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Articles 361 - 390 of 413
Full-Text Articles in Educational Psychology
Collective Teacher Efficacy And Its Enabling Conditions: Measurement And Associations, Christine Marie Anderson
Collective Teacher Efficacy And Its Enabling Conditions: Measurement And Associations, Christine Marie Anderson
Graduate Research Theses & Dissertations
Background/Purpose: Over two decades of research has demonstrated that collective teacher efficacy has a significant effect on student learning, and numerous studies have explored environmental variables related to high levels of collective teacher efficacy (Donohoo, 2018, Donohoo et al., 2020; Eells, 2011; Hattie, 2016). Donohoo et al.’s (2020) enabling conditions for collective teacher efficacy (EC-CTES) propose a synthesized framework educational practitioners can implement to foster collective teacher efficacy in their schools. The purpose of this quantitative study was to explore the validity of Donohoo et al.’s (2020) emerging EC-CTES and evaluate the strength and direction of its relationship to measures …
Black Women And Identity Development: Educational Experiences Of Black Women And Their Motivation To Persist, Anne Marie Edwards
Black Women And Identity Development: Educational Experiences Of Black Women And Their Motivation To Persist, Anne Marie Edwards
Graduate Research Theses & Dissertations
This dissertation explores the impact of educational experiences on the identity development of undergraduate Black women attending a predominantly White institution. The dissertation was organized into three chapters. Chapter 1 is a literature review for publication. Chapter 2 is a research study for publication and Chapter 3 is a multi-media project that highlights the narratives of Black women in their own voices. In Chapter 1, I present a literature review that documents published works centering on Black women and identity development. The first purpose of the review of literature is to provide a timeline of research on Black women and …
Understanding Prosocial Teasing In Early Adolescence, Kristina Wiemer
Understanding Prosocial Teasing In Early Adolescence, Kristina Wiemer
Graduate Research Theses & Dissertations
Prosocial teasing is not well known or understood by educators. Prosocial teasing is intentional but playful verbal and non-verbal provocation meant to be taken non-literally by the target of the tease (Keltner et al., 2001) and is not an uncommon experience for students to have (Barnett et al., 2004). While much research has been conducted on social and emotional skills (Nix et al., 2013; Smith & Low, 2013), there is still a gap in the literature looking at how these skills relate to prosocial teasing. The current study examined and described middle school students’ use of prosocial teasing and their …
Single Parent And Caregiver Perspectives On The Effects Of Caregiver Stress And Iep Meeting Eligibility, Kevin Mark Carter
Single Parent And Caregiver Perspectives On The Effects Of Caregiver Stress And Iep Meeting Eligibility, Kevin Mark Carter
Walden Dissertations and Doctoral Studies
The problem examined in this phenomenological study is how single African American parents and caregivers perceive the impact of caregiver stress on communications, trust, and intent to negotiate with school personnel after participation in their child’s annual IEP eligibility determination meeting. This research is important because parents’ and caregivers’ perceptions of their IEP meeting engagement may identify and reduce impediments to the formation of successful alliances with school personnel. Attribution and self-determination theories were used to analyze, interpret, and codify the experiences of study participants. Purposive sampling was used to select 18 single, African American parents and caregivers for participation. …
Decision-Making Of Unionized Men Toward Work And Post-Secondary Education: A Qualitative Study, Angela Pesce
Decision-Making Of Unionized Men Toward Work And Post-Secondary Education: A Qualitative Study, Angela Pesce
Walden Dissertations and Doctoral Studies
High school graduates who opt for labor-based unionized positions, versus matriculating, are typically viewed as unable to matriculate, less intelligent and a myriad of other less desirable qualities. Current literature fails to showcase the decision-making experiences of unionized men who did not matriculate. There is also a gap regarding unionized mens’ perceptions on matriculation, including their reasons for not. This general qualitative study explored the career decision-making experiences of unionized men and their perceptions on postsecondary education through semi-structured interviews with 10 unionized men in Delaware and Pennsylvania. Purposeful and convenience sampling were used for recruitment through posted flyers within …
Experiences And Perceptions Of School Principals Regarding School Safety Programs And Bullying, Denise Lowe
Experiences And Perceptions Of School Principals Regarding School Safety Programs And Bullying, Denise Lowe
Walden Dissertations and Doctoral Studies
