qualitative materials, along with other numerical data. Many other studies of medical practitioners, assessments of health beliefs and practices in various cultural settings, and other research in medical anthropology 40 to 50 years ago included descriptive quantitative data, along with the usual qualitative ethnographic data from the open-ended interviewing and participant observation.

Ethnographic Research Is Often Aimed at Multifaceted Descriptions Although some of the examples I have presented above included somewhat narrowly focused hypothesis-testing, many of the projects, such as the ethnographic study, People of Alor, by Cora DuBois (1961), and the ecological studies by Bennett (1967) and Knight (1974), are intended

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Qualitative Health Research 

to present comprehensive descriptions of specific cultural groups. The core data-gathering consists of qualitative, open-ended interviewing and participant observation, but some particular features, events, and behaviors require special attention in the form of some added methodological component. The “culture and personality” studies are a particularly clear example, in which the use of psychological tests (usually borrowed from psychology) constitutes the additional data-gathering. In many such studies, more than one psychological instrument was used to introduce possibilities for triangulation. Another motive for introducing some extra methodological components comes into play if the research population is large, with several special subgroups. In studies of some farming groups, there is often a complex system for study of selection of crops, soil types, farm implements, and other aspects of agricultural production, and then a somewhat separate set of issues in examination of marketing and transportation of the products. Early in the 20th century, British social anthropologists involved in research in large, complex African societies adopted the practice of quantitative surveys as a regular adjunct to the qualitative ethnographic methodological package. Elizabeth Colson (1954) commented 60 years ago: Today I find that when I make a statement about the Tonga [the large African tribal group she studied] I am inclined to first check it against the material drawn from the census [quantitative survey] to see whether or not I am coming anywhere near the facts of the case. Impressions can be thoroughly wrong; so can the statements of informants. (p. 58)

It appears that the British social anthropologists were doing more “mixed method research” than their North American counterparts in the early part of the 20th century.

Writing About Research Methods for Anthropology, Including Mixed Methods Serious writing about research methods in anthropology, and more generally, in ethnographic fieldwork, began to emerge in the middle of the 20th century. A very large compendium about the “current status” of anthropology was published in 1953, titled Anthropology Today: An Encyclopedic Inventory, prepared under the chairmanship of A. L. Kroeber. The book grew out of an international symposium (1952) sponsored by the Wenner Gren Foundation for Anthropological Research. This midcentury review and assessment of the discipline of anthropology included some chapters on research methodology, including both qualitative and quantitative data collection and

management. There had been some writing and discussions about field research methods in earlier decades, but those were mostly individual anthropologists’ commentaries about their own research and issues they encountered. In that “encyclopedic inventory,” Benjamin Paul (1953) had a chapter concerning “Interview Techniques and Field Relationships,” which dealt mainly with the qualitative side of ethnographic research. That was followed by Oscar Lewis (1953), with the title, “Controls and Experiments in Field Work.” Lewis had done significant mixed methods research, including a book, Life in a Mexican Village: Tepoztlan Restudied (1951), which included large amounts of quantitative data on economic inequalities, income sources, and results of psychological tests and other tables. In his 1953 chapter for Anthropology Today, Lewis stated, Perhaps the most significant developments in the past twenty years have been the greater attention paid to sampling, the increased use of schedules and questionnaires, the use of more informants in order to cover the major socio-economic, status, and age groupings, the specialization of research (we now get entire volumes on economics, social organization, magic, and other aspects of culture which were formerly [all] dealt with in a single monograph), the intensive use of photography, tape recording of interviews, and family studies. (p. 460)

