DadaJ.6-17DissertationReviewofChapters1.2.3.2.docx

213

I highlighted in Yellow the NEW comments to Do.

To Do List

· BETTER SEE EDITS AND TO DO Ten Strategic Points. Make sure you fill it out so that it is all CURRENT and brief. Comment by Jennifer R. Seymour: Not done yet
· OK Look at all south Texas and make sure it is correct. CTRL F South Texas to find the ones that are still capital.
· BETTER SEE EDITS AND TO DO Page 6, Background fill in the sections. Easy I think. Comment by Jennifer R. Seymour: I edited this to be more specific to your study.
· OK Definitions of Terms couldn’t find Comment by Jennifer R. Seymour: Need references see note.
· BETTER SEE TO DO Alignment Table- Copy and paste all pieces into it. Comment by Jennifer R. Seymour: I fixed some of it, other sections need improvement, see comments.
· OK Feasibility Checklist- work on together Comment by Jennifer R. Seymour: I changed a lot of this to be specific to your study.

· STILL NEEDS REFS. TO DO The Problem Space- work on together

· Empirical Articles that already used qualitative research methods to study mental health use. Comment by Jennifer R. Seymour: Needs references and focus on what your study truly is. I think you are confused.
·
· TO DO PAGE 122 Ethical Standards—Add definitions and examples of Belmont Report. Required. Comment by Jennifer R. Seymour: Need to do. Page 118
· Interview Questions – create together
. Comment by Jennifer R. Seymour: done
· Read the whole thing through for consistency and editing

Ten Strategic Points

Complete the Ten Strategic Points document below for your chair and committee members to reference during review of your proposal or dissertation. The Ten Strategic Points represents the foundational elements of your study, must be aligned, and should be continuously updated as appropriate based on each iteration of your proposal or dissertation document. For additional detail on the Ten Strategic Points refer to the full document located on the DC Network> Dissertation Resources>Folder 05 Dissertation Template. Please Note: The Ten Strategic Points should be moved to Appendix A in the final dissertation manuscript before moving into Level 7 Form and Formatting.

Ten Strategic Points Comment by GCU: Do not remove until Level 7 Review – Form and Formatting
The ten strategic points emerge from researching literature on a topic, which is based on, or aligned with a defined need or problem space within the literature as well as the learner’s personal passion, future career purpose, and degree area. The Ten Strategic Points document includes the following key points that define the research focus and approach:

Strategic Points Descriptor

Learner Strategic Points for Proposed Study Comment by GCU: Delete bulleted items within each box as you add your Ten Strategic Points information based on each descriptor.

Dissertation Topic.

The research will therefore specifically look at how mental health providers describe the strategies that influence individuals’ decision to utilize or reject mental health services at the commencement of, and continuation of, treatment in south Texas.

Literature Review –

· Background to the problem
· The background of the problem is identified by the fact that the researches that have been done in the previous years specifically by researchers such as Kohn et al. (2018) and Lund et al. (2018) identified that there was a gap between the people having mental issues and those that are seeking mental health treatments.
·
· Theoretical foundation
· Bandura’s Social Cognitive, which look at how people’s beliefs affect the way that they accept or reject mental health services that are provided to them. Bandura give the research more specific approach that is narrowed down in understanding the human beings believes and attitudes and how this affects their behavior in accepting or rejecting services.

Review of literature topics
The different topics that this research will be looking at include are mental health infrastructure, populations that accept mental health, populations that reject mental health, populations that have access to mental health, populations that do not have access to mental health, reasons for the rejection of mental health and the reasons for the use of mental health services.

Problem Statement –

The problem that the research will be addressing how mental health providers describe the strategies that influence individuals’ decision to utilize or reject mental health services at the commencement of, and continuation of, treatment in south Texas.

Sample and Location – Identifies sample, needed sample size, and location (study phenomena with small numbers).

· The size of the target sample is500 mental health professionals with a final sample of 20 participants
· There are 8 additional facilities that can be asked for site authorization if the 4 currently approved do not yield enough participants.

Research Questions

RQ 1: What strategies do mental health providers use to encourage patients to begin using mental health services? RQ 2: What strategies do mental health providers use to encourage patients to continue
using mental health services? Comment by Jennifer R. Seymour: COPY AND PASTE ALL FOUR FROM THE DOCUMENT HERE>

Phenomenon

The phenomenon is strategies used to encourage use of mental health services. The research will consider looking at the population in southern Texas.

Methodology and Design –

A qualitative methodology will be used in this study. Qualitative methodology is the most appropriate methodology that provides rich data and will help provide evidence from the interview

Purpose Statement – Provides one sentence statement of purpose including the problem statement, methodology, design, target population, and location.

. Comment by Jennifer R. Seymour: Copy and paste from the document.

Data Collection

The IRB will approve the study and the researchers will recruit the participants to take part in the study. The sample population for this study will include psychiatrists and therapists. There will be two forms of data collection: interviews and one focus group. The interviews will take place first and then the focus group will be held. Member checking will occur once data is collected and coded, the codes for each person will be sent to them with a table through email

10.

Data Analysis

After the data is collected from the questions asked to the participants in the interview, the questions being 12 The data collected will be grouped into three categories. The first category is the person from which data was collected. The second category will be the method used for data collection. The third category will be the contents of the data collected. Through the categorization it will be possible to collect evidence that supports that the quantity, and the quality of the data is sufficient to answer the research questions

The Proposal Title Appears in Title Case and is Centered Comment by GCU: American Psychological Association (APA) Style is most commonly used to cite sources within the social sciences. This resource, revised according to the 7th edition of the Publication Manual of the American Psychological Association, offers examples for the general format of APA research papers, in-text citations, footnotes, and the reference page. For specifics, consult the Publication Manual of the American Psychological Association, 7th edition, second printing. For additional information on APA Style, consult the APA website:
http://apastyle.org/learn/index.aspx

NOTE: All notes and comments are keyed to the Publication Manual of the American Psychological Association, 7th edition, second printing.

