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The Negotiated Identities Of Refugee-Background Women During Resettlement, Iuliia Fakhrutdinova Aug 2026

The Negotiated Identities Of Refugee-Background Women During Resettlement, Iuliia Fakhrutdinova

Graduate Doctoral Dissertations

Refugee-background women experience unique challenges while resettling in the U.S. as they navigate complicated transnational gender roles, education gaps, migration trauma, learning a new language, and literacy in the adaptation process during resettlement, which can derail the productive paths they are on. Therefore, ignoring refugee-background women’s unique experiences and failing to understand their identities prevents our society from doing social justice and creating a space for a smooth adaptation to the new context. Language plays a paramount role in identity formation, as it moves away from the belief that identity is an essential concept. For refugee-background women during resettlement, their …


Home, Neighborhood, And Community Environments And Social Isolation In Later Life: Joint Associations And Their Moderation By Life-Course Socioeconomic Mobility, Jeein Law Aug 2026

Home, Neighborhood, And Community Environments And Social Isolation In Later Life: Joint Associations And Their Moderation By Life-Course Socioeconomic Mobility, Jeein Law

Graduate Doctoral Dissertations

Social isolation is a major public health concern among older adults, yet less is known about how multilevel residential environments shape isolation among those aging in place. Guided by the Socio-Ecological Model, Person–Environment Fit, and a life-course perspective, this dissertation examined whether micro-level home hazards, meso-level neighborhood social cohesion and physical disorder, and macro-level census-tract structural conditions were associated with social isolation. It also examined whether life-course socioeconomic mobility moderated the associations between home and neighborhood environments and social isolation.

This dissertation used two nationally representative longitudinal studies of U.S. older adults. Aims 1 and 2 used the National Health …


Waves Of Exhaustion, Currents Of Renewal: An Autoethnography Of Academic Emotional Burnout And Recovery, Rofiza Aboo Bakar Aug 2026

Waves Of Exhaustion, Currents Of Renewal: An Autoethnography Of Academic Emotional Burnout And Recovery, Rofiza Aboo Bakar

The Qualitative Report

This autoethnography explores my experience of academic burnout and emotional recovery as a mid-career female educator in a Malaysian public university. Drawing from reflective journals, memory work, and embodied recollections between 2023 and 2025, I trace a personal journey through three experiential phases: the weight of expectations, burnout and emotional rupture, and embodied recovery through open sea swimming. The narrative is guided by Chang’s (2016) thematic structuring approach and interpreted through Lazarus and Folkman’s (1984) Transactional Model of Stress and Coping. My story reveals how burnout was not the result of overwork, but of institutional erasure. As I navigated the …


With Students, As A Student: Using Reflexive Autoethnography To Make Sense Of Navigating Student–Researcher Liminality In A Ph.D., Melody Bishop Aug 2026

With Students, As A Student: Using Reflexive Autoethnography To Make Sense Of Navigating Student–Researcher Liminality In A Ph.D., Melody Bishop

The Qualitative Report

Postgraduate researchers (PGRs) are increasingly encouraged to practice reflexivity. But there is a lack of PGR-authored literature about what it means to negotiate multiple identities, particularly for student–researchers doing research with students. This paper explores challenges experienced during a longitudinal Ph.D. project involving undergraduate students with long-term health conditions. I present outcomes of a reflexive autoethnographic analysis of a diary kept making sense of research challenges, including holding dual positions as a student–researcher at the same institution. Drawing on the notion of liminality, I argue that the boundaries between my student–researcher identities, and between myself and participants, have been consistently …


A Post-Positivist Perspective On The Varieties Of Qualitative Research: The Foris Framework, Marius Bytautas Aug 2026

A Post-Positivist Perspective On The Varieties Of Qualitative Research: The Foris Framework, Marius Bytautas

The Qualitative Report

With the aim of bringing clarity to the realm of qualitative research—and offering a transition from tradition to methodological rationale—I employ Millian and Popperian inductive analysis methods to build a post-positivist account regarding the diversity of qualitative research varieties. I am responding to the problem that common labels in qualitative research often obscure the epistemic reasoning through which a study approaches its object. A brief set of working definitions is introduced to support the framework, but the main contribution is the conceptualization of research approach in five dimensions: focus, orientation, relation to the object, researcher intrusiveness, and scale (FORIS). By …


