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How Can Egypt’S Technical And Vocational Education System Be Adapted To Improve The Employability Of Autistic Youth And Adults?, Miriam A. Menkarious
How Can Egypt’S Technical And Vocational Education System Be Adapted To Improve The Employability Of Autistic Youth And Adults?, Miriam A. Menkarious
Theses and Dissertations
This thesis provides original qualitative evidence on autism, employability, and TVET in an LMIC context, focusing on Egypt’s ongoing TVET reforms. The research investigated barriers and facilitators to employment for autistic youth and adults in Egypt, with a particular focus on technical and vocational education and training (TVET) as a potential pathway into work, and explored stakeholder perspectives on the potential, barriers, and conditions for adapting the Egyptian TVET system to improve their employability. Using the International Classification of Functioning, Disability, and Health (ICF) framework, this qualitative study relied on 20 semi-structured in-depth interviews with autistic youth and adults, parents …
Workers Authoring Assessment: Play And Power In Early Childhood Education, Phoebe M. Gilpin
Workers Authoring Assessment: Play And Power In Early Childhood Education, Phoebe M. Gilpin
Theses and Dissertations
Researchers assert that play-based pedagogy is an effective approach to teaching young children, but there is less consensus on the specific methods of play-based teaching. This mixed-methodology exploratory case study investigated early childhood (EC) educators’ conceptualizations of play-based pedagogy in three phases: Phase 1’s quantitative measure testing found a mismatch between researchers’ conceptualization of play-based pedagogy and EC educators’ (n=183) understandings. In Phase 2, EC educators (n=3) articulated their perspectives about teaching through play and co-authored a new tool, the Teacher-Authored Play and Teaching Scale (TAPTS). Within Phase 3, EC educators (n=60) completed the TAPTS, which I interpreted through a …
Identifying The Brain Circuits Involved In Religious Obsessive-Compulsive Disorder, Kiana Bunnell
Identifying The Brain Circuits Involved In Religious Obsessive-Compulsive Disorder, Kiana Bunnell
Theses and Dissertations
Obsessive-compulsive disorder (OCD) is an often-debilitating psychiatric disorder involving a pattern of obsessive thoughts and compensatory compulsions. Symptoms tend to be chronic, leading to substantial emotional burden and significant impairment across multiple domains of daily functioning. Previous research has identified some consistency in the brain regions implicated in OCD. In particular, cortico-striato-thalamo-cortical (CSTC) circuitry has been linked to behavioral features commonly observed in OCD. Moreover, some studies suggest that distinct patterns of brain activation and functional connectivity may be associated with different OCD symptom dimensions, though findings have not been consistent. One symptom dimension of OCD (scrupulosity) is characterized by …
Analyzing The Transition From Writing Center Tutor To Graduate Student Instructor, Luci Mackenzie Sullivan
Analyzing The Transition From Writing Center Tutor To Graduate Student Instructor, Luci Mackenzie Sullivan
Theses and Dissertations
Writing center tutoring is almost universally considered to be beneficial preparation for graduate student instructors (GSIs) of writing, so much so that many programs require writing center experience as part of their GSI training. Despite various similarities between the roles of tutor and teacher, the precise ways in which writing center experience influences GSIs as teachers remain unclear. This IRB-approved, mixed-methods study builds on previous empirical scholarship on transfer between tutoring and teaching to determine how new GSIs with previous writing center experience integrate practices, knowledge, and dispositions developed in the writing center. My findings echo those of previous studies …
Service Providers' Descriptions Of Survivors' Experiences With Mental Health Treatment, Melanie Gonzales Puente
Service Providers' Descriptions Of Survivors' Experiences With Mental Health Treatment, Melanie Gonzales Puente
Theses and Dissertations
Human trafficking survivors experience significant mental health challenges and barriers that limit their engagement towards treatment. A qualitative study was conducted that included semi-structured interviews of 33 professionals working with survivors of human trafficking in the United States. Findings indicate that survivors' engagement in treatment is limited by mistrust of providers, stigma, and a lack of access to services. Providers emphasize that addressing basic needs (e.g., safety and housing) must occur before engaging in trauma-focused therapy. Positive outcomes are associated with strong therapeutic relationships, autonomy, trauma-informed, individualized care, and offering comprehensive services. Furthermore, mental health providers should have certain abilities …
The Informal Impact Of The Headscarf Ban On Veiled Students’ Everyday University Experiences In Paris, Farah K. Lotfy
The Informal Impact Of The Headscarf Ban On Veiled Students’ Everyday University Experiences In Paris, Farah K. Lotfy
Theses and Dissertations
This study examines the informal impact of the 2004 headscarf ban on the everyday university experiences of veiled students in Paris. Although the ban applies formally to public schools rather than universities, the wider social climate surrounding laïcité and the veil continues to influence how veiled students experience visibility, belonging, and participation in higher education.