GENERAL FORMAT RULES:
Dissertations must be 12 –point Times New Roman typeface, double-spaced on quality standard-sized paper (8.5″ x 11″) with 1-in. margins on the top, bottom, and right side. For binding purposes, the left margin is 1.5 in. [8.03]. To set this in Word, go to:

Page Layout >
Page Setup>
Margins >
Custom Margins>
Top: 1” Bottom: 1”
Left: 1.5” Right: 1”
Click “Okay”

Page Layout>
Orientation>
Portrait>

NOTE: All text lines are double-spaced. This includes the title, headings, formal block quotes, references, footnotes, and figure captions. Single-spacing is only used within tables, figures, and bulleted lists [8.03].

The first line of each paragraph is indented 0.5 in. Use the tab key which should be set at five to seven spaces [8.03]. If a white tab appears in the comment box, click on the tab to read additional information included in the comment box. Comment by GCU: Formatting note: The effect of the page being centered with a 1.5″ left margin is accomplished by the use of the first line indent here. However, it would be correct to not use the first line indent and set the actual indent for these title pages at 1.5.” Comment by GCU: If the title is longer than one line, double-space it. As a rule, the title should be approximately 12 words. Titles should be descriptive and concise with no abbreviations, jargon, or obscure technical terms. The title should be typed in uppercase and lowercase letters [2.01], also known as “Title Case.”
Twelve words will fit on the spine of the printed dissertation.
Submitted by
Insert Your Full Legal Name (No Titles, Degrees, or Academic Credentials) Comment by GCU: For example: Raven Marie Garcia

A Dissertation Presented in Partial Fulfillment
of the Requirements for the Degree
Doctor of Education
(or) Doctor of Philosophy
(or) Doctor of Business Administration

Grand Canyon University
Phoenix, Arizona Comment by GCU: HINT: There are several “styles” that have been set up in this GCU Template. When you work on your proposal or dissertation, “save as” this template in to preserve and make use of the preset styles. This will save you hours of work!

[Insert Current Date Until Date of Dean’s Signature]
QUAL GCU Dissertation Template V9.0 Final 08-10-20_cnb 7 am
QUALITATIVE GCU Dissertation Template V9.0 08-10-2020

© by Your Full Legal Name (No Titles, Degrees, or Academic Credentials), 20xx Comment by GCU: NOTE: This is an optional page. If copyright is not desired, delete this page. The copyright page is included in the final dissertation and not part of the proposal. Comment by GCU: For example: © by Xavier William Lopez, 2020

This page is centered. This page is counted, not numbered, and should not appear in the Table of Contents.
All rights reserved.

QUALITATIVE GCU Dissertation Template V9.0 08-10-2020

The Dissertation Title Appears in Title Case and is Centered Comment by GCU: If the title is longer than one line, double-space it. The title should be typed in upper and lowercase letters, also known as “Title Case.”

Insert Learner Full Legal Name (No Titles, Degrees, or Academic Credentials) Comment by GCU: For example: Jane Elizabeth Smith

Successfully Defended and Approved by All Dissertation Committee Members
[Insert Date]

DISSERTATION COMMITTEE APPROVAL:
The following committee members certify they have read and approve this dissertation and deem it fully adequate in scope and quality as a dissertation for the degree of Doctor of XXX.

Full Legal Name, EdD, DBA, or PhD, Dissertation Chair
Full Legal Name, EdD, DBA, or PhD, Committee Member
Full Legal Name, EdD, DBA, or PhD, Committee Member

ACCEPTED AND SIGNED:

________________________________________ ____________________
Michael R. Berger, EdD Date
Dean, College of Doctoral Studies

GRAND CANYON UNIVERSITY Comment by GCU: This page is only included in the final dissertation and not part of the proposal. However, the learner is responsible for ensuring the proposal and dissertation are original research, that all scholarly sources are accurately reported, cited, and referenced, and the study protocol was executed and complies with the IRB approval granted by GCU.

The Dissertation Title Appears in Title Case and is Centered

I verify that my dissertation represents original research, is not falsified or plagiarized, and that I accurately reported, cited, and referenced all sources within this manuscript in strict compliance with APA and Grand Canyon University (GCU) guidelines. I also verify my dissertation complies with the approval(s) granted for this research investigation by GCU Institutional Review Board (IRB).

[Wet Signature Required]
_____________________________________________ ______________________
[Type Doctoral Learner Name Beneath Signature line] Date Comment by GCU: This page requires a “wet signature.”
Remove the brackets and type in the learner’s name.

The learner needs to sign and date this page and insert a copy into the dissertation manuscript as an image (JPEG) or PDF text box. This page must be signed and dated prior to final AQR Level 5 review.

Abstract Comment by GCU: On the first line of the page, center the word “Abstract” (boldface) Style with “TOC Heading”

Beginning with the next line, write the abstract. Abstract text is one paragraph with no indentation and is double-spaced. This page is counted, not numbered, and does not appear in the Table of Contents.

Abstracts do not include references or citations.

The abstract must fit on one page.

The abstract is only included in the final dissertation and not part of the proposal.