Community-Based Research: Key Considerations For Researchers And Community Partners When Collaborating, Bothwell Piason, Kathleen A. Fox Aug 2026

Community-Based Research: Key Considerations For Researchers And Community Partners When Collaborating, Bothwell Piason, Kathleen A. Fox

The Qualitative Report

Community-based research (CBR) is a research orientation that emphasizes equitable engagement in the process of knowledge production, though researchers and community partners may navigate collaborative partnerships with differing expectations, priorities, and understandings of success. Extant research has demonstrated that successful CBR partnerships can benefit both researchers and community partners, yet little is known about how both groups simultaneously conceptualize successful collaboration across diverse partnership contexts. In this study, we ask: What considerations do researchers and community partners identify as important when engaging in community-based research partnerships? Drawing on semi-structured interviews with 10 university researchers and 10 community partners engaged in …


The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea Aug 2026

The Lived Spirituality Experiences Of Adult Diabetes Patients In Adhering To Treatment, Dwight Mahaputera Marulitua Hutapea

The Qualitative Report

This descriptive phenomenological study explored the lived spirituality experiences of adult patients with Type 2 Diabetes Mellitus (T2DM) in adhering to treatment. Prior research has indicated that spirituality may influence attitudes toward and adherence to chronic disease management; however, empirical evidence addressing the spiritual dimension among people with diabetes remains limited. Guided by Colaizzi's (1978) phenomenological method, in-depth interviews were conducted with 12 purposively selected participants, equally distributed among Christians and Muslims. All interviews were transcribed verbatim and subjected to rigorous phenomenological analysis. Seven themes emerged from the data analysis: (a) spirituality strengthens relationships; (b) spirituality affects choices and outcomes; …


Autoethnography: Understandings, Evolution, And The Influence Of Genai, Prokopis Christou Aug 2026

Autoethnography: Understandings, Evolution, And The Influence Of Genai, Prokopis Christou

The Qualitative Report

Autoethnography occupies a central place within qualitative research because of its focus on lived experience, reflexivity, and meaning-making. In this paper, I critically examine the implications of generative artificial intelligence (GenAI) for autoethnographic inquiry through a reflexive and theoretically informed discussion situated within the contemporary AI-mediated era. By revisiting key understandings and developments of autoethnography while drawing on technological mediation theory, I explore how GenAI extends beyond a mere tool to become a mediating mechanism capable of profoundly shaping autoethnographic practice. Attention is given to how seemingly minor AI-generated alterations may transform lived experience into more polished, coherent, and emotionally …


Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells Aug 2026

Relational-Developmental Autoethnography: A Method Of Qualitative Inquiry That Fosters Personal Growth, Chris Wells

The Qualitative Report

This paper introduces relational–developmental autoethnography (RDA), a qualitative method for exploring psychological growth through personal writing and reflection. Developed through lived experience, RDA traces psychological development through sustained, recursive engagement with personal writing. Drawing on an archive of my journals, letters, clinical records, and correspondence spanning more than 30 years, I show how writing and reflection were first tools for my survival, and later became catalysts for insight, healing, and transformation. RDA is grounded in two developmental frameworks: Dąbrowski’s theory of positive disintegration, which views emotional intensity and inner conflict as signs of developmental potential, and relational-cultural theory, which …


The Furry Community As A Case Study In Identity-Related Conflict, Patrick Hampton Aug 2026

The Furry Community As A Case Study In Identity-Related Conflict, Patrick Hampton

Graduate Masters Theses

The “furry” community has gained notoriety both on the internet and in physical spaces for the dramatic portrayal of animal-based personas referred to as “fursonas.” This group has become the subject of ridicule and moral concern due to the occasionally controversial nature of the content produced by some members of the community. However, there are many different interpretations both within and outside of the community around what the community entails. In this thesis, I examine how the furry community and the identity of its members is shaped by external pressure or social stigmatization? I answer this through the following three …


Comfort In Cases Of Sickness: Health And Colonialism At The Eastern Pequot Reservation, 1800-1850, Katherine N. Brauckmann Aug 2026