AbstractMany researchers have documented the continued problem with safety in U.S. schools, which may be related to bullying. Though the most effective way to address bullying in schools is schoolwide programs, limited information is available relating to principals’ views on safety programs in U.S. suburban high schools. Accordingly, this study included two research questions and eight interview questions to address the problem relating to safety programs and interventions with 12 principals in Catholic suburban high schools in Kansas and Missouri. Six distinctive themes emerged from the data based on participant answers to interview questions: effective safety intervention programs, mental health …
The Long-Term Effects Of Teacher Participation In Mindfulness-Based Stress Reduction, Germaine Pentsil
The Long-Term Effects Of Teacher Participation In Mindfulness-Based Stress Reduction, Germaine Pentsil
Walden Dissertations and Doctoral Studies
The purpose of this quantitative study was to determine the long-term effects of mindfulness-based stress reduction (MBSR) on student disciplinary behavior, student academic progress and teacher absenteeism within the educational environment, using the theoretical framework of the Pro-Social Classroom theoretical model. Furthermore, by observing the before and after patterns of middle school teacher absenteeism, middle school student disciplinary behavior, and middle school student academic progress, this study addressed whether mindfulness-based stress reduction techniques were beneficial to the teacher professional development process. This study included 75 survey responses from teachers that met the sampling criteria via the Walden Participant Pool, as …
Narrative Study Of Educational Stigmatization In Parents Of Indigenous Children With Fasd, Wendy Dianne Sherren-Doucette
Narrative Study Of Educational Stigmatization In Parents Of Indigenous Children With Fasd, Wendy Dianne Sherren-Doucette
Walden Dissertations and Doctoral Studies
Often public stereotyping and prejudicial attitudes follow parents of Indigenous children with FASD throughout their day-to-day life. Stigma affects Indigenous people, particularly parents of Indigenous children with FASD, in different facets of their lives. The purpose of this study was to explore the perceptions that parents of Indigenous school-aged children with FASD have had of their experiences with school personnel. The study was grounded in Goffman’s social stigma theory and used a narrative inquiry approach in an interview-style format which collected data for this study. The research question explored the experiences of six parents of Indigenous children with FASD with …
The Impact Of Family Dynamics And Treatment Times For Adhd Children, Margaret Wilson
The Impact Of Family Dynamics And Treatment Times For Adhd Children, Margaret Wilson
Walden Dissertations and Doctoral Studies
Attention deficit hyperactivity disorder (ADHD) is a serious mental health condition that affects many of children. Studies show that 42-77% of children with ADHD may not be receiving treatment. Factors such as parent ethnicity, race, preference for treatment, socioeconomics, and child gender have been studied but do not account for the high numbers of untreated children. Differences between parents has been shown to effect ADHD treatment, the potential effects of family dynamics, children living in single or dual parent families, on ADHD treatment has not been studied. This secondary analysis finds there is a relationship between family dynamics, with the …
Self-Efficacy Of College Students With A Learning Disability During Freshman Year, Nicole Renee Adams
Self-Efficacy Of College Students With A Learning Disability During Freshman Year, Nicole Renee Adams
Walden Dissertations and Doctoral Studies
AbstractThe current study sought to understand the phenomena of educational programming and academic self-efficacy. The conceptual framework for this study was based on social cognitive theories of academic self-efficacy and motivation. This qualitative study used interpretive phenomenological analysis to gain a broader understanding of experiences of academic self-efficacy and motivation in college students diagnosed with a specific learning disability. Ten participants were recruited with snowball sampling and semi-structured interviews were conducted to guide this research study. Results of this research support additional analysis as necessary to close the gaps presented in the college transition and campus life of students with …
Structured Training Programs For Direct Support Professionals On Behavior Intervention Support Plans, Melody Lane Barnes-Meisenhelder
Structured Training Programs For Direct Support Professionals On Behavior Intervention Support Plans, Melody Lane Barnes-Meisenhelder
Walden Dissertations and Doctoral Studies
Direct support professionals work with developmentally disabled individuals and are responsible for implementing behavior intervention support plans (BISPs). Little is known about the efficacy of supplemental BISP training in these professionals. The purpose of this quantitative experimental study was to investigate the efficacy of BISP training to improve knowledge and applied understanding of BISPs in direct support professionals. Social validation, treatment fidelity, and change theories served as the foundations of the study. Seventy-three newly hired direct support professionals were randomized into an experimental group with a 2-day workshop training or a standard training group. BISP knowledge was assessed before and …
Factors Predicting Counselor Education And Supervision Doctoral Student Career Choices, Lisa Corbin