It is clear that Lewis was particularly interested in the possibilities for systematic quantitative comparisons of subgroups or comparing small numbers of communities within relatively bounded culture areas. He was particularly approving of Spindler and Goldschmidt’s (1952) study titled “An Experimental Design in the Study of Culture Change,” which “ . . . is an attempt to relate changes in individual personality with degree of acculturation in the study of the Menominee Indians of Wisconsin” (p. 464). Thus, Oscar Lewis can be counted as one of the first anthropologists seriously practicing and writing about what has recently come to be referred to as “mixed methods in field research.” The year after Anthropology Today was published, the first collection of articles devoted wholly to methodological issues in anthropology appeared. Method and Perspective in Anthropology (1954), edited by Robert F. Spencer, included several articles that referred to the need for more use of carefully designed quantitative data in connection with ethnographic studies. The lead article, by Melville Herskovits (1954) described “new techniques” in ethnographic studies that we can now regard as “development of mixed, qual/quan, methodology.” Herskovits (1954) wrote, The problem of rapport takes on added significance in view of certain new techniques of field research that are being urged on ethnologists as the study of large populations and

Pelto the search for quantitative data involve radical departures from the customary techniques of ethnography, directed toward obtaining qualitative findings. One of the instruments most favored for this newer approach is the questionnaire, or, if this is not feasible, the short interview . . . These data can then be manipulated statistically, and thereby yield results of greater reliability than can be had from the customary ethnographic technique of investigating crosscultural phenomena through the intensive study of small social units. (pp. 12–13)

In the middle of the 20th century, the main journal for publication of applied ethnographic research, with considerable numbers of mixed methods research examples, was Human Organization. It is the official journal of the Society for Applied Anthropology (SfAA). In 1960, the SfAA requested Richard Adams and Jack Preiss to edit a collection of methodology articles, most of which had appeared in Human Organization in the 1950s. The (relatively short) articles dealing with various aspects of research methods were authored by anthropologists (11), psychologists (10), and sociologists (20). Although the majority of these articles dealt with qualitative aspects of field research, several articles described issues and strategies in the management of interdisciplinary team research and issues of multisite large-scale projects. Those largescale projects generally included quantitative data-gathering in addition to the usual qualitative ethnographic procedures. An article by Edward LeClair Jr. titled “Problems of Large-Scale Anthropological Research” was based on his role as project field director for the Cornell University India Project, during 1955-1956. The project was located in the state of Uttar Pradesh, in which “ . . . the staff reached its maximum size in the late winter and early spring of 1956, when it numbered thirty-four full-time workers” (LeClair, 1960, p. 29). The field team included anthropologists, a psychologist, a sociologist, a linguist, a political scientist, two economists, and some nutritionists. The description of the data-gathering includes mention of unstructured interviews (and presumably other related qualitative methods), plus (1) survey schedules—structured interviews, generally made up of forced-choice questions . . . (2) questionnaires—very similar in content to survey schedules . . . (3) interview guides—semi-structured interviews, characterized by openended questions, to be administered to a number of informants in an uniform fashion . . . (LeClair, 1960, p. 34)

This extremely ambitious mixed method research project was set up to assess the impact of large-scale community development programs that had been established in a number of areas in India. Many other chapters in the book Human Organization Research dealt with projects and data-gathering situations

5 involving both quantitative and qualitative materials. To take just one more example, Kenneth J. Cooper presented an article for this collection titled “The Modified Q Technique in Rural-Urban Field Research,” in which he described how he developed a structured set of 20 items which he labeled the Leadership Role Expectations (LRE) Scale. The LRE Scale was administered to a total of 456 individuals in Mexico, ranging from a relatively isolated rural site to a semirural site (Tepoztlan), and a highly urban subgroup in Mexico City. In summing up the use of the “Modified Q Technique,” Cooper (1960) noted, The combination of observation of actual role behavior and the discovery of ideal role expectations through the use of the highly structured and controlled M.Q.T. enabled us to make a comparative study involving an unsophisticated, semiliterate peasantry and a large urban population in Mexico City. Limiting a study of leadership such as this only to observation and intense depth interviewing not only would necessarily reduce one’s total sample to a minimum and possibly prevent obtaining data from a representational urban population but would also preclude the data’s being of an objectively comparable nature. (pp. 350–351)