Comfort In Cases Of Sickness: Health And Colonialism At The Eastern Pequot Reservation, 1800-1850, Katherine N. Brauckmann

Graduate Masters Theses

Health and sickness were major concerns for the Eastern Pequot community in the first half of the 19th century. At this time, the Eastern Pequot’s collective finances were controlled by a court-appointed overseer who rented reservation land to non-Pequot individuals and used the generated funds to purchase goods and services for those on the reservation. In an 1841 petition to remove an overseer for failing in his duties, issues of health were brought up twice among their grievances: that they received little support “in Sickness or in health” and that “our Land if family rented […] would add much to …


Beyond Monolithic Narratives: The Interaction Of Ethnic-Racial Socialization And Resistance In Shaping Mental Health Among Black Immigrants In The U.S., Krystel Francis Aug 2026

Beyond Monolithic Narratives: The Interaction Of Ethnic-Racial Socialization And Resistance In Shaping Mental Health Among Black Immigrants In The U.S., Krystel Francis

Graduate Masters Theses

Black immigrants represent one of the fastest-growing segments of the U.S. Black population, yet their unique racialized and cultural experiences remain understudied within psychological research. This thesis examined how ethnic-racial socialization and resistance and empowerment against racism can influence how race-related stress was associated with psychological distress among Black immigrants in the United States. This study tested a moderated moderation model to determine whether ethnic-racial socialization and resistance and empowerment against racism, independently and jointly, buffered the adverse effects of race-related stress on psychological distress. Using data from a larger IRB-approved study on racism and mental health among people of …


Introduction To Film, Teresa A. Fisher Aug 2026

Introduction To Film, Teresa A. Fisher

Open Educational Resources

An introduction to the filmmaking process including film history, narrative, mise-en-scene, editing, cinematography, sound, and acting. Includes a chapter on documentary film, experimental film, and animation.


Comm 11 Fundamentals Of Interpersonal Communication Textbook, Teresa A. Fisher Aug 2026

Comm 11 Fundamentals Of Interpersonal Communication Textbook, Teresa A. Fisher

Open Educational Resources

A survey of interpersonal communication.


Effects Of A Shame-Focused Self-Compassion Writing Intervention In Individuals With Social Anxiety, Selen Amado Aug 2026

Effects Of A Shame-Focused Self-Compassion Writing Intervention In Individuals With Social Anxiety, Selen Amado

Graduate Doctoral Dissertations

The present study examined the efficacy of a brief, shame-focused self-compassion (SF-SC) writing intervention in reducing shame, social anxiety and related cognitive maintenance processes among individuals with elevated social anxiety. Shame is a core feature and maintaining factor of Social Anxiety Disorder (SAD), closely linked to self-focused attention, post-event processing, and self-criticism. Additionally, self-compassion demonstrates a robust inverse association with shame. However, few interventions have explicitly targeted shame as a primary mechanism of change using self-compassion strategies in socially anxious populations. Using a randomized controlled design, 94 participants with elevated levels of social anxiety and shame were assigned to either …


Effect Of Vocational Training Programs On The Mental Health Of Indian Women Living In Contexts Of Urban Poverty (Or Urban Slums), Sriramya Potluri Aug 2026

Effect Of Vocational Training Programs On The Mental Health Of Indian Women Living In Contexts Of Urban Poverty (Or Urban Slums), Sriramya Potluri

Graduate Doctoral Dissertations

Women living in contexts of urban poverty (IWLCUP) experience disproportionately high rates of psychological distress, yet their mental health needs remain largely underrecognized. Beyond individualized explanations, broader ecological perspectives situate these women’s distress within previously underemphasized macrolevel forces and acknowledge the role of inequity and related structural disparities (e.g., economic, sociocultural, political etc.) in their oppression and disempowerment, thereby contributing to increased psychological vulnerability. Such frameworks call for intervention efforts that reduce individual psychological risk by addressing structural determinants proximally and distally impacting the lives of IWLCUP. Specifically, targeting poverty and economic insecurity might drive positive downstream effects that ultimately …


Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh Aug 2026

Cultural Responsiveness: Examining Assessments Of Therapists For Ethical And Clinical Outcomes (Create Clout), Tsotso T. Ablorh