Factors Predicting Counselor Education And Supervision Doctoral Student Career Choices, Lisa Corbin
Walden Dissertations and Doctoral Studies
Despite the increased need for counselor educators, less than half of graduates of counselor education and supervision (CES) programs enter into faculty positions after graduation. There is also a significant lack of diversity among counselor educators. Some researchers found that the quality of a mentoring relationship influences the mentee’s self-efficacy and career choice. The purpose of this quantitative survey research study was to explore the perceived quality of the participant’s mentoring relationship as measured by the Mentorship in Clinical Training Scale (MiCTS) and whether that score predicted the participant’s career choice or a change in career choice, investigate whether students’ …
Emotional Support Dogs’ Effects On Anxiety, Depression, And Somatization In Elementary Students, Truman Arthur James Spring
Emotional Support Dogs’ Effects On Anxiety, Depression, And Somatization In Elementary Students, Truman Arthur James Spring
Walden Dissertations and Doctoral Studies
Within the last few decades, there has been an ever-increasing clinical role for trained emotional support dogs (ESD) and their trained therapists in hospitals, courtrooms, and schools. More recently, within the last 5 years, there has been a prevalent trend toward introducing ESDs into schools, which has created an ongoing controversy about the legitimacy of this practice due to the lack of objective data and research on the topic. In this study, archival data analysis was conducted using data from 68 students with elevated scores for anxiety, depression, or somatization, 34 of which were in the treatment group and the …
District Scores And Demographics As Predictors Of State Mathematics Assessment Scores, Carlos Alexander Bocel
District Scores And Demographics As Predictors Of State Mathematics Assessment Scores, Carlos Alexander Bocel
Walden Dissertations and Doctoral Studies
Prior research in mathematical assessments has indicated varying results of predictive variables and further research has been recommended to support students, parents, teachers, and school administration. The purpose of this research was to determine how well a student’s performance on a mathematics domain at the state level may be predicted based on student’s midyear and end of the year assessment scores, race, gender, and socioeconomic status. The constructivist theoretical foundation was reviewed because of the impact that this theory has on the assessments being researched. Archival records (n = 100) for eighth grade students were received from suburban South Florida …
Challenges, Practices, And Preferences Of Postsecondary Accessibility Service Providers In Alberta When Implementing Accommodations For Invisible Disabilities, Tara-Jean M. Wenc
Challenges, Practices, And Preferences Of Postsecondary Accessibility Service Providers In Alberta When Implementing Accommodations For Invisible Disabilities, Tara-Jean M. Wenc
Walden Dissertations and Doctoral Studies
Although the last few decades have seen an improvement in postsecondary opportunities for students with invisible disabilities in Alberta, service providers at postsecondary institutions continue to struggle to ensure they provide reasonable accommodations in a timely manner. Research questions explored the current practices and challenges of postsecondary accessibility services providers in Alberta, Canada, and their preferences for verification documentation for students requesting accommodations for invisible disabilities. The conceptual framework was based upon the medical and social models of disability, as well as the emerging justice theory of disability. Data were collected via semistructured interviews with 13 participants. A constant comparative …
Self-Efficacy And Self-Regulation As Predictors Of Academic Motivation Among Undergraduate Students In The United States, Fatimah Aljuaid
Self-Efficacy And Self-Regulation As Predictors Of Academic Motivation Among Undergraduate Students In The United States, Fatimah Aljuaid
Dissertations
Problem
Some undergraduate students demonstrate lack of academic motivation which negatively affects engagement and perseverance in higher education (Busse & Walter, 2017; Rizkallah & Seitz, 2017; Dresel & Grassinger, 2013). Amotivated students are more likely to drop out of school and disengage from learning activities or underachieve (Wang & Pomerantz, 2009). Although the lack of academic motivation is correlated with deficiency in self-regulation and self-efficacy, relatively little studies have been conducted to examine the impact of these factors on academic motivation particularly in the U.S. This study constructed a hypothesized model to investigate the role of self-regulation and self-efficacy in …
An Exploratory Study Of Mathematics Anxiety In Caribbean Preservice Teachers, Franka Atwell-Chin Hong
An Exploratory Study Of Mathematics Anxiety In Caribbean Preservice Teachers, Franka Atwell-Chin Hong
Dissertations
The Problem
