Integrating Multi-Source Qualitative Data Using Causal Loop Diagrams

A Methodological Framework for Developing Systems Thinking

Bibliographic Data

ID19479203
AuthorsMaryam Babaei Aghbolagh (0000-0002-4145-5218, Tehran University of Medical Sciences), Farnoosh Azizi (Tehran University of Medical Sciences), Aida Asghari (Tehran University of Medical Sciences), Efat Mohamadi (0000-0003-2297-7990, Iranian Institute for Health Sciences Research, corresponding author), Mohammadreza Mobinizadeh (0000-0003-3691-3744, Tehran University of Medical Sciences, corresponding author), Hakimeh Mostafavi (0000-0002-1969-7341, Tehran University of Medical Sciences), Alireza Olyaeemanesh (0000-0002-7417-2417, Tehran University of Medical Sciences, corresponding author)
Year2026
Volume25
Publication date2026-01-19
Open AccessYes
TypeARTICLE
VenueInternational Journal of Qualitative Methods (JOURNAL)
Journal identifiersISSN: 1609-4069 • E-ISSN: 1609-4069
PublisherSAGE Publications (PUBLISHER • US)
DOI10.1177/16094069261449020
OpenAlexW7160840935
LanguageEN
References cited54

Health systems, as complex adaptive systems, are influenced by the intertwined interactions among various actors and policies interactions that often defy explanation through linear analytical approaches. This article presents the methodological framework that integrates multi-source qualitative data through the use of system dynamics causal loop diagrams, thereby enabling the researcher to progressively develop and refine a systems-thinking perspective. Qualitative data were obtained from four sources: a literature review, semi-structured interviews with managers and experts, analysis of official documents from Social Security Organization of Iran, and an expert panel. Each method made a distinct contribution to shaping the dimensions of systems thinking: The literature review contributed to identifying key variables and shaping the initial model; document analysis supported understanding the organizational structure and further contextualizing the model; interviews enabled the discovery of organizational behavior as well as nonlinear and delayed relationships; and the expert panel facilitated the uncovering of hidden drivers underlying system behavior. The proposed “Integrating Qualitative Data for Systems Thinking” (IQDST) framework demonstrated that the convergence of these diverse data sources enabled a transition in the researcher’s analytical perspective, from descriptive analysis to structural and institutional analysis, while also identifying complex feedback loops. This article highlights that, structured integration of diverse qualitative data sources not only enriches conceptual models and enhances the ability to anticipate indirect and long-term consequences of policies but also serves as an effective mechanism for strengthening researchers’ systems thinking capacity during model development processes

Causal loop diagram · Causal model · Complex adaptive system · Conceptual framework · Key (lock) · Qualitative property · Qualitative research · System dynamics · Systems thinking · Complex Systems and Decision Making · Health Policy Implementation Science · Qualitative Comparative Analysis Research

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Open DOIOpen Access