Our team’s presentation on Fluid community-engaged mixed methods research during uncertain times: A healthcare transportation service case study has been accepted for the upcoming Mixed Methods Research International Association Conference being held in Brisbane, Australia in August.
ABSTRACT:
Purpose: We present a United States-based case study of designing and piloting a technology-mediated, non-monetary healthcare transportation service during societal and political uncertainty. We offer strategies for prioritizing the needs of the community while balancing the research project’s goals, and illustrate how sequential mixed methods research is particularly well-suited to respond to upstream shifts.
Methodology: We conducted a four-stage community-based mixed methods study (2020-2026) to investigate how to facilitate trust in the transportation service. Sztompka’s (1999) trust theory informed the study design and transportation features. Data collection techniques included participatory activities (n=30), surveys (n=35) and individual/group interviews (n=78) with riders, drivers and coordinators.
During stages-1 and -2, we worked with three local organizations to iteratively generate trust-centered design features to implement into an existing service exchange for the stage-3 pilot. When initial pilot goals were not met (i.e., 100 rides delivered over 4 months), we added stage-4 interviews to further investigate how mixed methods researchers can respond to upstream shifts.
Throughout our analysis, we created joint displays (Guetterman, et al., 2015) of thematically-analyzed qualitative data, descriptive statistics of the quantitative data and trust theory concepts. Community partners provided insights into each stage’s findings and offered direction for pivoting subsequent stages. Our final mixed analysis across all stages examines the influence of upstream shifts on study delivery.
Findings: A non-profit organization for newcomers who coordinated 40+healthcare rides over the 10-month period became central for facilitating rider-driver trust. Community partners and participants shared how the COVID-19 pandemic, executive orders and government shutdowns had negatively impacted feelings of safety, funding resources and delivery of the transportation project.
Our preliminary analysis provides four community-engagement strategies for mixed methods researchers during a time of polycrisis:
- Being agile with the data collection techniques and stages: The COVID-19 pandemic led us to shift in-person participatory sessions to online, and add health-related safety questions to early-stage data collection. We added stage-4 when the delivery and recruitment goals for the pilot were not met.
- Recognizing advocacy as a benefit of participation: In response to recent executive orders toward immigrants and refugees, drivers wanted to contribute to a service that was helping newcomers with access to healthcare.
- Developing trusting, short-term relationships: Changing staff from reduced resources necessitated developing short-term relationships with rotating community champions from existing and new partnered organizations.
- Reassessing community-centered outcomes: Seventeen people who became members of the organization offering the transportation service provided an unanticipated outcome of promoting social-connectedness within the community