Using a qualitative approach based primarily on semi-structured interviews, supported by informal observations conducted within university spaces in Paris, the study explores how exclusion is experienced through stereotypes, scrutiny, social discomfort, self-monitoring, and anticipation of discrimination rather than through formal university policy. The research focuses …
The Human Side Of Humanitarian Work: Well-Being And Performance Among Aid Workers In Egypt, Mai Osama Kenawy
The Human Side Of Humanitarian Work: Well-Being And Performance Among Aid Workers In Egypt, Mai Osama Kenawy
Theses and Dissertations
Well-being and productivity are widely recognized as central to the work performance of humanitarian aid workers. Despite increasing attention to staff well-being, performance within the humanitarian sector in Egypt remains stagnant or, in some cases, declining. This study examines why expanded well-being initiatives have not yielded sustained performance improvements by examining how actors' external roles, organizational factors, and individual factors affect humanitarian workers’ well-being and work performance. A mixed-methods approach was adopted, combining ten in-depth interviews with humanitarian workers from international organizations, INGOs, and local NGOs, as well as a survey of eighty workers operating in the same context. The …
Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef
Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef
Theses and Dissertations
Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …
From Institutions To Families: Assessing The Progress Of Egypt’S National Strategy For Alternative Child Care Reform, Yasmine M. El Hagry
From Institutions To Families: Assessing The Progress Of Egypt’S National Strategy For Alternative Child Care Reform, Yasmine M. El Hagry
Theses and Dissertations
This study serves as a critical mid-term review of the Egyptian National Strategy for Alternative Care for Children and Youth without Parental Care (NACS) (2021-2030). The 10-year strategy overall goal is to shift from institutional care, such as orphanages, to family-based care, such as kafala, the Islamic alternative to legal adoption, for children deprived of parental care. While the global literature strongly advocates deinstitutionalization, empirical research on the operational risks and unintended harms that can arise during such complex transformations remains scarce.
Adapting the International Civil Service Effectiveness (InCiSE) Framework, this research uses a qualitative approach to diagnose the …
Ethical Recruitment In Graduate Education: How Labor Market Intelligence Shapes Messaging For Master’S Programs With Varying Career Outcomes, Alexander Charles Harm
Ethical Recruitment In Graduate Education: How Labor Market Intelligence Shapes Messaging For Master’S Programs With Varying Career Outcomes, Alexander Charles Harm
Theses and Dissertations
Graduate recruitment messaging increasingly incorporates labor market information (LMI) to communicate the value of master’s programs, yet little is known about how marketing and admissions professionals decide when and how to use this data. This qualitative single-case study examines how recruitment and marketing professionals at a public research institution leverage LMI when framing the value of master’s programs with varying career outcomes. Drawing on interviews and analysis of recruitment materials, the study explores how data related to salary, job growth, and employer demand are selectively incorporated into recruitment messaging, shaping how program value is communicated to prospective students. While research …
The Role Of Risk And Resilience In Psychological Distress: An Application Of The Minority Stress Model, Rachel Clair Franklin
The Role Of Risk And Resilience In Psychological Distress: An Application Of The Minority Stress Model, Rachel Clair Franklin
Theses and Dissertations
LGBT individuals experience disproportionate levels of psychological distress compared to heterosexual populations, often attributed to minority stressors, including experiences of discrimination and victimization. Guided by the Minority Stress Model, the present study examined whether social and community support moderated the relationship between minority stress and psychological distress, and whether rejection sensitivity and fear of discrimination mediated these associations. Data were collected from a sample of 251 individuals who self-identified as lesbian, gay, bisexual, or transgender in the United States. Multiple regression, moderation, and mediation analyses using the PROCESS macro were conducted to examine relationships among experiences of discrimination, sexuality-based victimization, …
Comparison Of Degree Attainment Between Traditional And Nontraditional Community College Transfer Students From The Beginning Postsecondary Students Longitudinal Study, Diann Mills Nichols