Cooper’s statement, along with a number of others in this very influential volume, demonstrated a keen interest in introducing additional quantitative methods into the social scientists’ “ethnographic tool kit.” That keen interest in developing uses of quantitative methods was particularly on the increase in the mid-20th century. In 1953, the year that Anthropology Today appeared, I began graduate studies in anthropology. Probably because of my early interest in so-called “culture and personality” studies, I focused much of my attention on the mixing of qualitative and quantitative data-operations. In general, the anthropologists of that time did not have any objection to using quantitative methods, as in those days we were all expected to be familiar with the “four fields” of anthropology, of which physical (biological) anthropology generally included much use of quantitative methods. Early in the 1960s, I began writing a book about anthropological research methods, in which, I included the following statements in the Preface: 1. Anthropological generalizations and more complex theoretical structures can be built up only through careful operationalizing of basic concepts—the building blocks of all theory. 2. Successful description and hypothesis testing depend on the judicious mixing of quantitative and qualitative research materials. (Pelto, 1970, p. xiii, emphasis in original)

My book, Anthropological Research: The Structure of Inquiry, was the first comprehensive textbook on methodology for cultural anthropology. In the book, I

6 included a large number of examples of quantitative research, mixed with ethnographic methods of participant observation and various types of the open-ended interviewing. I also presented some descriptions of simple statistical methods. Many of the mixed method studies that I referred to were from the 1950s and 1960s. There were a few “early explorations” in the 1930s and 1040s, including Cora DuBois’s ground-breaking study of the Alorese.

Introduction of Statistical Methods Into Ethnographic Studies Inferential statistical methods were used by anthropologists and other ethnographic field researchers already in the 19th century, but most of that early statistical analysis was limited to physical anthropology and to the crosscultural comparisons that came into widespread use in the 1930s. Some anthropologists began to write instructional materials for quantitative comparative research around the middle of the 20th century. Harold E. Driver was one of the influential quantitatively oriented anthropologists, and his article titled “Introduction to Statistics for Comparative Research” was included in the book, Readings in Cross-Cultural Methodology, edited by Frank W. Moore (1961). My book on research methods in anthropology included a chapter on “Measurement, Scales and Statistics,” in which I present some of the main types of commonly used inferential statistical testing, including the chi-square test, Mann–Whitney U test, and ranging on up to factor analysis. My hope was to present these elements of statistics in simple language that could be the beginnings of statistical understanding among graduate students in anthropology. Those introductory guidelines for quantitative analysis were also included in the newer edition of that book (Pelto & Pelto, 1978). David Hurst Thomas (1976) wrote the first full-scale textbook of statistics for anthropologists, titled Figuring Anthropology, which came out in a second edition in 1986, slightly retitled as Refiguring Anthropology: First Principles of Probability & Statistics. Many of his examples of statistical analysis dealt with fairly recent studies. He also handled a number of examples that were crosscultural hypothesis-testing, using large samples of “cultures.” I am not considering those cross-cultural studies as “mixed method research,” as the statistical analysis was not directly connected to the analyst’s own (qualitative) field research. Those statistical studies, many of them based on the Human Relations Area Files (HRAF) at Yale University, were quite influential in introducing the use of statistical methods to a wide range of anthropologists and other social scientists.

