# Updating the Good Reporting of a Mixed Methods Study (GRAMMS) Reporting Guidelines: Protocol for a Methodological Review and Modified Delphi Process

## TL;DR

This paper outlines a project to update the GRAMMS guidelines for better reporting of mixed methods studies in health research.

## Contribution

The study introduces a protocol to develop GRAMMS 2.0, a revised reporting guideline for mixed methods research.

## Key findings

- The GRAMMS 2.0 guideline aims to improve consistency and transparency in mixed methods reporting.
- A methodological review and modified Delphi process will inform the updated guideline.
- The updated guidelines are expected to enhance the transferability of mixed methods research findings.

## Abstract

In mixed methods research (MMR), researchers combine elements of qualitative and quantitative methodologies, methods of data collection and analysis, viewpoints, and integration procedures to gain a deeper understanding of what is being studied, design culturally specific tools, and explore the conditions under which health care interventions succeed or fail. Integration is considered the hallmark of MMR and can occur at various levels, such as sampling, data collection, and analysis. MMR is particularly useful for investigating complex, multilevel programs and interventions and is well-suited to address research problems involving knowledge translation, program evaluations, or comparisons of therapeutic interventions. Although there are many potential benefits of mixed methods in health research, the extent to which mixed methods studies implement integration remains limited, with this specific gap persisting for almost 20 years. The Good Reporting of a Mixed Methods Study (GRAMMS) reporting guidelines were developed in 2008 to help improve the quality of reporting in mixed methods reports and articles. Since then, the field of mixed methods has evolved rapidly, and the guideline no longer reflects current practices and innovations.

The objective of this study is to develop an updated GRAMMS 2.0 guideline. This project aims to develop the GRAMMS 2.0 guideline and checklist to improve consistency, transparency, and quality of reporting on studies that use mixed methods in health services research. The specific research objectives of this protocol are to (1) examine the extent of mixed methods methodological literature and identify relevant reporting quality criteria for inclusion in GRAMMS 2.0 (ie, a methodological review), and (2) using the results of the first objective, prioritize the components of the updated GRAMMS 2.0 (ie, modified Delphi approach and consensus meeting).

This study will follow established methodological frameworks for reporting guideline development and will include a methodological review followed by a modified Delphi process.

The project has received funding from the Canadian Institutes of Health Research in April 2025.

The GRAMMS 2.0 guideline will improve the consistency, transparency, and quality of reporting of mixed methods studies by researchers and multiple knowledge users in policy and practice. Peer reviewers and editors may also use GRAMMS 2.0 to improve the review of manuscripts involving MMR. Ultimately, the updated guideline will increase the clarity of mixed methods research findings, thereby improving their potential transferability to practice and facilitating efficient use of new results in mixed methods in health research, bringing better returns on research investments.

PRR1-10.2196/82364