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Doctoral Dissertations and Projects

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Full-Text Articles in Social and Behavioral Sciences

Long-Term Psychological And Emotional Impacts On Survivors Of Child Sexual Abuse, Quanesha Lashay Johnson Jul 2025

Long-Term Psychological And Emotional Impacts On Survivors Of Child Sexual Abuse, Quanesha Lashay Johnson

Doctoral Dissertations and Projects

Child Sexual Abuse (CSA) has lasting psychological and emotional effects, yet limited research directly compares long-term outcomes between CSA survivors. This study addressed that gap by examining adult survivors’ long-term depression levels, emotional wellbeing, and sexual wellbeing, focusing on how the relationship to the perpetrator may influence outcomes. Using a quantitative, cross-sectional design, the study employed three validated instruments: the Beck Depression Inventory (BDI), BBC Subjective Wellbeing Scale (BBC-SWB), and the Natsal Sexual Wellbeing Measure. A total of 78 adults participated. Of these, 46 reported experiencing CSA by a family member or family friend, 17 experienced CSA by someone else …


Fieldwork Experiences Of Students In Cacrep Programs: A Descriptive Quantitative Study, Emily Norris Jul 2025

Fieldwork Experiences Of Students In Cacrep Programs: A Descriptive Quantitative Study, Emily Norris

Doctoral Dissertations and Projects

The following quantitative descriptive study explored the practicum and internship experiences of counselors in training (CIT) in consideration of the new 2024 Council for Accreditation of Counseling and Related Educational Programs (CACREP) standard requirements. The updated standards mandate fieldwork sites to provide “quantity, quality and variety of expected experiences,” yet they lack specific guidance on what these experiences might entail. Despite the importance of fieldwork in counselor training, current literature offers limited data on the specific experiences of CITs encounter during their placements. To address this gap, this study utilized an anonymous survey to capture a multitude of fieldwork characteristics …


The Meaning And Essence Of Depression And Loneliness In Widowhood: Discovering The Healthy Construct Of Self-Efficacy, Christine M. Ward Jun 2025

The Meaning And Essence Of Depression And Loneliness In Widowhood: Discovering The Healthy Construct Of Self-Efficacy, Christine M. Ward

Doctoral Dissertations and Projects

The purpose of this phenomenological study will be to describe the lived experience of widows aged 65-80 who lost their husbands within the past five years in one of three counties in Washington State: Pierce, Kitsap, or Mason. The two theories guiding this study will be Bowlby’s Attachment Theory and Bandura’s Social Learning Theory, (SLT), as they relate to post-loss identity and mourning. Both serve as vital tools for surviving and recovering from the impact of losing a spouse. When these affectional attachments are lost, a widow’s quality of life can be lessened or even damaged. A widow will go …


Exploring The Stigma Of Mental Health In Oneness Pentecostal Churches From A Pastoral Perspective, Jannett Liburd Jun 2025

Exploring The Stigma Of Mental Health In Oneness Pentecostal Churches From A Pastoral Perspective, Jannett Liburd

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to explore the stigma of mental health in Oneness Pentecostal churches in the Northeast from a pastoral perspective. The theory guiding this study is Sigmund Freud’s object relational theory (ORT), as it focuses on the past experiences an individual has with an object, person, or event, and how the experience, whether negative or positive, shapes the person’s attitude and behavior in the future. Mental health stigma is a phenomenon with which individuals may have had a harmful experience. In the study, the central research question was: What are the lived experiences of Oneness …


If The Halls Could Talk: Educator Narratives On Teen Media Literacy, Doda Lulgjuraj Jun 2025

If The Halls Could Talk: Educator Narratives On Teen Media Literacy, Doda Lulgjuraj

Doctoral Dissertations and Projects

Adolescents are avid yet vulnerable consumers of digital and social media, frequently exposed to non-credible information without possessing the essential tools to evaluate it effectively. The qualitative research conducted explores adolescent media literacy through the perspectives of middle school and high school educators, intending to understand students' ability to discern credible information. Additionally, this research aims to determine the extent to which current educational practices foster this skill. This study underscores the importance of equipping adolescents with media literacy skills in an increasingly complex and sometimes misleading digital environment. Thirty-six educators from four states in the U.S. participated in semi-structured …


