Embracing cultural humility in mixed methods research

The increasing use of mixed methods research in public health and medicine presents new opportunities for investigators to obtain a more inclusive and holistic understanding of the complex factors underlying today’s pressing health challenges. Yet, navigating the mixed methods research process can be a challenge. The methodology not only involves the integration of quantitative and qualitative data – something many researchers are not trained to do – it also requires a carefully crafted approach that encourages diverse participants and perspectives and recognizes cultural differences.

In a recent paper, Yale School of Public Health Associate Research Scientist Sinem Toraman Turk and Professor Leslie Curry – both experts in mixed methods research methodology – introduce the concept of ‘cultural humility’ as a way of strengthening mixed methods research and ensuring optimal outcomes. Toraman Turk recently took a moment to discuss the advantages of mixed methods research – particularly as it pertains to addressing health inequities – and how cultural humility can help drive the field forward.

Sinem Toraman Turk (STT): Mixed methods research is a type of research that collects, analyzes, and intentionally integrates qualitative and quantitative data. The approach takes advantage of the strength of each method in order to understand complex problems that cannot be addressed by one of the methods alone. Mixed methods can corroborate findings, generate more complete data, and enhance insights gained from each complementary method. We can use mixed methods to examine racial and ethnic disparities in health care and health outcomes in illuminating underlying drivers of inequity. We can uncover “causes of causes” of health outcomes through various combinations of qualitative and quantitative approaches and apply health justice theories to explain why we witness differences across groups.

STT: Mixed methods research can strengthen quantitative research and clinical studies in a few ways. First, this approach enriches diversity in practice, data, and applications. Second, it can reduce biases introduced by big data or AI. Some examples include (1) capturing the social, cultural, and psychological complexities of individual beliefs and experiences; (2) generating holistic and integrated descriptions of a wide range of structural and social determinants across individual, community, organizational, and structural levels in great depth; and (3) supporting development of the models on which AI runs through identifying novel variables to counteract the data mining that can spin out. Third, mixed methods research plays an important role in the growth of authentic team science as appropriate given the focal topic as a potentially high-impact innovation. Lastly, mixed methods research can help implement more system-wide changes that are required to enable translation and implementation (and deimplementation) of evidence.

STT: Cultural humility is a dynamic process in which individuals actively practice self-awareness in social interactions within and across their surroundings. In research, we can think of cultural humility as a reflection to gain a deeper understanding of differences among various scientific disciplines to improve the way researchers interact with each other, study participants, and their respective fields. Practicing cultural humility includes openness, cultural and self-awareness, supportive interactions, self-reflection, recognition of power/privilege differential, and critique. We can engage with differences as cultural phenomena as opposed to personal traits. So, we define cultural humility for mixed methods research as an ongoing process of critical reflection embracing diversity undertaken by mixed methods researchers to 1) generate awareness of one’s own culture at the intrapersonal level; 2) recognize and respect cultural differences among mixed methods research team members, research participants, trainees, and community members at the interpersonal level; and 3) explore and advocate for a respectful and open culture within the field of mixed methods research at the system level. The goal for this ongoing process is to celebrate, navigate, and promote diverse perspectives, approaches, methods, and rhetoric in mixed methods research.