Qualitative Health Research  Thomas did include selected materials from some earlier mixed methods studies. For example, he examined quantitative data developed by Julian Steward in the 1930s, in ethnographic fieldwork in several Northern Paiute native groups in the western United States. Steward’s ethnographic work included numerical data on population densities and also the following set of frequencies in a community: “spouse from own village” (4), “spouse within valley” (15), “spouse from another valley” (13) (Steward, 1938, cited inThomas, 1986, pp. 231, 238, 271). In another example from research carried out more than 50 years ago, Thomas examined the statistics that Stanley Freed used in an article on “An Objective Method for Determining the Collective Caste Hierarchy of an Indian Village” (Freed, 1963). Freed had randomly selected 25 informants within the village, each of whom was asked to rank the 12 caste groups in the study village. Freed (1963) described that he used a card-sorting technique to obtain the rank order data (Thomas, 1986). Thomas used the example from the Indian village data to discuss the usefulness of the Spearman rank order correlation coefficient for the kind of data that Freed (and his wife) had collected in a village in North India. In addition to their quantitative data, Stanley and Ruth Freed collected extensive qualitative materials in their ethnographic work. H. Russell (“Russ”) Bernard published the first edition of his comprehensive textbook Research Methods in Cultural Anthropology in 1988. His book, like the Pelto and Pelto textbook (10 years earlier), includes comprehensive, very readable, guidelines for both QUAL and QUAN data collection and analysis, including more than 100 pages of step-by-step instructions concerning use of statistics, ranging from univariate to bivariate and multivariate designs. At the time of that first edition of Bernard’s book, he had a very wide range of QUALQUAN studies to draw on, from various subfields of the social sciences. Since that first edition, almost three decades ago, his book is now in its fifth edition (Bernard, 2011). In 1998, Bernard added considerable weight and depth to the available literature on anthropological research approaches with the edited collection, Handbook of Methods in Cultural Anthropology. In keeping with the general inventory of cultural anthropology, the Handbook has chapters on “participant observation” (basically QUAL), “direct systematic observation of behavior” (basically QUAN), “structured interviewing and questionnaires” (QUAN), “reasoning with numbers” (QUAN), “text analysis (QUAL and QUAN), and many other topics illustrating the intermingling of qualitative and quantitative data collection and analysis.

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Pelto

Systematic Data Collection—Essential QUALQUAN Tools

QUAN-Qual Mixed Methods Textbook More Than 60 Years Ago!

Susan C. Weller and A. Kimball Romney published their “booklet,” Systematic Data Collection in 1988, the same year as the first edition of Russ Bernard’s methodology textbook. In just 95 pages, they presented exceedingly clear and useful instructions for ethnographic tools such as free-listing, pile sorting, triad sorts, rating scales, paired comparisons, and several other easy-to-use field data techniques. These are “mixed method tools”—as the data-gathering steps are qualitative, but when used systematically, with small but carefully selected samples, the analysis is quantitative. Thus, they are “qual-quan datagathering methods.” It is interesting that, although the little booklet is loaded with numerical tables, it was published in a Qualitative Research Methods Series!

My discussion about articles and books dealing with mixed methods research has focused mainly on works by anthropologist-ethnographers. However, it is useful to hark back to materials we studied before we had very much methodology writing in anthropology. Here at my desk, I have the old copy of Goode and Hatt’s (1952) Methods in Social Research. In my 1970 basic textbook, Anthropological Research, I quoted from Goode and Hatt concerning the “flexibility of concepts” (p. 11), development of interview schedules and questionnaire construction (p. 101), and calculations of sample size for various research designs (p. 168). In those years long ago, when I was writing that first textbook in anthropological/ethnographic research methods, I must have read with great interest Goode and Hatt’s (1952) long forgotten assertion:

The Ethnographers’ Toolkit, Field Methods, and Other Resources The inventory of articles and textbooks dealing with ethnographic field methods published in recent decades is now enormous, after those modest beginnings a little over half a century ago. My informal review here deals mainly with works in anthropology, and there are a great many writings about research methodology in other fields, such as nursing and other health research areas, education, geography, various subfields of sociology and social psychology, rural development studies, to name just a few. One other comprehensive, “mixed methods” resource for ethnographic field workers is a seven-volume set titled The Ethnographer’s Toolkit, put together by Jean J. Schensul, Stephen L. Schensul, Margaret D. LeCompte, along with a bunch of other writers (Schensul et al., 1999).

Field Methods (Journal) The idea for a journal devoted to methodology in field research was developed in the 1980s by Russ Bernard, myself, and several of our methods-minded colleagues, including Stephen Borgatti. We started with a newsletter, Cultural Anthropology Methods, sometimes referred to as the CAM Newsletter. Most of the editorial work and logistics for the CAM was managed by Russ Bernard and his team of colleagues and graduate students at the University of Florida. Quite soon, the CAM newsletter transformed into a full-scale journal, beginning in 1989. For ethnographers in the various social science disciplines, Field Methods is an invaluable source of methodologically oriented pieces from all different niches of the complex world of mixed methods field research.