Correlational studies suggest that gender, attitudes to mathematics, mathematics performance, the number of college mathematics courses taken, and mathematics teacher efficacy beliefs may be related to mathematics anxiety among preservice teachers (Boyd et al., 2014; Gresham, 2018; Jaggernauth & Jameson-Charles, 2015). Exploratory studies of mathematics anxiety and teacher self-efficacy among elementary teachers exist in Trinidad and Tobago (Jaggernauth 2012; Jaggernauth & Jameson-Charles, 2015). However, the differences in samples, and weakness in methodology, may make it challenging to generalize the results to the preservice teacher population. In addition, no studies have found which variable or combination of variables is …
Pediatric Mental Health Hospitalizations And The Return To School: School-Based Provider Perspectives On Commmunication, Collaboration, And Systematic Practices, Lauren Elizabeth Carr
Pediatric Mental Health Hospitalizations And The Return To School: School-Based Provider Perspectives On Commmunication, Collaboration, And Systematic Practices, Lauren Elizabeth Carr
Dissertations
The provision of pediatric mental health services has changed greatly over the last several decades with more children and adolescents requiring intensive mental health treatment. Despite this increase, systemic barriers continue to prevent youth from receiving appropriate treatment following psychiatric hospitalization. An important aspect of this treatment process includes a child’s return to school, one of the most common environments for a child or adolescent outside of their home. For many children, the hospital-to-school transition team may include regular and special education teachers, school psychologists, social workers or therapists, psychiatrists, medical doctors, case managers, and nurses. Because of this, it …
Trauma-Informed Teacher Wellbeing: Teacher Reflections Within Trauma-Informed Positive Education, Tom Brunzell, Lea Waters, Helen Stokes
Trauma-Informed Teacher Wellbeing: Teacher Reflections Within Trauma-Informed Positive Education, Tom Brunzell, Lea Waters, Helen Stokes
Australian Journal of Teacher Education
For the last 15 years, teacher wellbeing has been a priority area of exploration within education and positive psychology literatures. However, increasing teacher wellbeing for those who educate students impacted by trauma has yet to be comprehensively explored despite repeated exposure of teachers to child trauma and their experiences of associated negative effects such as secondary traumatic stress, vicarious traumatisation, compassion fatigue and burnout. This study follows teachers’ understandings and reflections upon their own wellbeing after learning the literatures supporting trauma-informed positive education. Interpretative phenomenological analysis was used as the methodological approach to represent teachers (N = 18) in order …
Academic Goal Orientation: New Insights And Cultural Adaptation Of Academic Goal Orientation Questionnaire Into The Turkish Language, Fuat Findikoglu, Mehmet Gurol
Academic Goal Orientation: New Insights And Cultural Adaptation Of Academic Goal Orientation Questionnaire Into The Turkish Language, Fuat Findikoglu, Mehmet Gurol
Georgia Educational Researcher
This study aims to review and provide new perspectives for academic goal orientation. The study introduces first chronological history of goal orientation and depicts how goal orientation evolved into a new construct in learning from the discussion on motivational factors. At first, this study isolates goal orientation from motivation and provides novel insights into goal orientation as a separated factor affecting learning. Then, this study provides analyses of the adaptation work of the academic goal orientation questionnaire into the Turkish language. The translated scale was applied to a sample of 729 undergraduate students, 376 (51.6%) of which were female and …
Program Evaluation Of The J-1 Visa Teacher Exchange Program From The Perspective Of Exchange Teachers Within A Rural School District, Gradesa Lockhart
Program Evaluation Of The J-1 Visa Teacher Exchange Program From The Perspective Of Exchange Teachers Within A Rural School District, Gradesa Lockhart
Doctor of Education Dissertations
Teacher shortages have had a significant impact on student learning outcomes in a time of immense testing accountability; yet, the way rural school districts handle the teacher shortage varies, from policies to incentive pay, to the use of international teachers. International teachers have become a significant resource for some rural districts to address teacher shortages. This study focused on the lived experiences of a subset of international teachers who are working in United States schools via the Exchange Visitor Program (EVP). The findings of the study authenticated the purpose of the Fulbright-Hays Act of 1946, more commonly known as the …
Teacher Perceptions Of The Social Emotional Support Offered And Received Following The Return To School During The Global Pandemic In Two South Carolina Regions, Mindy Duckworth
Doctor of Education Dissertations
This study determined teacher perspectives of the social emotional learning (SEL) support offered and received following the return to school during a global pandemic caused by the COVID-19 virus. The study is important, not only to those who returned during the global pandemic or because states are requiring districts to think of the whole child but for educational leaders who are understanding the importance of delivering SEL for the purpose of educational growth. The research questions were answered through the lens of a mixed methods design through a combination of survey items and the results of the focus group. The …