The abstract is the most important component of your dissertation! It is required for the dissertation manuscript only. The abstract is typically the last item written and should be updated based on final acceptance of manuscript by the dissertation committee members and reviewer(s). The abstract is intended as a precise, non-evaluative, summary of the entire dissertation presenting the major elements and findings of the study in a highly condensed format. Although few people typically read the full dissertation, the abstract will be read by many scholars and researchers. Consequently, great care must be taken in writing this page of the dissertation. The content of the abstract should mirror the structure of the entire dissertation, covering the research problem purpose of the study to solve the problem, theoretical foundation, research questions stated in narrative format, sample, location, methodology, design, data sources, data analysis approach, major findings or trends based on the analysis. The most important finding(s) should state the themes that support the conclusion(s). The abstract should close with a conclusion statement of the study implications and contributions to the field. The abstract does not appear in the table of contents and has no page number. The abstract is double-spaced, fully justified with no indentations or citations, and no longer than one page. Refer to the APA Publication Manual, 7th Edition, for additional guidelines for the development of the dissertation abstract. Make sure to add the keywords at the bottom of the abstract to assist future researchers. Comment by GCU: Please note this is crucial and must be included in the abstract at the final dissertation stage.

The most common error in abstracts is failure to present results.

This is required for dean’s signature.

Keywords: Abstract, one-page, vital information
Comment by GCU: Librarians and researchers use the abstract and keywords to catalogue and locate vital research material.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

ABSTRACT

(Dissertation Only—Not Required for the Proposal)

(one page)

The abstract provides a succinct summary of the study and MUST include: the purpose of the study, theoretical foundation, research questions stated in narrative format, sample, location, methodology, design, data sources, data analysis, results, and a valid conclusion of the research. Note: The most important finding(s) should be stated with actual codes and resulting themes data/numbers (qualitative).

The abstract is written in APA format, one paragraph fully justified with no indentations, double-spaced with no citations, one page, and includes key search words. Keywords are on a new line and indented.

The abstract is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

0 = Item Not Present or Unacceptable. Substantial Revisions are Required.
1 = Item is Present. Does Not Meet Expectations. Revisions are Required.
2 = Item is Acceptable. Meets Expectations. Some Revisions May be Suggested or Required.
3 = Item Exceeds Expectations. No Revisions are Required.

Reviewer Comments:

Dedication Comment by GCU: The Dedication page is the first page in the dissertation with a Roman Numeral. In the final dissertation, this is usually page vi, so we have set it as vi.
An optional dedication may be included here. While a dissertation is an objective, scientific document, this is the place to use the first person and to be subjective. The dedication page is numbered with a Roman numeral, but the page number does not appear in the Table of Contents. It is only included in the final dissertation and is not part of the proposal. If this page is not to be included, delete the heading, the body text, and the page break below. Comment by GCU: If you cannot see the page break, click on the top toolbar in Word (Home). Click on the paragraph icon. ¶Show/Hide button (go to the Home tab and then to the Paragraph toolbar).

Acknowledgments
An optional acknowledgements page can be included here. This is another place to use the first person. If applicable, acknowledge and identify grants and other means of financial support. Also acknowledge supportive colleagues who rendered assistance. The acknowledgments page is numbered with a Roman numeral, but the page number does not appear in the table of contents. This page provides a formal opportunity to thank family, friends, and faculty members who have been helpful and supportive. The acknowledgements page is only included in the final dissertation and is not part of the proposal. If this page is not to be included, delete the heading, the body text, and the page break below.

Table of Contents Comment by GCU: This is an automatic Table of Contents. This means that Word “reads” the headings and subheadings in the document that have been “styled,” and generates/updates the TOC. This is a time saver and ensures the headings and subheadings in the TOC exactly match those in the text.

The preferences for all styles in this template have already been set.

The Table of Contents pages are counted and show a Roman numeral page number at the top right. The page number is right justified. The page number should not be listed in the Table of Contents.

NOTE: The Table of Contents must be 12-point Times New Roman typeface, double-spaced. Titles that are longer than one line should be single spaced, and double spaced between entries. All the styles (TOC 1, TOC 2, TOC 3) have been set up this way already.

Unlike the body of the dissertation, the Table of Contents is right justified, (i.e., not ragged right). Dot leaders must be used. Title should be styled as “TOC Heading” (double spaced, no indent, bold, “keep with next”). The TOC styles have been set up this way in the template already.

The Table of Contents reflects the specific levels of organization within the dissertation. All major (chapter) headings must be worded exactly the same and occur in the same as they do in the GCU dissertation template. Any heading that appears in the Table of Contents must appear in the text, and any heading in the text must appear in the Table of Contents. As noted elsewhere in this comment, as long as you use this automatic TOC, the headings in the TOC will match those in the text since the automatic TOC “reads” the styles of the headings in the text.

Subheadings differentiate subsections of each chapter, are single-spaced and upper and lowercase.