It follows, then, that modern research must reject as a false dichotomy the separation between “qualitative” and “quantitative” studies, or between “statistical” and the “nonstatistical” approach. The application of mathematics to sociology does not ensure rigor of proof, any more than the use of “insight” guarantees the significance of the research. (p. 313)

That statement from Goode and Hatt, 65 years ago, gives us a clue to the general climate of theoretical writing about scientific research in the middle of the 20th century. It helps to account for the unquestioned acceptance of mixed methods research in some sectors of the social sciences during those earlier decades.

QUAL-Qual and QUAN-Quan Are Also Mixed Methods Although many people writing about “mixed methods” prefer to restrict the definition of mixed methods to refer only to the mixing of quantitative and qualitative dataoperations, I see no reason for that restriction. I would agree with writers like Janice Morse, who explicitly include the so-called “within paradigm” mixtures in their definition of “mixed methods.” Morse (2010), in her article on “Simultaneous and Sequential Qualitative Mixed Method Designs,” stated, While some researchers are uncertain if QUAL-qual designs are mixed methods, in this article, I argue that they may be a mixed method design and deserve attention as such. When qualitative data types, levels of analysis, or participant perspectives are different enough that it is necessary for the two methods to be handled differently and to be kept apart, we have the rationale for using mixed method design. (p. 491)

8 Morse (2010) gave several examples of proposed QUAL-qual designs for research in health care settings, such as examining the question “How do physicians report that they provide bad news? Do physicians tailor their message according to the type of message they must give and patient characteristics?” (p. 490). She suggested that the mix of methods for study of that question might have a qualitative semistructured interview with some physicians, followed by nonparticipant observation of physician–patient interactions (QUAL-qual design). In many studies of special, hard to reach, populations (e.g., sex workers, drug users, and other “socially disapproved people”), specialized mapping and case-finding are often a necessary early component of the research design. Another piece of early qualitative research should often include the use of free-listing and other special techniques for getting the local vocabulary and speech styles of the “hidden subgroups.” In some cases, researchers have made use of small group interviews to develop information about local specialized vocabularies. With the discovery of new themes and behavioral patterns, other specialized qualitative methods may be necessary in more advanced stages of qualitative research. In complex, long-term ethnographic studies, we are likely to encounter overall research designs that could be labeled as “qual-qual-QUAL-qual.” In that possible model, the early phases are “preparatory qualitative steps,” followed by the core ethnographic study (QUAL), followed by some specialized probing in a newly discovered subcategory of persons near the completion of the study.

Discussion The examples I have given of qualitative–quantitative mixing of data in earlier ethnographic studies are but a small and haphazard sampling from a much larger body of research literature that would clearly fall within the usual definitions of “mixed methods research.” However, the anthropologists (and sociologists, geographers, and others) pursuing mixtures of qualitative and quantitative field data never labeled their studies with that special identity—“mixed methods.” That was because the “qual/ quan distinction” was generally not significant or special. They were all doing “science,” in which some phenomena should be counted, and others simply described without any numerical treatment. After all, Darwin’s immensely important theoretical work, The Origin of Species, did not present numerical data. In the “natural history phase” of much biological, medical, geographical, and geological work, most of the research data were in descriptive, textual form. Then more and more systematic “counting” was developed in a somewhat later phase of scientific work.

Qualitative Health Research  The considerable history of earlier “mixed methods research” did not attract large amounts of attention in the literature about research methodology. Also, it should be noted that the pathway to mixed methods in anthropology and geography was through a slowly developing increase in use of quantitative methods within the (mainly qualitative) data approaches of traditional ethnographic studies. The recent interest in “rediscovery” of “mixed methods research” appears to have come from a different perspective. It apparently happened when researchers in heavily quantitative disciplines, for example, in fields of health research, gradually (and reluctantly) began to accept the use of some qualitative data-operations, usually secondary to the “core” of quantification. That appears to have been especially notable in the medical and health care fields. In further reading about the “recent development” of mixed methods, I have begun exploring the hypothesis that other influences leading to the focus on “the mixed methods paradigm” were the pervasive discussions and debates during the 1970s and 1980s, about “logical positivism” and its weaknesses, versus phenomenology, constructivism, (and others) as basic paradigms, some of which arose because of the widespread interest provoked by Thomas S. Kuhn’s (1962) book, The Structure of Scientific Revolutions. It appears that Kuhn’s use of the concept, “paradigms,” gave rise to considerable philosophical discussion, including (for some writers) the supposed “incompatibility” of qualitative and quantitative paradigms. It seems to me that there was a time of confusion in the closing decades of the 20th century, concerning the relationships between specific research methodology and the abstract philosophical discussions about “research paradigms.” In some discussions, it appeared that qualitative research was bundled up with antipositivist philosophical writing, while QUAN research was considered the domain of positivist and postpositivist philosophical positions.