The Role Of Math Anxiety And Math Self-Efficacy Levels On High School Equivalency Student Math Performance, Barbara A. Clarke
The Role Of Math Anxiety And Math Self-Efficacy Levels On High School Equivalency Student Math Performance, Barbara A. Clarke
Doctor of Education Dissertations
One of the most predominant measures of a community’s appeal is the high school graduation rate. National “best places to live” ratings utilize educational statistics to rank the quality of life in a community (Morse & Brooks, 2020). Additionally, an individual’s future prospects depend on a high school credential (HSC) as the minimum needed for postsecondary academics or gainful employment. One hindrance high school equivalency (HSE) students encounter is the inability to perform math sufficiently to earn an HSC due to the affective state of math anxiety and reduced math self-efficacy, particularly under pressure on tests/assessments. This quantitative study, using …
Can We Build It? An Action Research Study Of Integrated Academics And Resilience, Shanda Jones
Can We Build It? An Action Research Study Of Integrated Academics And Resilience, Shanda Jones
Doctor of Education Dissertations
This study was an action research project seeking to gather evidence regarding the impact of integrating academic objectives and resiliency-building topics. As the focus on trauma and mental health increased, literature provided rich descriptions of how trauma may negatively impact students. Research presented findings indicating potential physical, mental, emotional, social, academic, and behavioral effects resulting from trauma. What was lacking were studies investigating the impact of implementing trauma-informed instructional strategies. In an effort to address gaps in the literature and improve professional practice, action research in a mixed methods approach was conducted with two research questions exploring the impact, if …
The Role Of Stereotype Threat In Ethnically Minoritized Students' Science Motivation: A Four-Year Longitudinal Study Of Achievement And Persistence In Stem, Delaram A. Totonchi, Tony Perez, You-Kyung Lee, Kristy A. Robinson, Lisa Linnenbrink-Garcia
The Role Of Stereotype Threat In Ethnically Minoritized Students' Science Motivation: A Four-Year Longitudinal Study Of Achievement And Persistence In Stem, Delaram A. Totonchi, Tony Perez, You-Kyung Lee, Kristy A. Robinson, Lisa Linnenbrink-Garcia
STEMPS Faculty Publications
Grounded in expectancy-value and stereotype threat theories, this four-year longitudinal study examined associations between changes in stereotype threat and motivation (self-efficacy, task values, and perceived costs) among 425 undergraduates from racial/ethnic groups typically underrepresented in science, technology, engineering, and mathematics (STEM). Growth analyses indicated that students' stereotype threat and perceived cost of studying science increased during college, whereas science self-efficacy, intrinsic value, and attainment value declined. Parallel growth analyses suggested that higher initial stereotype threat related to a faster decline in attainment value and faster increase in perceived costs throughout college. Higher initial levels and a steeper increase in stereotype …
Educating For Global Competence: Co-Constructing Outcomes In The Field: An Action Research Project, Kristina A. Van Winkle
Educating For Global Competence: Co-Constructing Outcomes In The Field: An Action Research Project, Kristina A. Van Winkle
Antioch University Dissertations & Theses
Capacity building for globally competent educators is a 21st Century imperative to address contemporary complex and constantly changing challenges. This action research project is grounded in positive psychology, positive organizational scholarship, relational cultural theory, and relational leadership practices. It sought to identify adaptive challenges educators face as they try to integrate globally competent teaching practices into their curricula, demonstrate learning and growth experienced by the educators in this project, and provide guidance and solutions to the challenges globally competent educators face. Six educators participated in this three-phase project, which included focus groups, reflective journal entries, and an exit interview. Data …
Study Protocol For A Randomized Controlled Trial Comparing Two Low-Intensity Weight Loss Maintenance Interventions Based On Acceptance And Commitment Therapy Or Self-Regulation, Jason Lillis, Leah Schumacher, J. Graham Thomas, Michael E. Levin, Shira Dunsiger, Jessica L. Unick, Erin Evans, Jacqueline F. Hayes, Rena R. Wing
Study Protocol For A Randomized Controlled Trial Comparing Two Low-Intensity Weight Loss Maintenance Interventions Based On Acceptance And Commitment Therapy Or Self-Regulation, Jason Lillis, Leah Schumacher, J. Graham Thomas, Michael E. Levin, Shira Dunsiger, Jessica L. Unick, Erin Evans, Jacqueline F. Hayes, Rena R. Wing
Psychology Faculty Publications
Background: Weight regain is common following behavioral obesity treatment and attenuates many of the benefits of initial weight loss. This paper describes a randomized controlled trial that will evaluate the efficacy of two low-contact weight loss maintenance interventions based on Acceptance and Commitment Therapy (ACT) and self-regulation (SR). Potential mechanisms of action and moderators of treatment effects will also be evaluated.