In the Table of Contents, these
TOC1: Left: 0″, Hanging: 0.5″ Tab stops: 6″
TOC2: Left: -0.25″, First line Indent 0.5: Tab stops: 6″
TOC 3: Left: 0.63”; no first line indent, Tab stops: 6″

The headings and subheadings in the Table of Contents must exactly match the text body, and they will do so automatically when you use this automatic TOC (which “reads” the headings in the text. Comment by GCU: HINT! If you see lots of text (not just headings) when you update the TOC, that means that those sections of text have been styled as a heading, rather than as “Normal” or List Bullet or List Number. Fix this IN THE TEXT (not in the TOC!!)
List of Tables xii
List of Figures xiii
Chapter 1: Introduction to the Study 1
Introduction 1
Background of the Study 7
Definition of Terms 9
Anticipated Limitations 12
Summary and Organization of the Remainder of the Study 13
Chapter 2: Literature Review 17
Introduction to the Chapter and Background to the Problem 17
Identification of the Problem Space 19
Theoretical Foundations 23
Review of the Literature 27
Problem Statement 34
Summary 36
Chapter 3: Methodology 38
Introduction 38
Purpose of the Study 39
Research Questions 40
Rationale for a Qualitative Methodology 41
Rationale for Research Design 42
Population and Sample Selection 44
Qualitative Sample Size 45
Recruiting and Sampling Strategy 45
Sources of Data 47
Research Data 48
Additional Data 49
Trustworthiness 52
Credibility 53
Dependability 54
Transferability 54
Confirmability 55
Data Collection and Management 57
Data Analysis Procedures 60
Ethical Considerations 62
Assumptions, and Delimitations 66
Assumptions 66
Delimitations 67
Summary 68
Chapter 4: Data Analysis and Results 70
Introduction 70
Preparation of Raw Data for Analysis and Descriptive Data 72
Preparation of Raw Data for Analysis 72
Descriptive Data 73
Data Analysis Procedures 77
Reflexivity Protocol 78
Data Analysis Steps 78
Results 80
Presenting the Results 80
Limitations 86
Summary 88
Chapter 5: Summary, Conclusions, and Recommendations 90
Introduction and Summary of Study 90
Summary of Findings and Conclusion 91
Overall Organization 91
Reflection on the Dissertation Process 92
Implications 93
Theoretical Implications 94
Practical Implications 94
Future Implications 94
Strengths and Weaknesses of the Study 95
Recommendations 96
Recommendations for Future Research 96
Recommendations for Future Practice 97
Holistic reflection on the Problem Space 99
References 100
Appendix A. Ten Strategic Points 107
Appendix B. Site Authorization 109
Appendix C. IRB Approval Letter 110
Appendix D. Informed Consent 111
Appendix E. Copy of Instrument(s) and Permission Letters to Use the Instrument(s) 112
Appendix F. Codebook 113
Appendix G. Transcripts 114
Appendix H. Feasibility and Benefits Checklist 115
Appendix I. Strategies to Establish Trustworthiness 119
Appendix J. Developing Qualitative Interview Questions Systematically 120
Appendix K. Sample Frames, Interview Duration, Transcript Expectations 126
Appendix L. Additional Appendices 127

List of Tables
Table 1. Correct Formatting for a Multiple Line Table Title is Single Spaced and Should Look Like this Example xii
Table 2. Alignment Table 15
Table 3. Description of Building Blocks for the Theoretical Foundations Section 25
Table 4. Steps for the Theoretical Foundations Section 26
Table 5. Qualitative Core Designs and Descriptions 43
Table 6. Example of a Clean, Easy-to-Read Table 75
Table 7. Example of Clean, Easy-to-Read Table for Focus Group Data 75
Table 8. Example of Case Unit Profiling (in Narrative) 76
Table 9. Initial Codes 83
Table F10. Sample Codebook 113

To update the List of Tables: [Place cursor on the page number or title Right click Update Field Update Entire Table], and the table title and subtitle will show up with the in-text formatting. Below is a sample table:

Table 1.
Correct Formatting for a Multiple Line Table Title is Single Spaced and Should Look Like this Example

Participant Comment by GCU: To fit a table to the page margins:
Click anywhere in the table.
Choose the LAYOUT menu from Table Tools in the menu ribbon.
Choose the AUTO FIT dropdown.
Select AutoFit Window to autofit the table to the page margins.

Gender

Role

Location

Susan

Principal

School A

Mary

Teacher

School A

Joseph

M Comment by GCU: To vertically center text in each cell, highlight cells, right click when cursor is in cells to format, click Table Properties > Cell > click on image with centered text

Principal

School B

Note; Adapted from: I.M. Researcher (2010). Sampling and recruitment in studies of doctoral students. Journal of Perspicuity, 25, p. 100. Reprinted with permission.

List of Figures
Figure 1. The Relationship of Things xiii
Figure 2. Incorporating Theories and Models of Research 24
Figure 3. IRB Alert 64
Figure 4. Diagram of a Blank Sociogram 84

To update the List of Figures: [Place curser on page number or title Right click Update Field Update Entire Table], and the figure title and subtitle will show up with the in-text formatting. Below is a sample figure:

Figure 1.

The Relationship of Things Comment by GCU: Formatting Tip:
The caption for each figure should be placed above the figure, and be “styled” as “Caption” (as this one is).
Placing the Figure title and subtitle above the graphic is new in APA 7th edition. Comment by GCU: In general, high quality graphics software handle the technical aspects of constructing figures.” [5.22].

Each figure must be numbered in sequence throughout the entire dissertation (Figure 1, Figure 2, etc.), or within chapters (Figure 1.1, Figure 1.2 for Chapter 1; Figure 2.1, Figure 2.2 for Chapter 2, etc.).
xii

QUALITATIVE GCU Dissertation Template V9.0 08-10-2020

Chapter 1: Introduction to the Study Comment by GCU: This heading is styled according to APA Level 1 heading (style: “Heading 1”) [3.03]. Do not modify or delete as it will impact your automated table of contents

Introduction Comment by GCU: This heading is styled according to APA Level 2 heading (style: “Heading 2”) [3.03]. Do not modify or delete as it will impact your automated table of contents