Comparison Of Degree Attainment Between Traditional And Nontraditional Community College Transfer Students From The Beginning Postsecondary Students Longitudinal Study, Diann Mills Nichols
Theses and Dissertations
Nontraditional students have been part of higher education for over a century, yet their enrollment has increased substantially in recent decades and is expected to continue rising. Many return to college to gain credentials and skills needed for career advancement or reentry into the workforce. Despite their growing presence, nontraditional students remain less likely than traditional students to complete a degree within six years, often due to competing responsibilities such as work, family obligations, and financial strain. The purpose of this study was to compare nontraditional community college students who transferred to four-year institutions with their traditional counterparts in terms …
Intersection Of Food Insecurity And Housing Among Veterans And Disabled Adults, Julie Anne Stepp
Intersection Of Food Insecurity And Housing Among Veterans And Disabled Adults, Julie Anne Stepp
Theses and Dissertations
This study examines how housing tenure is associated with food insecurity (FI) among veterans and adults with disabilities, utilizing the housing-food insecurity nexus framework. Previous research documents elevated FI among veterans and individuals with disabilities, yet few studies assess housing tenure as a mechanism connecting these statuses to food hardship. Using data from the 2024 National Health Interview Survey Adult Sample (n=32,629), logistic regression models estimate the independent and interactive effects of renting, veteran status, and disability status on FI. Results suggest renters have significantly higher odds of FI than homeowners, even after adjusting for poverty status, SNAP participation, and …
The Cost Of Compassion: Mixed Methods Insights Into Healthcare Chaplains’ Experiences Of Workplace Violence, Dana Fachner
The Cost Of Compassion: Mixed Methods Insights Into Healthcare Chaplains’ Experiences Of Workplace Violence, Dana Fachner
Theses and Dissertations
Healthcare workers’ exposure to workplace violence has been well documented, with research emphasizing both its frequency and severity among clinical staff like physicians and nurses. Still, one group remains markedly overlooked: healthcare chaplains. Despite their frequent presence in high-stress, unpredictable, and emotionally charged situations, chaplains have never before been included in research regarding healthcare workers’ exposure to workplace violence. Healthcare chaplains provide spiritual and emotional care to patients, families, and staff by offering support that is culturally sensitive and appropriate to patients’ religious traditions. Chaplains collaborate with medical teams to deliver holistic care and are involved in a wide range …
Under The Guardianship: Experiences Of Mothers In Egypt’S El Nayaba El Hesbaya, Hana Khayry
Under The Guardianship: Experiences Of Mothers In Egypt’S El Nayaba El Hesbaya, Hana Khayry
Theses and Dissertations
This thesis explores the intersectional lived experience of El Nayaba El Hesbaya in Egypt. El Nayaba El Hesbaya, operating under Law 119/1952, is the administrative and judicial body responsible for overseeing the financial and legal affairs of minors whose father or mother had passed. Hundreds of thousands of mothers in Egypt have (had) children under the guardianship of El Nayaba El Hesbaya. This research delves into the experience of mothers whose children are or were under the guardianship of El Nayaba El Hesbaya, examining how it shape(s/d) their everyday life as women, mothers, widows or ex-wives, citizens, and legal subjects. …
Toward Transformative Social Protection: Integrating Economic Empowerment And Addressing Graduation Challenges In Egypt’S Takaful And Karama Program, Mennatalla Ahmed Zayed
Toward Transformative Social Protection: Integrating Economic Empowerment And Addressing Graduation Challenges In Egypt’S Takaful And Karama Program, Mennatalla Ahmed Zayed
Theses and Dissertations
This study investigates how Egypt's Takaful and Karama Program (TKP) can enhance long-term poverty reduction and program sustainability through the inclusion of economicempowerment interventions. Based on the frameworks of Social Risk Management 2.0 and Transformative Social Protection, the study places Egypt's experience in the context of international discussions about conditional cash transfers, multidimensional poverty, and graduation models. The study uses a qualitative methodology, conducting semi-structured interviews with academics, civil society experts, and policymakers. The interviews' findings are supported by content analysis of policy documents and impact evaluations on TKP and Forsa. According to the research analysis, cash transfers help alleviate …