The Relationship Between Hope, Religiosity, And Meaning In Life In Adults Who Experienced Relational Loss, Elyse Hope Linder Jun 2025

The Relationship Between Hope, Religiosity, And Meaning In Life In Adults Who Experienced Relational Loss, Elyse Hope Linder

Doctoral Dissertations and Projects

Relationship loss from death or living loss significantly impacts almost every human being at some point in life. Extensive research has examined the constructs of hope, religiosity, meaning in life, and grieving. Researchers have identified the contributions of these constructs in helping individuals understand and make sense of relational loss. However, limited, if any, literature exists on the relationships between all the constructs, particularly with an interdisciplinary view of hope. This present study examined these relationships and the moderating effect of hope and religiosity in adults who have experienced significant relationship loss within the past six years. Data was collected …


Quantifying Experiences Of Religious Abuse Among Sexual And Gender Minority Populations, Joshua Sink Jun 2025

Quantifying Experiences Of Religious Abuse Among Sexual And Gender Minority Populations, Joshua Sink

Doctoral Dissertations and Projects

A niche venue of research around religious trauma and spiritual abuse has demonstrated adverse outcomes of individuals who feel manipulated or harmed by institutions or individuals holding an imbalance of religious power. While general claims are often made that religion is a positive force on health and psychological wellness, religious trauma is usually associated with PTSD, anxiety, depression, and other pathological symptoms. Interestingly, an area where religion is not related to positive outcomes is among sexual and gender minorities, who show poorer health, higher suicidal rates, and poorer psychological well-being correlated with higher religiosity. While research has been conducted to …


Pastoring The Pastor: Self-Care Among African American Clergy, Alexander Jamerison Jun 2025

Pastoring The Pastor: Self-Care Among African American Clergy, Alexander Jamerison

Doctoral Dissertations and Projects

When self-care is effectively implemented, it can help individuals avoid or reduce mental health challenges throughout their lives (Luis et al., 2021). Unfortunately, research indicates numerous mental health challenges faced by clergy (Chan & Chen, 2019; Jackson, 2013; Gallagher, 2019; Edward, 2020). To assist ministers in cultivating a healthier life and a more effective ministry, this study will specifically explore the relationship between self-care and mental health challenges among African American clergy. The literature on this subject will identify historical, cultural, and spiritual influences. It will also examine specific mental health concerns, effective self-care practices, and relevant outcomes. Although research …


Finding Strength In The Broken Places: Examining The Influence Of Aces On The Mother/Daughter Relationship, Taressa R. Copeland Jun 2025

Finding Strength In The Broken Places: Examining The Influence Of Aces On The Mother/Daughter Relationship, Taressa R. Copeland

Doctoral Dissertations and Projects

Daughters raised by mothers who experienced childhood adversity may be ill-equipped for motherhood themselves due to the mother’s guilt and societal stigma associated with the adversity and the impact on lived experiences. Current studies fail to consider the bidirectional influence of adverse childhood experiences (ACEs) on the mother-daughter relationship. Community stakeholders such as healthcare providers must find a way to support the mother-daughter relationship by providing a safe platform to share and understand experiences as well as identify opportunities for resilience. Resources are also necessary to raise awareness and support mental health. This study used a qualitative phenomenological approach to …


Examining The Effectiveness Of Anti-Recidivism Programs In Fresno County, California, James Mora Jun 2025

Examining The Effectiveness Of Anti-Recidivism Programs In Fresno County, California, James Mora

Doctoral Dissertations and Projects

The purpose of this phenomenological research is to examine the perceived effectiveness of anti-recidivism programs in California and the lived experiences of ex-offenders who participate in the programs. This research will employ a qualitative methodology, utilizing a phenomenological design and interviews to collect data. The guiding theory for this research will be the Life-Course Theory, which examines relationships, significant life events, or turning points and their correlation with sobriety, gainful employment, and a crime-free lifestyle. The open coding system will synthesize and categorize interview responses before inputting the data into NVivo 15, a qualitative analysis software. The participant sample will …


Investigating The Relationship Between Social Media Usage, Perceived Stress, Depression And Spirituality, Jeffrey Leyland King Jun 2025

Investigating The Relationship Between Social Media Usage, Perceived Stress, Depression And Spirituality, Jeffrey Leyland King