Mental health and its dis s are among one of the leading causes of global disability (Schnyder et al., 2017). The increase of these conditions creates substantial societal costs in the United States (Schnyder et al., 2017). Mental dis s are often treatable and possibly preventable (American Psychiatric Association, 2018). Despite the demand and raising societal awareness of its importance highlighted by the coronavirus-19 (COVID-19) pandemic, help-seeking remains deferred or absent indicating a need to encourage people to begin and continue mental health services (Schynder et al., 2017).Given that some individuals suffer from mental health dis s, they need help, and it unclear how clinicians encourage them to begin and continue mental health services. Comment by Daniel Smith: Consider adding your own synthesis of ideas here versus ending a paragraph with the ideas of another author. Follow the MEAL plan of writing. Comment by Jennifer R. Seymour: We added a few sentences.
Multiple factors influence one’s help-seeking for mental health issues. The reasons include handling the problem themselves, lack of awareness, low mental health literacy, and financial are linked with decreased help-seeking (Magaard et al., 2017). Other literature, such as the National Alliance on Mental Health (2020); Hipes and Gemoets (2018), illuminated that mental health-seeking behaviors occur when self-awareness and self-discipline are sought. Fear of social stigmatization is another reason why a patient rejects treatment.

Prior research conducted by Kohn et al. (2018) and Lund et al. (2018) emphasized a gap between mental health patients requiring treatment and those successfully receiving help. The authors suggested a need to identify the social determinants of mental dis s, align them with sustainable development goals, and identify potential mechanisms and targets for interventions (Lund et al., 2018). Lund et al. (2018) expressed a need to further research why people decide to utilize or reject mental health services. The use or rejection of mental health services depends on the collaborative nature of participating in treatment by the patient and the provider working together to make the therapy worthwhile.

The purpose of this qualitative descriptive study is to examine how mental health providers describe the strategies that influence individuals’ decision to utilize or reject mental health services at the commencement of, and continuation of, treatment in south Texas. The proposed study addresses the gap in the literature and contributes to advancing the science by exploring factors according to mental healthcare providers that influence an individual’s decision to utilize or reject mental health services. The mental healthcare providers are regularly asked by their supervisor health providers to encourage patients to accept and not reject treatment at the start of treatment and continuing treatment. The high numbers of individuals coping with mental health conditions necessitate raising public awareness and campaigning for a better health care system in providing care (Hamilton et al., 2016). Part of this effort is identifying the reasons why people choose to utilize or reject mental health support.
In the southern Texas region, there is an unequal number of adults experiencing mental health problems. The numbers have increased from 9.4% in 2015 to 11.8% in 2018 (Understanding Houston, 2021). It has been reported that a higher percentage of adults’ report 14 days or beyond of undergoing poor mental health (Understanding Houston, 2021). Unfortunately, the populations being the most affected are Blacks, Hispanics, and Asian-Americans. Many of this population affected are between 30-44 years of age (Understanding Houston, 2021). These statistics illuminate the need for this proposed study to address mental health providers’ perceptions of the factors influencing their patients to seek or continue mental health services.
Chapter 1 introducesd the topic along with the background of the study. Other sections of the chapter include theoretical foundation using Bandura’s Social Cognitive Theory, problem, and purpose statements. The research questions, advancing scientific knowledge, rationale for the methodology, and nature of research design will be discussed. The last few sentences of the chapter will provide a summary and insight into Chapter 2.
The gap in the literature is a need to identify the reasons why people use or reject mental health treatment (Lund et al., 2018). The gap used to define the problem statement. The study research questions each then targets uncovering reasons contributing to the mental health patients’ use or rejection of treatment. This study may add to the literature, which focuses on stigma and insurance, and broaden it to look at the reasons patients who have access to treatment choose to use or reject it. For example, there is research that many people drop out of therapy before they planned to (O’Keeffe et al., 2019). These people had access but chose to reject therapy. If it is known why patients reject treatment, it becomes possible to develop policies or plan interventions to decrease the likelihood of rejecting treatment. This research will contribute to finding solutions for mental health acceptance by better defining the problems associated with approval and rejection from mental health professionals’ perspectives (Klymchuk et al., 2019 ). In summary, the goal is to learn what strategies counselors use that help patients continue treatment.
The results gotten from this research may be of help to practitioners in determining the necessary strategies to use to allow more individuals to receive the essential health care services that they require. Healthcare professionals may use the information during awareness programs about mental health (England, 2015). The information also is relevant for providers when handling mental health patients and also relatives for home care. It will also help establish effective methods that will be successful at implementing and sustaining interventions in therapy and for training purposes for providers.
The findings may enhance knowledge of the Social Cognitive Theory by extending it to the context of mental health promotion and prevention. It may help to describe how motivations in health and behaviors are influenced by the interaction of people’s beliefs, environment, and behaviors (Morin, 2019). For example, people may be motivated to reject therapy because of their beliefs, according to this theory (Peteet, 2019). Or they may be motivated to use therapy because of the best interactive behavior of mental health professionals according to this theory (England, 2015).

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Introduction

(Minimum three to four paragraphs or approximately one page)

The learner introduces the dissertation topic supported by prior research as defined by the problem space (see Chapter 2 for more information regarding problem space).

The learner states the purpose statement.