Mythology About the Characteristics of Qualitative and Quantitative Research One of the major “myths” about quantitative research is the frequently encountered assumption that QUAN research is most usually hypothetico-deductive in structure. For example, Teddlie and Tashakkori (2009) stated, QUAN researchers typically employ deductive logic or reasoning, which involves arguing from the general (e.g., theory, conceptual framework) to the particular (e.g., data points). The hypothetico-deductive model (H-DM) is a model employed by QUANS involving the a priori deduction

9

Pelto of hypotheses from a theory or conceptual framework and the testing of these hypotheses using numerical data and statistical analyses. (p. 23)

That kind of generalization appears to ignore the very large numbers of research projects in which structured surveys are used to find out (discover) the frequencies of specific illness symptoms, domestic violence episodes, use of alcohol, TV watching, and a great many other behavioral and ideational items, with little or no focus on testing of specific hypotheses. Various types of surveys are often used as “situation assessments” prior to development of intervention projects. The HIV/AIDS pandemic, for example, has led to very large numbers of research projects directed to examining the characteristic behaviors and situations of sex workers, customers of sex workers, men who have sex with men, and other “at risk” populations. I have a collection of large-scale research reports carried out by the Population Council researchers and other NGOs in India, focused on detailed study of sex workers and male migrant workers. One such “typical” study is a 73-page booklet titled Patterns of Migration/Mobility and HIV Risk Among Female Sex Workers: Maharashtra 2007-2008 (Saggurti et al., 2008). The study was carried out in seven districts of Maharashtra state, with a total of 2,274 sex workers surveyed. In addition, “ . . . a total of 65 key informant interviews and 140 in-depth interviews [of sex workers] were carried out in the selected study areas” (Saggurti et al., 2008, p. 1). The report has 24 figures (mainly bar graphs) and 8 maps of migration/mobility patterns. The appendix contains 16 data tables, all of which present frequencies in the form of percentages. Those quantitative data include “mobility of female sex workers by number of moves,” “reasons for entry into sex work,” “ . . . sources of income,” “ . . . experienced physical violence and their perceived risk for HIV infection,” “ . . . places of solicitation for clients,” and also the usual background data on age, marital status, ownership of cell phone, and other variables. As is common in this type of survey research, no cross-tabulations or other statistics were presented. The large number of variables presented in the tables, figures, and maps actually constitute a loose conceptual framework, although there is no theoretical discussion in the report. Like hundreds of other, similar, research products, this is an inductively produced situation assessment, intended for HIV/AIDS program planning. Researchers from the Population Council in India carried out this same type of QUAN + qual situation assessment of female sex worker mobility in four states with the highest HIV infection rates, and also (separately), situation assessments of migratory workers in those four states.