Graduate Doctoral Dissertations

The Multicultural Counseling Competencies (MCC) and Multicultural and Social Justice Counseling Competencies (MSJCC) are well-researched and supported counseling practices for decreasing microaggressions in therapy and consequent attrition, lack of satisfaction, and maltreatment (Ratts et al., 2016; Sue et al., 1982). However, scholars critique existing methods for measuring therapists’ cultural responsiveness for being disconnected from therapeutic process and outcomes (Hays, 2020; Wilcox et al., 2020). This study examined which MSJCC measures associated with variables clinically and ethically relevant to better treatment outcomes and lower microaggressive, neglectful, and stereotypical treatment for hypothetical Black, female clients by White therapists. 62 White psychologists in …


Gendered Precarity, Informality And Survival Among Cambodian Women Migrants In Thailand, Sokha Eng Aug 2026

Gendered Precarity, Informality And Survival Among Cambodian Women Migrants In Thailand, Sokha Eng

Graduate Doctoral Dissertations

Migration scholars have long assumed that women migrant laborers move as individuals, leave family behind, are governed by labor migration policies, and are employed full-time. However, in the context of South-South migration, many workers migrate as families, with husbands, wives, and sometimes even children. Some engage in the informal economy, serving as casual and on-call workers. These types of employment fall outside the scope of standard labor migration policies and therefore receive less attention. As a result, migrants’ experiences in such work arrangements remain underexplored. This study examines the experiences of Cambodian migrant women in Thailand by examining the case …


A Discursive Analysis Of Lesbian And Queer Experiences Of Unwanted Consensual Sex, Sarah E. Swanson Aug 2026

A Discursive Analysis Of Lesbian And Queer Experiences Of Unwanted Consensual Sex, Sarah E. Swanson

Graduate Doctoral Dissertations

This study drew on a critical discursive psychology (CDP) analytical approach to examine how lesbian and queer participants made sense of unwanted consensual sex (UCS).  The data analysis traced how UCS was constructed on three discursive levels: the construction of UCS across narratives, the interpretive repertoires mobilized (including sexual scripts), and the broader sociocultural discourses that shaped what elements of their experiences were intelligible. Therefore, I sought to understand both how participants drew on familiar heteronormative and queer ways of talking about sex and how various discursive resources shaped how they could construct themselves and others. Data for this research …


Factorial Structure Of A Bilingual Progress Monitoring Tool For Mindfulness Interventions, Andrea V. Molina Palacios Aug 2026

Factorial Structure Of A Bilingual Progress Monitoring Tool For Mindfulness Interventions, Andrea V. Molina Palacios

Graduate Doctoral Dissertations

Mindfulness-based interventions (MBIs) are an increasingly popular option for schools to support youth in each of the multi-tiered systems of support (MTSS). MBIs have proven to increase attention, help with emotion regulation, decrease symptoms of anxiety and depression, and overall increase students’ wellbeing with a cost-effective package that makes it affordable for schools to implement. Moreover, MBIs have also proven to be effective for Hispanic youth who are at a higher risk of experiencing low access to mental health care and higher levels of poverty, which puts them at risk for dropping out and having low academic achievement. However, there …


From Structure To Experiences: How Facility Capacity And Staffing Shape The Adoption And Impact Of Lgbt-Affirming Policies In Long-Term Care, Andrew Alberth Aug 2026

From Structure To Experiences: How Facility Capacity And Staffing Shape The Adoption And Impact Of Lgbt-Affirming Policies In Long-Term Care, Andrew Alberth

Graduate Doctoral Dissertations

Long-term care (LTC) settings – including nursing homes (NHs) and assisted living facilities (ALFs) – provide necessary care for individuals with extreme health and functioning limitations. Sexual and gender minority (LGBT) older adults report challenges receiving effective, person-centered care LTC. Some LGBT older adults may hide their sexual orientation and gender identity when entering LTC settings or delay seeking needed LTC fearing discrimination from staff and other residents. Furthermore, staff in LTC settings indicate little awareness of LGBT-residents and possess inadequate LGBT-cultural competency necessary for providing person-centered care. Therefore, LGBT-residents LTC experiences remain underexplored in the broader research. Adopting LGBT-affirming …


