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Using Mixed Methods Integration to Evaluate the Structure of Help-Seeking Barriers Scale: A Survivor-Centered Approach

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  • Karen Birna Thorvaldsdottir

    (School of Health Sciences, University of Akureyri, 600 Akureyri, Iceland
    Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI 48109, USA)

  • Sigridur Halldorsdottir

    (School of Health Sciences, University of Akureyri, 600 Akureyri, Iceland)

  • Denise M. Saint Arnault

    (Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI 48109, USA)

Abstract

Despite the high prevalence of adverse health and trauma-related outcomes associated with intimate partner violence (IPV), help-seeking and service utilization among survivors is low. This study is part of a larger mixed-methods and survivor-centered validation study on the Icelandic Barriers to Help-Seeking for Trauma (BHS-TR) scale, a new barriers measure focused on trauma recovery. A mixed-methods legitimation strategy of integration was employed to evaluate the BHS-TR structure in samples of IPV survivors. The merging of qualitative ( n = 17) and quantitative ( n = 137) data through a joint display analysis revealed mainly complementarity findings, strengthening the scale’s overall trustworthiness and validity evidence. Divergent findings involved items about mistrust, perceived rejection, stigmatization, fearing vulnerability, and safeguarding efforts that were significant help-seeking barriers in the survivors’ narratives, whereas factor analysis indicated their removal. These BHS-TR items were critically evaluated in an iterative spiraling process that supported the barriers’ influence, illuminated core issues, and guided potential refinements. This work contributes to the growing field of mixed methods instrument validation placing equal status on qualitative and quantitative methods and emphasizing integration to provide more complete insights. Moreover, the study’s findings highlight the added value of further exploring divergence between two sets of data and the importance of giving attention to the voices of the target population throughout the validation process.

Suggested Citation

  • Karen Birna Thorvaldsdottir & Sigridur Halldorsdottir & Denise M. Saint Arnault, 2022. "Using Mixed Methods Integration to Evaluate the Structure of Help-Seeking Barriers Scale: A Survivor-Centered Approach," IJERPH, MDPI, vol. 19(7), pages 1-21, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:4297-:d:786532
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    References listed on IDEAS

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    2. Antonovsky, Aaron, 1993. "The structure and properties of the sense of coherence scale," Social Science & Medicine, Elsevier, vol. 36(6), pages 725-733, March.
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