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Why and how to apply exploratory sequential mixed methods in health-related psychometric research
  1. Mehrdad Amir-Behghadami1,2 and
  2. Homayon Sadeghi-Bazarghani1,3
  1. 1Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran
  2. 2Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
  3. 3Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  1. Correspondence to Mr Mehrdad Amir-Behghadami, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN 5165665811, Tabriz, East Azerbaijan, Iran; Behghadami.m{at}; Professor Homayon Sadeghi-Bazarghani, Road Traffic Injury Research Center, Side to Shahr Tower, Golshahr Square, El Goli Road, Tabriz, East Azerbaijan, Iran; homayoun.sadeghi{at}

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Applying mixed methods to develop new instruments since 2000 is not a new idea. However, there is insufficient literature to discuss instrument development using mixed methods, with steps including how to design the study, how to implement the process and how to perform validation. This letter presents a practical framework using mixed methods to develop new tools and using several methods to conduct validation analysis. The proposed framework consists of several steps that highlight both quantitative and qualitative methods. The tool development framework and validation analysis are practical and useful for researchers who want to provide valid and reliable tools.

In the health sciences, researchers usually find the need to develop new instruments because of the lack of instrument available in their fields. Traditionally, researchers have referred to psychometric literature on validity and reliability for item production and survey methodology when developing new instruments.1 In recent years, they have realised that developing an instrument is as a process in a research project and a structured study from the level of the research design to implementation.2 Precise selection of a study design can help researchers plan a study as well as guide readers either toward what has been done or will be done in the study. Using mixed methods to develop new instruments is not a new idea.

Why use mixed methods for instrument development

Since the early 2000s, methodologists have been discussing why mixed methods should be used. This method can lead to the development of valid and reliable instruments because of the production of valid, …

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  • MA-B and HS-B contributed equally.

  • Collaborators Mehrdad Amir-Behghadami, Homayoun Sadeghi-Bazargani .

  • Contributors MAB and HSB conceptualised and designed the study, contributed to the writing of the first draft of the manuscript, reviewed the revisions and approved the final manuscript as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.