Doctoral Dissertations and Projects

The rapid rise in social media usage (SMU) in the past two decades correlates with a sharp rise in depression (Dep) and self-harm in emerging adults. Many studies have focused on the aspects of diminished well-being, self-harm and suicide, and a possible association between daily spiritual experiences (DSE) and Dep, although there is a paucity of research on DSE to moderate the association. This study was guided by three theories; need-to-belong, social comparison, and cognitive dissonance. The present quantitative study aimed to explore the significance of the association between SMU, perceived stress (PS), and Dep moderated by DSE in emerging …


To Use Or Not To Use Exclusionary Discipline In Early Childhood Education? A Phenomenological Analysis Of Pre-Kindergarten Teachers In Alabama, Christal C. Coker Jun 2025

To Use Or Not To Use Exclusionary Discipline In Early Childhood Education? A Phenomenological Analysis Of Pre-Kindergarten Teachers In Alabama, Christal C. Coker

Doctoral Dissertations and Projects

This qualitative phenomenological study was conducted to examine the lived experiences of pre- kindergarten teachers in Alabama regarding their use of and restraint from using exclusionary discipline. The study aimed to find outcomes that could potentially improve social contexts in Alabama's preschools by creating more equitable learning environments. The problem addressed by the study is that the lived experience of preschool teachers regarding their use of and restraint from using exclusionary discipline when students misbehave at school remains to be discovered. A purposive sampling strategy was employed to recruit seven preschool teachers licensed in Alabama for a one-on-one semi-structured Zoom …


Media Richness In Nfl Communications: A Content Analysis Case Study, Ashley Menard Jun 2025

Media Richness In Nfl Communications: A Content Analysis Case Study, Ashley Menard

Doctoral Dissertations and Projects

This qualitative study aimed to examine the social media engagement of fans of the National Football League (NFL). The central problem identified was a lack of understanding of brand storytelling across different social media platforms, particularly concerning the richness of information each platform provided. Guided by media richness theory, developed by Daft and Lengel, this research explored the varying communication styles employed in brand storytelling on social media. The study sought to provide insights into how NFL brands can effectively utilize different platforms to enhance their storytelling and engage with their audience more richly and effectively. The results indicate that …


The Use Of Geographical Information Systems In The Eastern United States Emergency Management Organizations, From A Public Administration Perspective, Daron Jay Keesee Jun 2025

The Use Of Geographical Information Systems In The Eastern United States Emergency Management Organizations, From A Public Administration Perspective, Daron Jay Keesee

Doctoral Dissertations and Projects

This phenomenological study explored the use of Geographical Information System (GIS) technology in federal, state, and local government emergency management organizations. Using the Technology Acceptance Model (TAM), the research focused on understanding local governments' perceptions of GIS access. The study theorizes that GIS is underutilized by local government emergency management due to cost, perceived limited benefits, data security concerns, and lack of experience. The central question is: How do public administration professionals perceive the value and benefits of GIS in emergency management? The study involved interviews, focus groups, and writing prompts with emergency management officials from the eastern U.S. The …


The Lived Experiences Of Young Adult Children Of Veterans Attachment In Responses To Unique Lifestyle Challenges, Amanda M. Fife Jun 2025

The Lived Experiences Of Young Adult Children Of Veterans Attachment In Responses To Unique Lifestyle Challenges, Amanda M. Fife

Doctoral Dissertations and Projects

The purpose of this phenomenological study is to describe young adult children of veterans’ experiences with frequent relocations. Military-connected youth experience unique stressors that their civilian peers do not encounter and may experience frequent disruptions in attachment relationships. The theories guiding this study are John Bowlby and Mary Ainsworth’s attachment theory, Norman Garmezy’s resiliency theory, and Lazarus and Folkman’s transactional theory of stress and coping. These theories provide the structural framework for understanding the meaning of attachment, factors that promote resiliency, and structures for coping with stress. Individual interviews were conducted with each of the 10 selected participants that meet …


The Call (And Aftermath) Of The Void: Understanding Suicide Loss And Bereavement Processes Amongst Student Populaces, Saraha K. Brawner Jun 2025

The Call (And Aftermath) Of The Void: Understanding Suicide Loss And Bereavement Processes Amongst Student Populaces, Saraha K. Brawner