Women Representation In Higher Education Leadership In Egypt: A Qualitative Study, Eman Fouda
Women Representation In Higher Education Leadership In Egypt: A Qualitative Study, Eman Fouda
Theses and Dissertations
The purpose of this research is to investigate women representation in higher education leadership in Egypt. Currently, the representation of women in leadership roles in higher education is not proportionate to the percentage of women in Egypt, or even to the percentage of women employed in education. The importance of this topic arises from the implications of gender inequality. This research explores the perceptions of women in higher education regarding the social and cultural barriers that hinder their advancement to leadership positions. The discussion is in light of the social dominance theory and the cultural and social issues that stand …
Keeping It Together: Assessing The Wellbeing Of Project-Based Development Practitioners In Egypt, Amira Ahmed Abdallah Fekry Ahmed
Keeping It Together: Assessing The Wellbeing Of Project-Based Development Practitioners In Egypt, Amira Ahmed Abdallah Fekry Ahmed
Theses and Dissertations
This thesis examines the wellbeing of project-based development practitioners in Egypt, revealing how systemic pressures—bureaucracy, job insecurity, and fragmented workloads—undermine both wellbeing and productivity. The study employed a mixed-approach, combining 10 in-depth interviews with subject matter experts and practitioners and 75 surveys with development practitioners in Egypt. Data revealed that while many practitioners are driven by purpose, structural challenges erode resilience and motivation over time. Social support networks and personal coping strategies help but cannot replace institutional protections. The study argues that wellbeing must shift from being treated as an individual concern to a structural responsibility. Reframing organizational models around …
The Relationship Of Federal Title V Funding To Retention And Graduation Rates Of Hispanic-Serving Institutions In The Southeastern United States, Julio Cesar Llanos Jr.
The Relationship Of Federal Title V Funding To Retention And Graduation Rates Of Hispanic-Serving Institutions In The Southeastern United States, Julio Cesar Llanos Jr.
Theses and Dissertations
The number of Latino/a or Hispanic students, also known as Latinx students, are expected to grow demographically in various regions of the United States over the next several years. To ensure Latinx students are progressing toward graduation in their respective cohorts, it may be beneficial to anticipate and prepare for the increase in this student demographic. This study focused on institutions in the Southeastern region of the United States. This study compared the relationship of federal Title V funding and retention rates and graduation rates of students; it also compared degrees awarded to Hispanic students and enrollment of Hispanic students …
Constructing And Deconstructing Homelessness: Challenging The Stigmatization Of The Unhoused Through Lived Experience, Brenna Jones
Constructing And Deconstructing Homelessness: Challenging The Stigmatization Of The Unhoused Through Lived Experience, Brenna Jones
Theses and Dissertations
As homelessness rises across the United States, public discourse plays an important role in shaping how the housing crisis is understood and addressed. This study examines how homelessness is constructed through local media narratives and how these constructions shape the experiences of unhoused individuals. Using a case study of Greater Bangor, Maine, this research combines a critical content analysis of 315 news articles from the Bangor Daily News (2020-2025) with in-depth interviews with 18 unhoused and precariously housed individuals. The findings demonstrate how media portrayals construct homelessness as a stigmatized identity associated with disorder, addiction, and danger. These narratives contribute …
Child Maltreatment Risk Identification In Complex Caregiving Environments: A Public Health Review Of Split-Custody And Multi-Household Family Contexts, Makenzie Lee
Theses and Dissertations
Child maltreatment remains a significant public health concern with lifelong consequences for children's health, development, and well-being. As children's caregiving environments become increasingly diverse through split-custody arrangements, blended families, kinship care, and other multi-household contexts, recognizing and assessing child safety concerns may become more complex. Although these family structures are not inherently associated with maltreatment, the distribution of caregiving responsibilities and information across multiple households may complicate child maltreatment risk identification.
