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Abstract Background Action research (AR) and randomized controlled trials (RCTs) are usually considered to be theoretically and practically incompatible. However, we argue that their respective strengths and weaknesses can be complementary. We illustrate our argument from a recent study assessing the effect of telemonitoring on health-related quality of life, self-care, hospital use, costs and the experiences of patients, informal carers and health care professionals in two urban hospital services and one remote rural primary care service in New Zealand. Methods Data came from authors' observations and field notes of discussions with three groups: the healthcare providers and healthcare consumers who participated in the research, and a group of 17 researchers and collaborators. The consumers had heart failure (Site A, urban), airways disease (Site B, urban), and diabetes (Site C, rural). The research ran from 2008 (project inception) until 2012 (project close-off). Researchers came from a wide range of disciplines. Both RCT and AR methods were recognised from early in the process but often worked in parallel rather than together. In retrospect, we have mapped our observed research processes to the AR cycle characteristics (creation of communicative space, democracy and participation, iterative learning and improvement, emergence, and accommodation of different ways of knowing). Results We describe the context, conduct and outcomes of the telemonitoring trial, framing the overall process in the language of AR. Although not fully articulated at the time, AR processes made the RCT sensitive to important context, e.g. clinical processes. They resulted in substantive changes to the design and conduct of the RCT, and to interpretation and uptake of findings, e.g. a simpler technology procurement process emerged. Creating a communicative space enabled co-design between the researcher group and collaborators from the provider participant group, and a stronger RCT design. Conclusions It appears possible to enhance the utility of RCTs by explicitly embedding them in an AR framework to shape stronger RCT design. The AR process and characteristics may enable researchers to evaluate telehealth while enhancing rather than compromising the quality of an RCT, where research results are returned to practice as part of the research process. Trial registration Australian New Zealand Clinical Trials Registry, reference ACTRN12610000269033 .

PurposeThis article aims to explore the meanings of positionality and demonstrate how reflective memos can illustrate positionality in a constructivist grounded theory (CGT) study.Design/methodology/approachAcknowledging the positionality of the researcher through a reflective approach is an essential element of CGT studies. The first author (IS) used reflective memoing in her CGT study on Indian immigrant children's asthma to practice reflexivity and make her positionality explicit. Through memos, IS acknowledges her knowledge, beliefs, practices, experience and pre-existing assumptions about the research topic. This article is a compilation of the reflective memos that IS wrote during the initial phase of her research and draws on her motivations as they relate to the topic under study in the context of current literature.FindingsThe reflective accounts of a researcher's background and experience can act as a lens for understanding the research question and the choice of methodology.Practical implicationsThis article may be useful to novice qualitative researchers who are struggling to define and establish their own positionality. John Dewey's and David Schon's works on reflective thinking serve as valuable tools to practice reflexivity. Philosophically underpinned reflections in the form of memos, employed from the outset and throughout the study, can enhance the study rigour by making research decisions transparent.Originality/valueThis article provides practical guidance on how to outline positionality at the outset of a CGT study.

Der symbolische Interaktionismus (SI), eine Perspektive zum Verständnis menschlichen Verhaltens, wird gemeinhin als Grundlage für die Grounded-Theory-Methodologie (GTM) angesehen. Der Zweck der GTM besteht jedoch darin, aus Daten eine substanzielle, erklärende Sozialtheorie zu erstellen, ohne sich auf vorherige Annahmen zu stützen. Daher argumentieren einige, dass SI eine unnötige theoretische Einschränkung des Hauptziels der GTM - der freien Konzeptualisierung von Daten - darstelle. In diesem Artikel verwenden wir Beispiele aus einer laufenden konstruktivistischen Grounded-Theory-Studie über die Aushandlung der Rollen von Krankenschwestern in der Allgemeinmedizin in Neuseeland, um zu zeigen, was SI in Bezug auf die konzeptionelle Entwicklung und das Verständnis des Kontextes beitragen kann. Wir argumentieren, dass durch das Stellen von drei Fragen aus einer symbolisch-interaktionistischen Perspektive in jeder Phase des Forschungsprozesses die Freiheit der Konzeptualisierung erhöht und das Bewusstsein für kontextuelle Belange gefördert werden kann, um eine bessere Brücke zwischen den Weltsichten zu schlagen.