Combining action research and grounded theory in health research: A structured narrative review Tiffany Williams a, * , Janine Wiles b , Melody Smith a , Kim Ward a a School of Nursing, University of Auckland, Private Bag, 92019, Auckland, 1142, New Zealand b School of Population Health, University of Auckland, Private Bag, 92019, Auckland, 1142, New Zealand ARTICLE INFO Keywords: Participatory action research Participatory approaches Qualitative methods Qualitative inquiry Pragmatism ABSTRACT Action research and grounded theory are popular methodologies in qualitative health research. The aim of this structured narrative review was to develop a contemporary understanding of combining action research and grounded theory. We searched Web of Science Core Collection and Google Scholar for empirical peer-reviewed articles that used both methodologies in a health- or healthcare-focused study. We identified 28 studies published from 2004 to 2022 that combined various types of action research and interpretations of grounded theory in innovative ways. Our results highlighted that combining the two methodologies is feasible and growing in use. Benefits identified by the study authors were opportunity to work with participants, methodological compati- bility, enhancement of action, theoretical understanding, and perceived legitimacy of research processes and outputs. Key challenges were compromising on both methodologies, and conceptual and practical limitations. Our findings also highlighted that important synergies and tensions exist between the two methodologies, but tensions are not insurmountable. We suggest a combined action research and grounded theory approach underpinned by pragmatism as a methodologically congruent path forwards. In an academic environment which increasingly implores health researchers to translate new-found knowledge to timely real-world change, innovative ap- proaches to research methodologies and design are required. 1. Introduction Drawing on more than one qualitative methodology in a health research study has the potential to harness unique strengths and mitigate limitations of each approach. Implications must be carefully considered, however, to ensure methodological congruence (i.e., alignment of pur- pose, questions and methods) and philosophical alignment (Creswell, 2013). Action research and grounded theory are two established meth- odologies that have historically been combined and advocated by a small but committed group of scholars (Dick, 2007; Simmons & Gregory, 2003). A strong logic for a combining action research and grounded theory exists due to methodological overlap and the potential for elements of each to make a valuable contribution to the other (Azulai, 2021; Dick, 2007). Action researchers and grounded theorists have much to learn from each other, yet the approaches are also complementary in that what is explicit in one methodology (e.g., theory development in grounded theory) is lacking in the other (e.g., generation of theory from knowledge and experience in action research) (Dick, 2007). However, consensus on how to combine these methodologies whilst remaining methodologically congruent remains fragmented. In this article we aim to contribute contemporary insights as a prac- tical starting point for health researchers considering this combination of methodologies. We highlight approaches to combining action research and grounded theory, identify examples of application in empirical health research, offer additional perspectives on key areas of methodo- logical and philosophical synergy/tension, and consider future directions. 1.1. Background The average 17-year gap between research findings and the incor- poration of evidence-based practices to routine general practice in health provides a compelling impetus for health researchers to explore inno- vative research designs (Bauer et al., 2015). Action research and grounded theory are popular methodologies in qualitative health * Corresponding author. E-mail addresses: tiffany.williams@auckland.ac.nz (T. Williams), j.wiles@auckland.ac.nz (J. Wiles), melody.smith@auckland.ac.nz (M. Smith), k.ward@auckland. ac.nz (K. Ward). Contents lists available at ScienceDirect SSM - Qualitative Research in Health journal homepage: www.journals.elsevier.com/ssm-qualitative-research-in-health https://doi.org/10.1016/j.ssmqr.2022.100093 Received 22 December 2021; Received in revised form 24 March 2022; Accepted 5 May 2022 Available online 11 May 2022 2667-3215/© 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by- nc-nd/4.0/). SSM - Qualitative Research in Health 2 (2022) 100093