This capstone presents a scoping review of peer-reviewed literature examining child maltreatment risk identification within complex caregiving environments. The review synthesized evidence related to caregiving environments, caregiver relationships, child …
Why We Stayed, Why We Left: A Hermeneutic Phenomenological Study Of Hispanic/Latino Child Welfare Professionals’ Experiences Of Organizational And Safety Culture, Cynthia Franco
Theses and Dissertations
This hermeneutic phenomenological study examines the lived experiences of Hispanic/Latino child welfare professionals who were formerly employed at a large urban public child welfare agency. Despite the growing representation of Hispanic/Latino children and families in child welfare systems and the strong vocational commitment of Hispanic/Latino professionals, this group remains underrepresented in the workforce and experiences notable patterns of early attrition. Grounded in safety science and psychological safety frameworks, this study explores how organizational culture, leadership practices, and identity-related dynamics shape professional meaning-making, well-being, and decisions to remain in or leave the field.
Data were collected through in-depth, semi-structured interviews and …
Moderators Of Change In Parent Child Relationship Quality In Trauma-Focused Cognitive Behavioral Therapy, Emilie Paul
Moderators Of Change In Parent Child Relationship Quality In Trauma-Focused Cognitive Behavioral Therapy, Emilie Paul
Theses and Dissertations
The parent-child relationship may protect children against negative mental health outcomes after trauma. One aim of evidence-based interventions for trauma-related symptoms in children is often to improve the parent-child relationship, as seen in trauma-focused cognitive behavior therapy (TF-CBT). This study investigated changes in parent-child relationship quality during TF-CBT in child-parent dyads. Participants were families receiving TF-CBT through a community-based training clinic as part of an ongoing open trial of TF-CBT (N=287). Children reported on relationship quality at pre-, mid-, and post-treatment. Multilevel growth modeling examined changes in relationship quality across TF-CBT and moderating effects of caregiver symptoms, homework completion, and …
The Relation Between Referral Source And Completion Of Trauma-Specific Assessment And Therapy In A Community-Based Training Clinic, Olivia Fiallo
The Relation Between Referral Source And Completion Of Trauma-Specific Assessment And Therapy In A Community-Based Training Clinic, Olivia Fiallo
Theses and Dissertations
In the United States, more than 60% of youth experience at least one trauma by age 16, and about one-third develop a trauma-related disorder. Evidence-based trauma-specific cognitive behavioral therapies (TS-CBTs) exist, yet fewer than 20% of trauma-exposed youth receive trauma-focused treatment, with dropout rates as high as 75% after treatment initiation. Referral sources are gatekeepers to TS-CBTs and may be a key system-level factor shaping barriers to starting and staying in treatment. This study examined whether referral source was associated with entry into and completion of a full TS-CBT service delivery pathway in a community-based trauma clinic. Participants were 346 …
Connectedness And Help-Seeking Among Veterans: Integrating The Andersen Behavioral Model And The Three-Step Theory Of Suicide, Samuel Ochinang
Connectedness And Help-Seeking Among Veterans: Integrating The Andersen Behavioral Model And The Three-Step Theory Of Suicide, Samuel Ochinang
Theses and Dissertations
Veteran suicide rates remain higher than those of nonveterans, yet many veterans who die by suicide are not engaged in care prior to death. Veteran help-seeking research often focuses on healthcare utilization, overlooking informal sources of support and the decision-making processes that precede service use. Connectedness is a central protective factor in suicide theory but has received limited attention within help-seeking models. This study examined how connectedness influences veterans’ willingness to seek help. Guided by the Andersen Behavioral Model and the Three-Step Theory of Suicide, this secondary analysis used data from the Military Health and Well-Being Project. The analytic sample …
Family- And Cultural-Level Influences For Latine Adolescent Nicotine Use: A Qualitative Study Informing Prevention, Cindy M. Hernandez Castro
Family- And Cultural-Level Influences For Latine Adolescent Nicotine Use: A Qualitative Study Informing Prevention, Cindy M. Hernandez Castro
Theses and Dissertations