Methods: Adults (anticipated N=480)with overweight or obesity will complete an initial 3-monthonline weight loss program (Phase 1). Participants who achieve ≥4 kg weight loss (anticipated N=288) will then be randomized to an ACT or SR weight loss maintenance intervention. …
A Randomized Trial Of Brief Online Interventions To Facilitate Treatment Seeking For Social Anxiety, Margaret R. Tobias, Lauren N. Landy, Michael E. Levin, Joanna J. Arch
A Randomized Trial Of Brief Online Interventions To Facilitate Treatment Seeking For Social Anxiety, Margaret R. Tobias, Lauren N. Landy, Michael E. Levin, Joanna J. Arch
Psychology Faculty Publications
Objective: This study developed and evaluated a brief, single-session online intervention designed to facilitate treatment seeking among adults with clinically significant social anxiety (SA) symptoms, who generally seek treatment at exceptionally low rates.
Method: Adults (N= 267) reporting significant SA symptoms were recruited online and randomized to a brief, single-session online intervention: Education consisted of brief psychoeducation and treatment resources, or Education+Motivation which added treatment seeking-focused motivational content adapted from Motivational Interviewing and Acceptance and Commitment Therapy. Attitudes, intentions, perceived control, and treatment seeking were assessed at Pre, Post, and one-month follow-up (FU).
Results: Both interventions were feasible …
Deployments To Diplomas: An Examination Of Academic Motivation Among Military Dependents Using Self-Determination Theory, Meagan C. Arrastia-Chisholm, Samantha Tackett, Kelly Torres, Khushbu Patel, Jacob W. Highsmith, Kacy Mixon
Deployments To Diplomas: An Examination Of Academic Motivation Among Military Dependents Using Self-Determination Theory, Meagan C. Arrastia-Chisholm, Samantha Tackett, Kelly Torres, Khushbu Patel, Jacob W. Highsmith, Kacy Mixon
Journal of Higher Education & Student Affairs
Using self-determination theory, the academic motivation of college students from deployed military families was examined. Implementing a case study methodology, interviews with 14 college students were transcribed and coded using a theory-driven rubric to identify their needs for autonomy, competence, and relatedness. Each case was analyzed for one’s self-determination regulatory style (external, introjected, integrated, or identified). The need for relatedness was the most prevalent in the data and the majority of cases exhibited regulatory styles consistent with introjected motivation.
A Phenomenological Study Of First-Year Elementary Teachers Managing Disruptive Behaviors, Lucina Smith
A Phenomenological Study Of First-Year Elementary Teachers Managing Disruptive Behaviors, Lucina Smith
Walden Dissertations and Doctoral Studies
Research consistently reflects novice teachers' feelings of inadequacy in effectively responding to students disruptive classroom behaviors. Some teachers may quickly default to disciplinary write-ups or make behavior-related referrals to special education. The purpose of this phenomenological study was to examine the perspectives of first-year elementary general education teachers about their competency and their tolerance for managing problem behaviors; to identify supports that will strengthen their ability to acquire and use effective behavior management skills, and thus reduce referrals. Social constructionism was the guiding conceptual framework. In-depth, semistructured interviews were conducted via telephone and analyzed using Moustakas' adaptation of the Van …