Another interesting example of this common pattern of “inductive, discovery-focused quantitative research” is a study of abortion in an urban area in Ecuador, carried out by Susan Scrimshaw in the 1970s (Scrimshaw, 1985). Her study was actually a QUAL-QUAN model, and her Table 1 presents a “Summation of the Advantages and Disadvantages of Two Methods” (ethnography and largescale survey). Her comparison of the “QUAL” and “QUAN” approaches does not include the usual “subjective-objective dichotomy,” nor does she mention “inductive vs. deductive” in her list of differences between ethnographic and survey methods. The article presents five tables of quantitative data, including “Opinions on Induced Abortion (Ethnographic Sample),” “Pregnancy Outcomes by Age of Mother,” (Survey Data), “Outcomes of First and Subsequent Pregnancies,” abortion providers (survey data), and “Number of Children [in] Ideal Family.” In addition, men’s and women’s attitudes about abortion in the survey data (eight questions) are given in the text, without a table. The random sample of survey respondents concerning the “ideal family” gives the totals as 2,936 women and 1,119 men. Scrimshaw (1985) compared the quantitative results from ethnographic research and the survey data and concluded, The data indicate quite clearly that this barrio [where ethnography was carried out] can be regarded as a credible representation of the generality of urban poor of the city. Statistical similarities with regard to fertility attitudes and behaviors (including abortion) give me confidence that the complex processes of coping with pregnancies and repeated childbirths that I observed in the barrio are widespread in the low income settlements of the city. (pp. 141–142)

There are many research projects in community health topics, which have that same style—large-scale survey as a “situation assessment,” often preceded by, or contemporaneous with, ethnographic data-gathering. In some cases, the studies refer explicitly to some theoretical framework, but in a great many examples, the quantitative data are presented in the form of frequencies only, without explicit hypothesis-testing, as in these two examples. The practical, applied nature of Scrimshaw’s study is made even more evident when we note that the research was requested by the Ecuadorian government.

The “Two Paradigms” Debate and the “Objective Versus Subjective Myth” Another “mythical feature” in the various philosophical discussions has been the frequent linking of qualitative research with the label “subjective,” and conversely,

10 quantitative research has been seen as “objective.” Here I agree with Reichardt and Cook (1979), who noted, Often subjective is meant to imply “influenced by human judgment.” According to this usage, all methods and measures, both qualitative and quantitative, are subjective. Indeed, modern philosophers of science largely agree that all facts are imbued with theory and so are at least partly subjective. (pp. 12–13)

Reichardt and Cook (1979) have quite convincingly demonstrated that . . . all of the attributes which are said to make up the paradigms are logically independent. Just as the methods are not logically linked to any of the paradigmatic attributes, the attributes themselves are not logically linked to each other. (p. 18)

With that line of reasoning, they effectively showed that research data-gathering techniques are not determined by, or tied to, specific philosophical paradigms, and also, in the varieties of research endeavors, the investigators should be free to mix and match whatever methods are useful for achieving the objectives of the study. Reichardt and Cook (1979) added the comment that “there is no reason for researchers to be constrained to either one of the traditional, though largely arbitrary, paradigms when they can have the best from both” (pp. 18–19).

Not All Research Is Intended to “Build Theoretical Systems” I have already noted that much of ethnographic field research in the 19th century and the early decades of the 20th century was directed to description of the cultural and social features (beliefs and behaviors) of specific, delineated, populations (tribal or ethnic groups and other social entities). In such descriptive ethnographic studies, the conceptual structures and the written products of research certainly contained many points of implicit “theory.” However, the descriptive aims were usually to get clear, useful information pertaining to the specific study populations. In modern day applied research, for example, in areas of clinical and community health, agricultural development, issues in schools and education, and other topical areas, many studies are aimed at using contemporary knowledge, including theoretical concepts from social psychology and other sources to solve specific problems or to initiate specific programmatic changes. There may be some “testing” of theoretical constructs, to see whether they help to solve problems, but the goals are practical

Qualitative Health Research  economic, social, and other changes. The main aims are often not focused on “theory-building” as such. Thus, the “hypothetico-deductive models” of research that some people use as the framework for design of proposed studies are not particularly useful for many applied research projects, particularly in the case of the special needs of evaluation research. In most field research, whether distinctly “applied” or “evaluation,” or more academic, nonapplied studies, there is often very considerable inductive research, although components within a project may also include deductive components. Many researchers may not even be familiar with the terminology, but their studies often have elements that fit under the label, “abduction, or abductive research design.” Teddlie and Tashakkori (2009) define “abductive logic” as . . . the third type of logic . . . [that] involves the process of working back from an observed consequence (or effect) to a possible antecedent (or cause). Abduction entails creatively generating insights and making inferences to the best possible explanation. (p. 329)

It should be noted that those many research projects that shift back and forth between inductive and deductive processes nearly always involve “mixing of methods.”