Early tobacco use among Latine adolescents represents a critical public health concern, with 23.8% reporting current use and exceeding rates among other racial/ethnic groups (Birdsey et al., 2023; Gaddy et al., 2022). This early initiation elevates risks for nicotine dependence and related morbidity in adulthood (Tsao et al., 2023). Guided by Structural Ecosystems Theory (Szapocznik & Coatsworth, 1999) and contemporary grounded theory analysis (Braun & Clarke, 2006; Charmaz, 2006; Noble & Mitchell, 2016), this study examined multilevel influences on nicotine-related attitudes among Latine youth, including: (1) familial factors (i.e., parental monitoring, caregiver-youth communication), (2) cultural dynamics (i.e., cultural values and …
Tuberculosis In Jim Crow Virginia, 1900-1972, Elizabeth Dooley
Tuberculosis In Jim Crow Virginia, 1900-1972, Elizabeth Dooley
Theses and Dissertations
Tuberculosis (TB) was a major public health concern in the United States, especially in the first half of the twentieth century. Transmission and treatment of the disease, which is spread between humans through close contact, was complicated by racial segregation laws in the South known as Jim Crow laws. Virginia subscribed to these laws, which played a role in how and where Black Virginians with TB could be treated. Segregated treatment facilities with an inadequate number of beds for the number of infected people and deaths in the state added to these complications of disease control and plan for eradication. …
Managing Identity, Claiming Expertise, And Emotional Labor: A Constructivist Grounded Theory Of The Experience Of People With Serious Mental Illnesses In Primary Care, Jeffrey Ciak
Theses and Dissertations
People with serious mental illnesses (SMI) die 15 to 20 years before their peers without mental illness primarily due to chronic physical health conditions. Preventative care and treatment for chronic physical health conditions primarily occurs through primary care, but the experience of people with SMI in primary care is understudied. This constructivist grounded theory dissertation explored the experiences of people with SMI in primary care. Theoretical sampling resulted in 19 participants who were adults with SMI and long-term anti-psychotic use. Data was collected through one-to-two-hour long intensive interviews. The analytical process occurred concurrently with data collection. The abductive analytical process …
Perceptions And Experiences Of Teachers Regarding How Their Students’ Attendance Rate Impacts Their Academic Achievement, John Logan Jr.
Perceptions And Experiences Of Teachers Regarding How Their Students’ Attendance Rate Impacts Their Academic Achievement, John Logan Jr.
Theses and Dissertations
Chronic absenteeism has emerged as a critical educational concern nationwide, particularly following the COVID-19 pandemic. National data indicate that chronic absence rates increased from 15% in 2019 to 28% in 2022, and in the targeted rural South Carolina district, 25% of students were chronically absent in 2022–2023, rising to 28% in 2023–2024. Persistent absenteeism is associated with lower academic performance, widened achievement gaps, and diminished long-term educational and workforce outcomes, especially among socioeconomically disadvantaged and minority students.
The purpose of this qualitative phenomenological study was to examine teachers’ perceptions and experiences regarding how students’ attendance rates influence academic achievement in …
Instructional Systems Design In Lesson Planning For Substance Use Treatment Groups: A Mixed Methods Exploratory Study, Michelle Robin Gould
Instructional Systems Design In Lesson Planning For Substance Use Treatment Groups: A Mixed Methods Exploratory Study, Michelle Robin Gould
Theses and Dissertations
This study explored lesson planning for substance use disorder (SUD) treatment groups, investigating the presence of components from the ADDIE (Analysis, Design, Development, Implementation, Evaluation) instructional systems design (ISD) process in routine facilitator lesson planning practices. Using an exploratory mixed-methods convergent parallel design, data were collected via an online survey featuring closed- and open-ended questions regarding self-reported planning activities and perceived effectiveness. Quantitative analysis confirmed that SUD facilitators perform tasks associated with all five ADDIE phases. Qualitative findings showed that facilitators perceive themselves as effective planners despite logistical and organizational constraints. However, facilitators do not appear to conceptually link instructional …