Mixed methods (MM) involve combining qualitative (QUAL) and quantitative (QUAN) methods in program evaluation, primary research, and literature review (Creswell & Plano Clark, 2011;Johnson, Onwuegbuzie, & Turner, 2007;Pluye & Hong, 2014;. They are being increasingly used, specifically in health sciences. Over the years, several strategies to integrate QUAL and QUAN phases, results, and data have been proposed but rarely conceptualized and never tested in a comprehensive manner (Greene, 2008). For each MM researcher and teacher, one of the challenges is to plan, conduct, and report simply and clearly what are the applied specific MM strategies and their combinations. As a contribution for addressing this issue, the purpose of this article is to propose and test a conceptual framework of the combinations of strategies that are used in primary MM research.In this article, to be considered MM, studies had to meet the following criteria (Creswell & Plano Clark, 2011): (a) at least one QUAL method and one QUAN method are combined; (b) each method is used rigorously in accordance to the generally accepted criteria in the area (or tradition) of research invoked (e.g., ethnography and randomized controlled trial); and (c) the combination of the methods is carried out at minimum through a MM design (defined a priori, or emerging) and the integration of the QUAL and QUAN phases, results, and data. The QUAL and QUAN methods can be also combined (but not necessarily) with regard to the data collection (mixed instrumentation), the literature review (mixed studies review justifying the MM research questions and design), and the MM team members' interpretations of sciences in terms of epistemology, ontology, teleology, and methodology (hereafter termed worldview). ABSTRACTMixed methods (MM) are increasingly popular. Researchers integrate qualitative (QUAL) and quantitative (QUAN) methods (e.g., research questions, data collections and analyses, and results). Several integration strategies have been proposed, but their conceptualization is usually design-driven, or fragmented, or not empirically tested. This is challenging for planning and conducting MM studies, and for training graduate students. Based on the methodological literature, we developed a conceptual framework including types of integration and practical strategies, and possible combinations. Then, we tested this framework using 93 health-related 2015 MM studies with a method-detailed description, which illustrated all types of combinations. Our work contributes to advance methodological knowledge on MM via (a) a call for better reporting healthrelated MM studies, and (b) a tested conceptualisation comprising 3 types of integration and 9 specific strategies, which explain current and future possibilities for combining strategies to integrate QUAL and QUAN phases, results, and data.

BackgroundOnline consumer health information addresses health problems, self-care, disease prevention, and health care services and is intended for the general public. Using this information, people can improve their knowledge, participation in health decision-making, and health. However, there are no comprehensive instruments to evaluate the value of health information from a consumer perspective.ObjectiveWe collaborated with information providers to develop and validate the Information Assessment Method for all (IAM4all) that can be used to collect feedback from information consumers (including patients), and to enable a two-way knowledge translation between information providers and consumers.MethodsContent validation steps were followed to develop the IAM4all questionnaire. The first version was based on a theoretical framework from information science, a critical literature review and prior work. Then, 16 laypersons were interviewed on their experience with online health information and specifically their impression of the IAM4all questionnaire. Based on the summaries and interpretations of interviews, questionnaire items were revised, added, and excluded, thus creating the second version of the questionnaire. Subsequently, a panel of 12 information specialists and 8 health researchers participated in an online survey to rate each questionnaire item for relevance, clarity, representativeness, and specificity. The result of this expert panel contributed to the third, current, version of the questionnaire.ResultsThe current version of the IAM4all questionnaire is structured by four levels of outcomes of information seeking/receiving: situational relevance, cognitive impact, information use, and health benefits. Following the interviews and the expert panel survey, 9 questionnaire items were confirmed as relevant, clear, representative, and specific. To improve readability and accessibility for users with a lower level of literacy, 19 items were reworded and all inconsistencies in using a passive or active voice have been solved. One item was removed due to redundancy. The current version of the IAM4all questionnaire contains 28 items.ConclusionsWe developed and content validated the IAM4all in partnership with information providers, information specialists, researchers and representatives of information consumers. This questionnaire can be integrated within electronic knowledge resources to stimulate users’ reflection (eg, their intention to use information). We claim that any organization (eg, publishers, community organizations, or patient associations), can evaluate and improve their online consumer health information from a consumers’ perspective using this method.

IntroductionPatients with complex care needs (PCCNs) often suffer from combinations of multiple chronic conditions, mental health problems, drug interactions and social vulnerability, which can lead to healthcare services overuse, underuse or misuse. Typically, PCCNs face interactional issues and unmet decisional needs regarding possible options in a cascade of interrelated decisions involving different stakeholders (themselves, their families, their caregivers, their healthcare practitioners). Gaps in knowledge, values clarification and social support in situations where options need to be deliberated hamper effective decision support interventions. This review aims to (1) assess decisional needs of PCCNs from the perspective of stakeholders, (2) build a taxonomy of these decisional needs and (3) prioritise decisional needs with knowledge users (clinicians, patients and managers).Methods and analysisThis review will be based on the interprofessional shared decision making (IP-SDM) model and the Ottawa Decision Support Framework. Applying a participatory research approach, we will identify potentially relevant studies through a comprehensive literature search; select relevant ones using eligibility criteria inspired from our previous scoping review on PCCNs; appraise quality using the Mixed Methods Appraisal Tool; conduct a three-step synthesis (sequential exploratory mixed methods design) to build taxonomy of key decisional needs; and integrate these results with those of a parallel PCCNs’ qualitative decisional need assessment (semistructured interviews and focus group with stakeholders).Ethics and disseminationThis systematic review, together with the qualitative study (approved by the Centre Intégré Universitaire de Santé et Service Sociaux du Saguenay-Lac-Saint-Jean ethical committee), will produce a working taxonomy of key decisional needs (ontological contribution), to inform the subsequent user-centred design of a support tool for addressing PCCNs’ decisional needs (practical contribution). We will adapt the IP-SDM model, normally dealing with a single decision, for PCCNs who experience cascade of decisions involving different stakeholders (theoretical contribution). Knowledge users will facilitate dissemination of the results in the Canadian primary care network.PROSPERO registration numberCRD42015020558.

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