Doctoral Dissertations and Projects

Each year, over 800,000 people die via lethal self-harm, leaving behind millions of survivors to navigate qualitatively unique manifestations of grief. Despite the profound psychosocial and psychopathological effects associated with suicide loss, research addressing these experiences remains extremely limited. This quantitative survey study examined the relationship between suicide loss and grief-related distress among students, focusing on sociodemographic, psychosocial, and psychopathological factors influencing bereavement over time. It also explored how the individual learned about the suicide and expanded upon 1st, 2nd, and 3rd-degree relationships. Forty-one participants recruited from universities and mental health organizations across the United States completed a loss summary/death …


Burnout Among Adjunct Faculty: A Quantitative Study, Christopher D. Sclafani Jun 2025

Burnout Among Adjunct Faculty: A Quantitative Study, Christopher D. Sclafani

Doctoral Dissertations and Projects

Adjunct faculty, who are employed on a contractual, as-needed basis, comprise nearly 70% of the higher education workforce in the United States. Despite their essential role, they often face challenges that may impact their well-being and organizational commitment. This quantitative, non-experimental study examined the relationships between workload, course format, compensation, institutional support, and burnout among adjunct faculty. Data was collected from 85 adjunct faculty members across the United States using an online survey. Guided by the Job Demands-Resources (JD-R) Theory and Social Exchange Theory (SET), multiple regression analyses were conducted to explore the predictive effects of workload, compensation, and institutional …


Electro Transcranial Magnetic Stimulation (Etms) Effects On Pharmacoresistent Sleep Disorders Using A Quantitative Electroencephalogram (Qeeg), Sarah Diane Dean Jun 2025

Electro Transcranial Magnetic Stimulation (Etms) Effects On Pharmacoresistent Sleep Disorders Using A Quantitative Electroencephalogram (Qeeg), Sarah Diane Dean

Doctoral Dissertations and Projects

The following quantitative correlational study investigated the effects of eTMS on individuals with pharmacoresistant sleep disorders using a qEEG. This research measures the dimensions of anxiety, depression and quality of life (QoL) as it relates to untreated secondary diagnosis. Additionally, this research examines the activity level of the dorsolateral prefrontal cortex in relation to eTMS treatments. It was found that correlation with anxiety (rs = -.466, p < .001), depression (rs = -0.556, p < 0.001), quality of life (rs = -.436, p < .001), and sleep disturbances (rs = -0.452, p < 0.001), have a statistically significant negative correlation with dlPFC activity level. Finally, it was found that eTMS does have a statistically significant relationship with sleep disturbances as well as anxiety, depression and general quality of life (U (195) = 4647, p = .971). This is important to the field of neuroscience as it provided a more precise form of individualized neuromodulation through the use of a uncommon type of transcranial magnetic stimulation.


Olfactory Training: Reclaiming Our Wellbeing, Nathan Smetzer Jun 2025

Olfactory Training: Reclaiming Our Wellbeing, Nathan Smetzer

Doctoral Dissertations and Projects

The connection between the sense of smell and memory offers a promising avenue for enhancing cognitive, emotional, and mental health, thereby contributing to overall wellbeing. This research explores how olfactory stimuli relate to memory and emotion, aiming to expand understanding of the effects of scent-based interventions on mental health. Utilizing a 12-week longitudinal phenomenological approach with experimental components, the study engaged seven participants in a regimen of olfactory training twice daily. Participants used essential oils—citrus, cloves, eucalyptus, and rose—applied to cotton and kept in sealed containers, along with a pen and daily planner. Data were gathered through recurring qualitative interviews …


Building Resilience In Ministry With Effective Supports Amid The Covid-19 Pandemic: A Phenomenological Study Of Long-Tenured Pastors In The Southeastern United States, Tina Marie Powell Jun 2025

Building Resilience In Ministry With Effective Supports Amid The Covid-19 Pandemic: A Phenomenological Study Of Long-Tenured Pastors In The Southeastern United States, Tina Marie Powell

Doctoral Dissertations and Projects

This phenomenological study, which involved long-tenured pastors in a southeastern state in the United States, explored how these pastors framed resiliency in ministry during COVID-19 and what tools or practices helped them to be resilient. The study also explored the effects of social distancing on the demands of ministry, on pastors, and their congregations, and if earlier resiliency practices continued to suffice. Pastors were often the first professionals people went to when guidance was needed in every aspect of life. Pastors aided with not only spiritual guidance, but also, they were sought after for guidance in mental health and emotional …


