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Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs-exploratory sequential, explanatory sequential, and convergent-and through four advanced frameworks-multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods.

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This article discusses some procedural issues related to the mixed-methods sequential explanatory design, which implies collecting and analyzing quantitative and then qualitative data in two consecutive phases within one study. Such issues include deciding on the priority or weight given to the quantitative and qualitative data collection and analysis in the study, the sequence of the data collection and analysis, and the stage/stages in the research process at which the quantitative and qualitative data are connected and the results are integrated. The article provides a methodological overview of priority, implementation, and mixing in the sequential explanatory design and offers some practical guidance in addressing those issues. It also outlines the steps for graphically representing the procedures in a mixed-methods study. A mixed-methods Comment [CT1]:This describes the type of MM design that the study employs. Comment [CT2]:Both QUAN and QUAL data are gathered and analyzed in this study. Comment [CT3]:This MM study involves the integration of both QUAN and QUAL results. sequential explanatory study of doctoral students' persistence in a distance-learning program in educational leadership is used to illustrate the methodological discussion.Keywords: mixed methods; quantitative; qualitative; design; survey; case studyIn recent years, more social and health sciences researchers have been using mixed-methods designs for their studies. By definition, mixed methods is a procedure for collecting, analyzing, and "mixing" or integrating both quantitative and qualitative data at some stage of the research process within a single study for the purpose of gaining a better understanding of the research problem (Tashakkori and Teddlie 2003;Creswell 2005). The rationale for mixing both kinds of data within this one study is grounded in the fact that neither quantitative nor qualitative methods are sufficient, by themselves, to capture the trends and details of a situation. When used in combination, quantitative and qualitative methods complement each other and allow for a more robust analysis, taking advantage of the strengths of each (Green, Caracelli, and Graham 1989;Miles and Huberman 1994;Green and Caracelli 1997; Tashakkori and Teddlie 1998).There are about forty mixed-methods research designs reported in the literature (Tashakkori and Teddlie 2003). Creswell et al. (2003) identified the six most often used designs, which include three concurrent and three sequential designs. One of those designs, the mixed-methods sequential explanatory design, is highly popular among researchers and implies collecting and analyzing first quantitative and then qualitative data in two consecutive phases within one study. Its characteristics are well described in the literature (Tashakkori and Teddlie 1998; Creswell 2003Creswell , 2005 Creswell et al. 2003), Comment [CT4]:The survey is a QUAN research design, while the case study is often classified as a QUAL research design. Comment [CT5]:This is the definition of MM research. Com...

The American Psychological Association Publications and Communications Board Working Group on Journal Article Reporting Standards for Qualitative Research (JARS–Qual Working Group) was charged with examining the state of journal article reporting standards as they applied to qualitative research and with generating recommendations for standards that would be appropriate for a wide range of methods within the discipline of psychology. These standards describe what should be included in a research report to enable and facilitate the review process. This publication marks a historical moment—the first inclusion of qualitative research in APA Style, which is the basis of both the Publication Manual of the American Psychological Association (APA, 2010) and APA Style CENTRAL, an online program to support APA Style. In addition to the general JARS–Qual guidelines, the Working Group has developed standards for both qualitative meta-analysis and mixed methods research. The reporting standards were developed for psychological qualitative research but may hold utility for a broad range of social sciences. They honor a range of qualitative traditions, methods, and reporting styles. The Working Group was composed of a group of researchers with backgrounds in varying methods, research topics, and approaches to inquiry. In this article, they present these standards and their rationale, and they detail the ways that the standards differ from the quantitative research reporting standards. They describe how the standards can be used by authors in the process of writing qualitative research for submission as well as by reviewers and editors in the process of reviewing research.