The learner overviews how the study advances knowledge and practice.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Background of the Study Comment by GCU: This heading uses Word Style “Heading 2”
Mental dis s create a tremendous global financial hardship more than chronic diseases (Tan et al., 2020). According to Jenifer (2014) to the Centers for Disease Control and Prevention [CDC] (2018), the disease has become a significant public health issue in the United States (U.S.) that is requiring immediate attention. The U.S. economic cost is approximately $2.5 trillion worldwide and is expected to double by 2030 (Tan et al., 2020). Unfortunately, many individuals not seeking help could result in adverse ramifications to the patients (Tan et al., 2020). There are many reasons for people not to participate in help-seeking towards mental health. Some of the reasons include cultural beliefs, stigma, perceived stigma, and healthcare providers’ attitudes towards them (Brown et al., 2019). Overall, there is a need to understand what strategies support clients’ use of mental health services when they begin to use and continue using treatment services.
Research shows that there are multiple reasons why people do not participate in seeking mental health treatment (Lund Hall et al., 2018). Furthermore, these patients tend to discontinue treatment before the physicians’ or healthcare providers’ specified date. Vega et al. (1999) emphasized the need for further research related to the underutilization of mental health services and issues for the minority and vulnerable populations. In this arena, healthcare providers could make a difference in how a patient continues or rejects mental health services. There is a gap in the research regarding why people utilize or reject mental health treatment (Lund Hall et al., 2018). This study will specifically address what mental health providers’ strategy use in the process of influencing the individual decisions to utilize or reject mental health services initially and when they are continuing treatment.
This topic needs to be understood better because it will help others know some of the dominant and effective strategies mental health practitioners use to encourage patients to begin and continue treatment. This is important becauseproviding early intervention ensures good communication in working with other interdisciplinary teams and agencies (Thomas et al., 2016).

Thís study is justified because it may play a significant role in understanding and informing the mental health providers to understand the best methods that can be used in the process of making sure that the mental ill patient does agree with the kind of treatments that they are being offered. Therefore, helping to make the treatment process easier and acceptable by the patients. Comment by Jennifer R. Seymour: The learner builds a justification for the current study, using a logical set of arguments supported by appropriate citations.
This research is applicable beyond the local setting because people globally are in the process of determining if they will start or continue mental health treatment and their mental health professionals are in the similar situation of trying to encourage them to accept treatment. This study will expose strategies that may be applicable to different settings and people.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Background of the Study
(Minimum two to three paragraphs or approximately one page)

The learner provides a brief history of the problem space, and a summary of results from the prior research on the topic.

The learner identifies what still needs to be understood within the problem space.

The learner provides a clear statement of what still needs to be understood: “The research that needs to be better understood is …”

The learner builds a justification for the current study, using a logical set of arguments supported by appropriate citations.

Learner situates what needs to be understood by discussing how the research is applicable to/beyond the local setting and may be contributory to professional or broader societal needs.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Definition of Terms Comment by Jennifer R. Seymour: I put them in alpha for you.
EACH one needs an academic reference.

Capitalize the beginning of the sentences. Comment by Jennifer R. Seymour: Need to add Mental Health Strategies – to encourage people to continue

Mental health acceptance- this usually needs to develop and evolve over timetime, and it should be appropriate to the different life stages of a person’s concern. This is the willingness of a person to accepting that they do have mental problems and that they are willing to get medical assistance (Cage et al., 2018).

Mental health dis s- A broad term that is used to refer to a range of conditions affecting one’s mood, thinking, and behavior. It is condition that could be occasional or chronic influencing one’s ability to function (Medline Plus, 2021).

Mental health – This is a state of well-being where an individual understands their abilities, cope with normal stresses, works productively, and contributes to their community (World Health Organization, 2018).

Mental health literacy- A construct taken from health literacy, which refers to an individual’s knowledge, beliefs concerning mental dis s that usually affects their management, recognition, and prevention (Kutcher et al., 2016).

Mental health services- these are the specific services that are fully devoted to the process of treating mental illnesses and the improvement of mental health in people with mental problems (Abuse, 2013).

Mental health rejection- in mental illness, rejection can be referred to as the feeling of sadness, shame, or grief that people usually feel when other people do not accept them. In this research however, this term is used to refer to the fact that people who are mentally ill reject mental health services willingly or unwillingly (Rohner & Britner, 2002).

Mental health strategies- Describes a behavior or habit performed routinely. Typically, these are lifestyle amendments time-tested and clinically proven to be effective in decreasing anxiety, depression, or other mental health dis s (Israel, 2019). These are just the basic and fundamental steps that are taken to ensuring that the mental wellbeing of people who are mentally affected are identified and stabilized (Powell et al., 2012).

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Definitions of Terms
(Each definition may be a few sentences to a paragraph.)

The learner defines any words that may be unknown to a lay person (words with unusual or ambiguous meanings or technical terms) from the research or literature.

The learner conceptually defines the phenomena in the study

The learner supports definitions with citations from scholarly sources, where appropriate.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Anticipated Limitations
Limitations associated with this study included:

1. Some of the findings might not be truthful because honesty of the participants cannot be known. The only strategy that can be applied in this situation is to tell the participants to be as honest as possible. As an interviewer, I will try to be open and kind so that they feel they can be honest. This is unavoidable because people are prone to embellish. The consequence of this limitation is that the validity or trustworthiness of the study could be compromised.
2. Participant bias. This occurs when a participant is reacting or answering the questions according to what they believe the doctoral investigator wants (Leedy & Ormrod, 2014). To minimize this occurrence, the doctoral investigator will reassure the participants that their answers and data are confidential (which will allow them to talk freely and truthfully). The doctoral investigator will inform the participants that if they feel a topic is to sensitive it discussion will stop.
3. Doctoral investigator bias related to subjectivity and errors. Aggarwal and Ranganathan (2019) stress that descriptive studies may contain errors as the researcher may ignore data that conforms to the study’s hypothesis. To minimize this, the doctoral investigator will use open coding and MaxQDA to capture all the findings. The program allows the creation of an audit trail to track the coding process so that they may be reviewed, and any mistakes corrected. Also, having a second trained individual to review the coding will be implemented. Hence, decreasing the possibility of the trustworthiness or credibility of the study being compromised.
4. There is a possibility of researchers, subjectivity, and errors. Aggarwal & Ranganathan, (2019), stresses that descriptive studies may contain errors as the researcher may ignore data that conforms to the hypothesis of the study. To minimize this the researcher will use open coding and MaxQDA to try to capture all the findings. The program allows of the creation of an audit trail to track the process of coding so that they may be reviewed, and any mistakes corrected. Above all, repeatedly reviewing coding to be confident in the analysis will be the strategy used. This is unavoidable because bias is largely unknown. The consequence of this limitation is that the trustworthiness or credibility of the study may be compromised.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Anticipated Limitations
(Each definition may be a few sentences to a paragraph.)