Our Claims Matter: Latin American Migrants’ Nonviolent And Everyday Resistance Across Transnational Spaces, Pryanka Penafiel-Cevallos Aug 2026

Our Claims Matter: Latin American Migrants’ Nonviolent And Everyday Resistance Across Transnational Spaces, Pryanka Penafiel-Cevallos

Graduate Doctoral Dissertations

This dissertation examines how Latin American migrants engage in nonviolent resistance across transnational spaces in Ecuador, challenging dominant narratives that portray migrants primarily as passive actors or humanitarian subjects. Focusing mainly on Venezuelan, Colombian, and returned Ecuadorian migrants, the study places migrants’ political agency at the center of analysis. It asks how migrants resist, for what purposes, and under which conditions they mobilize nonviolent and everyday resistance practices to claim rights, dignity, and human security in a host country marked by both legal innovation and growing exclusion.

Drawing on civil resistance theory, everyday resistance approaches, and migration scholarship, the research …


Governing Climate Change For Sustainable Food Security In The Busoga Region Of Uganda, James Kintu Aug 2026

Governing Climate Change For Sustainable Food Security In The Busoga Region Of Uganda, James Kintu

Graduate Doctoral Dissertations

Busoga, Uganda's most sugarcane-intensive sub-region, hosts seven mills and an expanding outgrower economy, yet remains among Uganda's most food-insecure areas, with over half of its households food-insecure. This study examined how governance of climate change and sugarcane expansion shapes capabilities for food access, land tenure, and decision-making among women, youth, and land-poor households in Jinja and Buyende.

The study developed an integrated CA-CEP-RFS framework, combining the Capability Approach, Comparative Environmental Politics, and the Resilient Food Systems framework, with Sen's Entitlement Framework bridging capabilities to production, trade, own-labor, and transfer entitlements. A qualitative case study drew on a documentary review, 27 …


The Effect Of State Policy On Individuals With Mental Illness In Nursing Homes: A Multilevel Analysis, Adrita Barooah Aug 2026

The Effect Of State Policy On Individuals With Mental Illness In Nursing Homes: A Multilevel Analysis, Adrita Barooah

Graduate Doctoral Dissertations

ABSTRACT

THE EFFECT OF STATE POLICY ON INDIVIDUALS WITH MENTAL ILLNESS IN NURSING HOMES: A MULTILEVEL ANALYSIS

August 2026

Adrita Barooah, B.Sc., University of Delhi, India

M.S., University of Massachusetts Boston

Ph.D., University of Massachusetts Boston

Directed by Professor Pamela Nadash

The proportion of individuals living with a mental illness in U.S. nursing homes has grown substantially over the past few decades (Fashaw et al., 2020), raising serious concerns about care quality, resource adequacy, and costs to both nursing homes and government payers. The lack of adequate resources and knowledge has resulted in sub-par mental health care (O'Connor et al., …


I Must Be Well, To Do Well: Examining The Relationship Between Toxic Stem Environments, Trauma, Stem Support, And Academic Outcomes Among Diverse Graduate Women In Stem, Aisha Farra Aug 2026

I Must Be Well, To Do Well: Examining The Relationship Between Toxic Stem Environments, Trauma, Stem Support, And Academic Outcomes Among Diverse Graduate Women In Stem, Aisha Farra

Graduate Doctoral Dissertations

Women, particularly Women of Colour (WOC), remain underrepresented in STEM. In the last two decades, research has sought to better understand women’s experiences in STEM, highlighting challenges such as isolation, sexism, and racism, which negatively impact mental health and STEM persistence. While these mental health challenges have been documented, further work is needed to examine how these experiences are related to trauma symptoms and physical health outcomes, as well as the mechanisms through which they shape academic outcomes. This quantitative study investigated the relationships among toxic STEM experiences (i.e., gendered racism, sexism, and isolation), trauma symptoms and physical health concerns, …


Level Of Discrimination Experienced By Gender In Athletic Trainers And Professional Athletic Training Students, Emily Ghaussy, Seungyeon Kim, Jennifer Xu, Emily Madrak Aug 2026

Level Of Discrimination Experienced By Gender In Athletic Trainers And Professional Athletic Training Students, Emily Ghaussy, Seungyeon Kim, Jennifer Xu, Emily Madrak

Clinical Practice in Athletic Training

Context: Although women make up the majority of the athletic training field, gender-based discrimination continues to exist in the profession. Previous research exists; however, more current research on gender discrimination in the workplace is limited. This cross-sectional study examined level of perceived gender-based discrimination experienced by credentialed women athletic trainers and athletic training students in comparison to men athletic trainers and athletic training students. Four hundred forty-six cisgender men and women athletic trainers and athletic training students participated in our study. The median age was 28 years among cisgender women and 35 years among cisgender men.