A Quantitative Study Of Ai-Voice Based Assistant Users That Anthropomorphize Technology As Social Actors, Brandon Alton Bassett Jun 2025

A Quantitative Study Of Ai-Voice Based Assistant Users That Anthropomorphize Technology As Social Actors, Brandon Alton Bassett

Doctoral Dissertations and Projects

The problem was that there were limited studies that acknowledged how voice-based assistant users perceive the intelligence of voice-based assistants and the different variation levels of trust towards it. The purpose of this quantitative research was to investigate how demographic variables such as generation, ethnicity, gender and education level influence perceptions of trust and perceive intelligence towards AI-voice based assistants. The rationale for this research was that voice-based assistants have garnered 46% of the human-technology interaction. It is pivotal that voice-assistant applications listen to the need of its users’ as it pertains to the user experience. Voice-based assistants users’ perception …


Exploring Age And Employee Experience Among Healthcare Workers Post-Covid-19 Pandemic, Sheila-Celestine Bonner Jun 2025

Exploring Age And Employee Experience Among Healthcare Workers Post-Covid-19 Pandemic, Sheila-Celestine Bonner

Doctoral Dissertations and Projects

This study focused on the well-being of healthcare employees and their experience following COVID-19. The pandemic has negatively affected adults over the age of 50 in the United States and limited their ability to return to work. Older adults who have returned to work have faced challenges with discrimination, lack of work, stress, and other factors. A survey of 59 adult healthcare workers, 21 years and older, was conducted to determine whether there is a relation between age and perceptions of organizational support during the pandemic including work factors such as stress, job satisfaction, and age discrimination. A non-experimental research …


Exploring The Differences Of Gender On Physician Burnout And Perceptions Of Work Environment, Holly C. Adams Jun 2025

Exploring The Differences Of Gender On Physician Burnout And Perceptions Of Work Environment, Holly C. Adams

Doctoral Dissertations and Projects

Physician burnout is a growing public health crisis, threatening care quality, patient safety, and workforce sustainability. Research suggests gender may influence burnout levels and perceptions of the work environment. This quantitative, cross-sectional study examined gender differences in physician burnout and workplace perceptions among U.S. physicians that impact burnout. A total of 170 licensed physicians completed an online survey using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS (MP)) and the Areas of Worklife Survey (AWS). MANOVA results indicated a significant multivariate effect of gender on burnout. Follow-up ANOVA testing revealed that gender was significantly related to emotional exhaustion and personal accomplishment. …


A Multivariate Time Series Analysis Of Secular Stagnation: A Critical Realist Perspective, Francis N. Mensah Jun 2025

A Multivariate Time Series Analysis Of Secular Stagnation: A Critical Realist Perspective, Francis N. Mensah

Doctoral Dissertations and Projects

The study investigated whether excess saving over investment explains secular stagnation or is linked to structural break (hysteresis) in aggregate economic activity as measured by the changes in the level of GDP. The U.S. economy, including the advanced economies, is experiencing secular stagnation, potentially caused by excess savings over investment. This condition, if present, could have significant implications for how we can conduct economic policy. Instead of focusing on gross domestic product (GDP), a measure of economic activity, the study extends the existing literature by concentrating on aggregate private-sector output. The rationale is that if there is secular stagnation or …


Sense Of Belonging In The Workplace: Development And Validation Of A Scale, Campbell C. Dunson Jun 2025

Sense Of Belonging In The Workplace: Development And Validation Of A Scale, Campbell C. Dunson

Doctoral Dissertations and Projects

In this dissertation, I describe the development and validation of the Sense of Belonging in the Workplace Scale (SBWS). A comprehensive, multidisciplinary review of the belonging construct revealed five key components of a sense of belonging in the workplace: (1) accepted/liked, (2) known/understood, (3) purpose/status, (4) respected/voice, and (5) safety/trust. Scale validation began with a review of 40 initial items by a panel of 12 subject matter experts (SMEs). The items were then revised, and a pilot study involving 67 participants was conducted to test these 40 items through exploratory factor analysis and construct validation. The top-performing 25 items were …


Strengthening Communication Between Staff And Health Providers In A Mental Health Setting, Michael Tricoli Jun 2025