Concluding Comment In my view, much of the debates and discussions about “research paradigms” in the last quarter of the 20th century produced stereotypic versions of research designs, “paradigms,” “science,” and other aspects of knowledge. In some cases, it appears that methodological discussions in specific disciplines approach issues about the conduct of research without paying attention to the ways in which the forms of research in other disciplines may have different assumptions and different strategies, including different histories of “mixing data-gathering techniques.” I have the feeling that in the first half of the 20th century (and earlier), both academic scholars and applied researchers out in fieldwork had very little thought or worry about “paradigms.” So, my belief is that “mixed methods” (as it is now being defined) was happening across the 20th century in various research contexts, but it was not considered as “mixed” in those earlier times, because the concepts of two different paradigms had not become salient. In earlier decades, they were not “mixing methods,” because the (artificial) divide between qualitative and quantitative “paradigms” had not yet been invented. If we look closely at the research products of the 19th and early 20th centuries, I doubt we will find very many theoretical arguments for segregating of numerical data and verbal, descriptive

11

Pelto data into separate systems. After all, we ordinary folks mix those two—verbal descriptions and some numbers— all the time. So, where did we get these supposedly separate paradigms? Here we get “culture.” In the cultural traditions of certain academic disciplines, it became standard practice that quite constricted quantitative studies were considered the “gold standard” for being considered excellent (e.g., for advanced degree research). In other disciplines—in anthropology and some programs in sociology (for example)—the standards for excellent data-gathering were focused on qualitative, descriptive methods. The various scientific and not-so-scientific disciplines have evolved differing cultural models of research practices, reflecting the differences in subject matter, as well as differences in the practical uses of the resulting data. The different culturally shaped models of research have been taken up by enterprising writers and thinkers, who have developed philosophical and logical justifications and critiques of differing research styles, as well as other, related cultural lore. Disciplinary differences in research styles and “cultural expectations” gave rise to a new wave of philosophical speculations (and various writings) about the differences between research that has many numbers and statistical maneuvers and data products with extensive, often colorful verbal descriptions of specific events, situations, and outcomes. The writings about the supposedly different “paradigms” were sometimes the academic, theoretical exercises of scholars who were not much involved in actual, applied, practical dealings with real-world issues. I am not saying here that the various writings about the “two paradigms” and the concepts of “mixed methods” have been a total waste of time. Those discussions have, to some extent, introduced us to the (often unstated and undocumented) different philosophies of academic disciplines. Those discussions about the “two paradigms” undoubtedly led to some rethinking among researchers (and funding sources) that motivated improved precision and care in data-gathering and increased explorations in new combinations of qualitative and quantitative dataoperations. However, I have a feeling that for people who are involved in real, applied research projects, dealing with real-world issues, much of the language about the abstract characteristics of the qualitative and quantitative paradigms is not particularly useful. What counts for applied practical research is whatever is cost-effective and “time-effective,” for getting answers to specific issues and problems. The lesson from the real world is that researchers need to use all the qualitative and quantitative datagathering and analyzing methods they have available, within the budgetary limits and timetables set by the funding sources and other “stakeholders”—whatever is

necessary to understand the characteristics and situations of populations and other phenomena to be studied, and solve problems concerning present and future program actions. Declaration of Conflicting Interests The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding The author received no financial support for the research, authorship, and/or publication of this article.

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Author Biography Pertti J. Pelto is Professor Emeritus of Anthropology at the University of Connecticut. Early in his professional career he authored a major book on research methodology, Anthropological Research: The Structure of Inquiry (1970), and recently wrote another book of research methods, Applied Ethnography: Guidelines for Field Research (2013). He has also edited a number of major works, including Listening to Women Talk About Their Health (co-edited with J. Gittelsohn, M. Bentley, M. Nag, S. Pachauri, A. Harrison, & L. Landman; 2nd ed., 2011), and Sexuality, Gender Roles, and Domestic Violence in South Asia, (co-edited with M. E. Khan & J. W. Townsend, 2014).