Methods: Participants completed a …


Process And Change In The Global Governance Of Sustainable Development, S. Beth Fascitelli Aug 2026

Process And Change In The Global Governance Of Sustainable Development, S. Beth Fascitelli

Graduate Doctoral Dissertations

In 2015, to euphoric acclaim, the world adopted the 2030 Agenda for Sustainable Development. But with less than five years to deliver its seventeen Sustainable Development Goals (SDGs), the Agenda’s “transformational vision” remains unrealized. To understand why, this dissertation looks not to the Agenda’s implementation but to its birth, asking how the three-year process that produced it was designed, implemented, and experienced, and whether its mechanisms reinforced or challenged the structures that shape global sustainability governance. The premise is simple: how global agreements are negotiated matters as much as their substance. The study thus pushes back against a celebratory view …


Shaping Disease: Colonial Stigma And The Politics Of Health In Banyuwangi, The Early Twentieth Century, Rifa'i Shodiq Fathoni, Skriptyan Noor Hidayatullah Syuhri, Vini’Matu Hikmah, Ardhita Zahra Namira Aug 2026

Shaping Disease: Colonial Stigma And The Politics Of Health In Banyuwangi, The Early Twentieth Century, Rifa'i Shodiq Fathoni, Skriptyan Noor Hidayatullah Syuhri, Vini’Matu Hikmah, Ardhita Zahra Namira

Paradigma: Jurnal Kajian Budaya

This article examines the colonial stigma attached to Banyuwangi as an “unhealthy region” in the early 20th century, a label used to justify massive exploitation of its natural resources. Using a historical method, this research analyzes how this stigma not only served as a tool for colonial legitimation but also causatively created conditions that triggered ecological disasters and a public health crisis in a previously isolated area. Through an analysis of primary sources such as colonial reports, health journals, and newspapers, this article traces how large-scale plantation exploitation, enabled by the stigma, led to deforestation, uncontrolled labor migration, and poor …


Transmutation Of Psychological Phenomena (Academic Burnout And Fomo) Into Cyanotype Art Creation, Zulfan Ali Mujtaba, Adi Kuntoro Aug 2026

Transmutation Of Psychological Phenomena (Academic Burnout And Fomo) Into Cyanotype Art Creation, Zulfan Ali Mujtaba, Adi Kuntoro

Paradigma: Jurnal Kajian Budaya

The pressure of hustle culture and the Fear of Missing Out (FOMO) in the digital era have triggered an escalation of academic burnout among students, demanding alternative psychological recovery interventions beyond verbal clinical approaches. This research aims to explore the creation of alternative Cyanotype photography as a medium for catharsis and resistance against toxic productivity. Utilizing a Practice-Based Research methodology with an autoethnographic approach, data were extracted from the researcher's subjective experiences and transmuted into a visual artifact titled "Metamorfosis yang Lelah". The cultural studies approach and wabi-sabi aesthetics are specifically applied to analyze visual elements in the Prussian Blue …


“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne Aug 2026

“When I’M Not Heard, I Feel Like I Don’T Matter”: Advancing Equity In Disability Policy Through Critical Participatory Action Research With People With Intellectual Disability, Cris Marchionne

Student Theses

People with intellectual disability deserve a system that offers flexible, timely, and person-centered support — one that is innovative, sustainable, and holistic in enabling them to live fulfilling lives. This qualitative study, grounded in Critical Participatory Action Research (CPAR), examines how people with intellectual disability experience participation in decision-making within New York State's disability service system. By centering lived experience, the study identifies factors that facilitate or hinder participation in decision-making and examines structural, social, and policy-related barriers that limit agency. Through six focus groups and a Photovoice project with self-advocates receiving OPWDD services, participants described systemic barriers that limited …