Strengthening Communication Between Staff And Health Providers In A Mental Health Setting, Michael Tricoli

Doctoral Dissertations and Projects

Communication between nursing staff and providers is essential for supporting optimum patient outcomes. Each component of the communication process needs to be clearly defined to create an environment of safety for both patients and caregivers. The SBAR (situation, background, assessment, recommendation) is a nurse-driven protocol that is widely used as a communication and documentation template in health care organizations. This format is currently not being used effectively on the mental health units where the evidence-based project was implemented. Recognizing and reiterating the value of SBAR as a communication tool is necessary when communication deficits are noted. The purpose and scope …


The U.S. And Japan: Containing A Rising China?, Kaitlyn Elizabeth Early Jun 2025

The U.S. And Japan: Containing A Rising China?, Kaitlyn Elizabeth Early

Doctoral Dissertations and Projects

This research involved investigating the impact that the coherence between international relations (IR) theories and national strategies and policy practice through effective implementation (independent variables) have on China’s perceived vulnerabilities (CPV; dependent variable) using the Cold War, the United States, and Japan case studies. The research focused on how the coherence between these variables could shape CPV and strategic calculations, particularly concerning Taiwan and the South China Sea. Additionally, the research involved analyzing how the modern strategies of conventional deterrence (i.e., the strategy of denial and integrated deterrence) influence CPV. This study was guided by the hypothesis that the degree …


A Phenomenological Exploration Of The Church In The Healing Process For African American Women In The Washington, D.C., Area Suffering From Self-Diagnosed Depression In Recovery From Intimate Partner Violence, Kimberly D. Brooks Jun 2025

A Phenomenological Exploration Of The Church In The Healing Process For African American Women In The Washington, D.C., Area Suffering From Self-Diagnosed Depression In Recovery From Intimate Partner Violence, Kimberly D. Brooks

Doctoral Dissertations and Projects

The purpose of this descriptive phenomenological study is to describe the lived experiences of African American women who have utilized the church after intimate partner violence (IPV) suffering self-diagnosed depression in the Washington, D.C. area. The approach guiding the methodology of this study is Clark Moustakas’ (1994) phenomenological approach. There is a need to explore what type of support the church offers as a source of healing for those who need assistance and will not seek professional counseling for various reasons. While there has been much research on depression resulting from IPV, there is a gap in the literature regarding …


Therapists’ Inclusion Of Forgiveness During Cognitive Processing Therapy For Post-Traumatic Stress Disorder, Marybeth Goodman Jun 2025

Therapists’ Inclusion Of Forgiveness During Cognitive Processing Therapy For Post-Traumatic Stress Disorder, Marybeth Goodman

Doctoral Dissertations and Projects

This study investigated whether the inclusion of an evidence-based forgiveness therapy during a course of Cognitive Processing Therapy (CPT) for Post-Traumatic Stress Disorder (PTSD) improved the efficacy of the treatment. This quasi-experimental, quantitative study examined 201 completed episodes of care from CPT-trained and rostered clinicians. Participants were divided into two groups. Group one contained clinicians who used no less than 46 minutes of an evidence-based forgiveness therapy intervention (n = 102), and group two (n = 99) contained clinicians who did not utilize an evidence-based forgiveness intervention. Pre- and post-treatment PTSD symptom severity was measured using the PTSD Checklist for …


Identifying Effective Counseling Strategies For Working With Women Who Endorse A Strong Black Woman Schema: Exploring The Perspectives Of African American Clinicians, Jacqueline Javonne Hill Jun 2025

Identifying Effective Counseling Strategies For Working With Women Who Endorse A Strong Black Woman Schema: Exploring The Perspectives Of African American Clinicians, Jacqueline Javonne Hill

Doctoral Dissertations and Projects

African American women underutilize mental health services despite experiencing high rates of psychological distress. Existing literature has not fully explored how the Strong Black Woman (SBW) schema influences this behavior. The purpose of this phenomenological study was to understand how the lived experiences of African American women positively influenced or impeded their help-seeking behaviors to address mental health problems through the lens of African American women mental health clinicians via Zoom Video Communications. This study addressed the gap in research on how cultural norms, systemic barriers, and therapeutic strategies shape access to care for this population.

Semi-structured interviews were conducted …