The learner identified anticipated limitation.

Learner provided a rationale for each anticipated limitation.

Learner discussed consequences for the transferability and applicability of the findings based on anticipated limitations.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Summary and Organization of the Remainder of the Study
The problem being addressed is that it is not known how mental health providers describe the strategies that influence patient decisions to utilize or reject mental health services at onset of possible treatment, and during treatment, in south Texas. The research specifically looks at how mental health providers are describing the strategies that influence individuals’ decision to utilize or reject mental health services at the commencement of, and continuation of, treatment in south Texas. The proposed study addresses the gap in the literature and contributes to advancing the science by exploring factors according to mental healthcare providers, which influences individual’s decision to utilize or reject mental health services. The purpose of the qualitative study is to examine how mental health providers describe the strategies that influence individuals’ decision to utilize or reject mental health services at the commencement of, and continuation of, treatment in south Texas.

For the proposal, the learner must include a project timeline for completion of the dissertation. This may include going through committee review, level 2 peer review, proposal defense, IRB, data collection, data analysis, completing chapters 4 and 5 and updating proposal language, committee review of dissertation, level 5 peer review, dissertation defense, form and formatting, etc. (See the Dissertation Milestones Guide for more information.) When the dissertation is complete, this section should be revised to eliminate the timeline information.
For both the proposal and the dissertation, the learner will also summarize feasibility of the study and complete the feasibility and benefits checklist in Appendix H. The learner will complete the alignment table below and assess if the items are aligned. If the items are not aligned, the learner will work with the committee to discuss alignment until alignment of the items occurs. It is vital that the learner work on alignment during the courses prior to attending the first residency and then continue to use and update the table as the research study matures.

Insert Project Timeline Here:

2021

June: Sent to Methodologist, Edits

July: Sent to Content Expert, Edits

August & September: Sent to AQR, Edits

October: Proposal Defense Meeting

November: IRB Application and Approval

December Data Collection

2022

January: Data Collection

February: Data Analysis

March: Ch 4 Results

April: Ch 5 Conclusions

May: Sent to Methodologist, Edits

June: Sent to Content Expert, Edits

July and August: Sent to AQR, Edits

September: Final Defense Meeting

Table 2.

Alignment Table Comment by Jennifer R. Seymour: COPY AND PASTE INTO HERE.

Alignment Item

Alignment Item Description

Problem Space Need:

The problem space that needs is to be understood is the different factors that do influence an individual from seeking mental health services and how these identified factors help in making the required decisions especially by the medical service providers.

Problem Statement:

The problem is that it is not known how mental health providers describe the strategies that influence patient decisions to utilize or reject mental health services at onset of possible treatment, and during treatment, in south Texas. Comment by Jennifer R. Seymour: I got this from the problem statement section at the end of ch 2.

Purpose of the Study:

The purpose of this study is therefore to examine how mental health providers do describe the different strategies that do influence the decisions to ether utilize or reject mental health services or treatment.

Phenomenon:

The research will look at the strategies mental health professionals use to encourage patients to begin or continue mental health treatment.

Research Questions:

RQ 1: What strategies do mental health providers use to encourage patients to begin using mental health services?
RQ 2: What strategies do mental health providers use to encourage patients to continue
using mental health services?

Methodology/Research Design:

A qualitative methodology will be used in this study. Qualitative methodology is the most appropriate methodology that provides rich data and is not bound by limitations. Qualitative methods will help provide evidence from the interview with participants who have experienced giving primary data

Chapter 2 will present a review of current research on the mental health utilization and rejection. Chapter 3 will describe the methodology, research design, and procedures for this investigation. Chapter 4 details how the data was analyzed and provides both a written and graphic summary of the results. Chapter 5 is an interpretation and discussion of the results, as it relates to the existing body of research related to the dissertation topic.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score Comment by Jennifer R. Seymour: Needs to be done

Feasilbility checklist

Table pasting

Chapter 1 Summary and Organization of the remainder of the study
(Minimum one to two pages)

FOR PROPOSAL ONLY: The learner provides a project timeline for completion of the dissertation.

The learner provides a summary of feasibility of the study. The learner completes Appendix H (feasibility and benefits checklist).

The learner completes the alignment table above. Furthermore, the items within the table are aligned.

The learner describes the remaining Chapters and provides a transition discussion to Chapter 2.

The learner correctly formats the chapter to the Template using the Word Style Tool and APA standards. Writing is free of mechanical errors.

All research presented in the chapter is scholarly, topic-related, and obtained from highly respected academic, professional, original sources. In-text citations are accurate, correctly cited, and included in the reference page according to APA standards.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

. Comment by GCU: Use INSERTPage Break to set a new page for the new chapter.

Do not use hard returns to create a new page.

Do not insert a section break

Chapter 2: Literature Review

Introduction to the Chapter and Background to the Problem Comment by Jennifer R. Seymour: Need to reformat headings throughout paper to be APA 7

APA Headings and Seriation // Purdue Writing Lab
There are some populations that will reject mental health services regardless of whether they need it or not citing stigmatization and victimization (Sebastian & Richards, 2017). According to Laugharne et al. (2018), the need to understand the populations, either accepting or rejecting mental health services stems from the need to improve the nation’s mental health status. This literature review will address the issue that some populations openly seek mental health services as they have identified that they are at high risk of mental illness (Naslund et al., 2020).
The literature review seeks to reveal what is known concerning the nation’s mental health. This literature review will address the topic of mental health services, with emphasis being placed on the availability of the service, the availability of infrastructure supporting the service, and the perception of people towards the service. The review will analyze the populations that have readily accepted and are willing to seek mental health services those that reject and are unwilling to seek mental health services. The review being conducted because not all people have embraced mental health services and on the fact that there is a gap in the delivery of mental health care services.
The chapter will be divided into seven sections. The seven sections are mental health infrastructure, populations that accept mental health, populations that reject mental health, populations that have access to mental health, populations that do not have access to mental health, reasons for the rejection of mental health and the reasons for the use of mental health services. All the sections will have three sub-sections. The subsections will include the introduction of the section, themes in the section, and synthesis of the sections.
The literature review in addition, aims to compare the existing literature on mental health. The comparison is supposed to provide light on whether there are similar opinions and views on the subject. The comparison as well helps in the identification of the various divergent views on the subject matter. Seven sections organize this paper. The literature review is divided into seven sections to touch on all subjects associated with mental health. It is not reviewed, as it is not the focus of the study. The first section is mental health infrastructure, and it focuses on the availability of mental health infrastructure in the nation. The literature review is based is based on the knowledge that mental health services infrastructures are not well distributed to help those in need of mental health services.
The second section focuses on the reasons for the lack of access to mental health. The need to review related literature is driven by the knowledge individuals need mental health; however, they choose not to seek it. The third section analyzes the population that has easy access to mental health services. The fourth section deals with the populations that use mental health services. The fifth section focuses on the populations that reject mental health services. The sixth section focuses on the reasons for the use of mental health services. The review is on the need to understand why people seek or do not seek mental health services. The seventh section focuses on the reasons for the rejection of mental health services.
The literature was conducted through a systematic review using Scopus, Science Direct, PubMed, Cuiden, Cochrane, google scholar, ISI, and PsycINFO databases. The review was conducted using key terms related to the sections of the study. : For the study to remain relevant, the doctoral student reviewed only studies conducted and published within the past five years. Other inclusion criteria were:
· Written in English.
· Related specifically to mental health.
· Published in the United States
The problem of mental health has evolved historically overtime. According to Higgins (2017), mental health in the United States has declined in the last twenty years. He cites that suicide rates have increased two-fold from 1990. Furthermore, he cites that substance abuse, more so of opiates, has become an epidemic. Higgins claims that the disability award for mental dis s has also increased dramatically, a possible indication of the nation’s mental health dwindling. Comment by Jennifer R. Seymour: I think this needs to be about your problem. We have to revisit it.
This study will focus on the gap in research regarding the reasons people utilize or reject mental health treatment. The problem is that it is not known how mental health providers describe the strategies that influence individual decisions to utilize or reject mental health services at the beginning and when they are continuing treatment in south Texas. Without an understanding of the reasons are for use or rejection, it is unlikely that successful interventions can occur that would enable more people to utilize mental health services including among the minority population of Hispanic-Americans, African Americans, and the Asian-American families.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Introduction (to the chapter) and Background (to the problem)
(Minimum two to three pages)

Introduction
: The learner provides an orienting paragraph, so the reader knows what the literature review will address.

Introduction
: The learner describes how the chapter is organized (including the specific sections and subsections).

Introduction:
The learner describes how the literature was surveyed so the reader can evaluate thoroughness of the review. This includes search terms and databases used.

Background:
The learner discusses how the problem has evolved historically into its current form.

1 Comment by Jennifer R. Seymour:

Background
: The learner describes the what still needs to be understood defined in the problem space in current literature and how it leads to the creation of the topic and problem statement for the study. Note: This section is a significant expansion on the Background of the Study section in Chapter 1.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Identification of the Problem Space
The problem space has evolved over time with early research on mental health treatment in the 1980s focusing on the number of people getting treatment and the types of treatment. Later (Sebastian & Richards, 2017) looked at the impact of different types of treatment. Current research is looking at how to support people to engage in mental health treatment, which has indicated a gap in the research to look at how therapists encourage patients to begin and continue treatment as, will be investigated in this study. (Yoon, 2001). Comment by Jennifer R. Seymour: Add references Comment by Jennifer R. Seymour: Add references Comment by Jennifer R. Seymour: Add references
The learner summarizes the problem space, highlighting what has been discovered and what still needs to be understood related to the topic from literature or research dated primarily within the last five years.

In the many research studies that have been carried out, there have been many issuess such as attitudes, demographics, beliefs (Naslund et al., 2020) that have been discovered and that are currently being used in the field of studying the mental health people. Some of the findings that many researchers have concluded in the past include, the relationship between mental health illness and issues is closely related to the personal information and factors (Sebastian & Richards, 2017). . However, the research that were carried did not actually pinpoint the specific individual or personal factors, instead the research gave a direction and a gap to which many researchers are currently exploring (Naslund et al., 2020) Comment by Jennifer R. Seymour: Add references
The research is currently working because, this is an area that the government has seen to be having many gaps that are needed to be addressed,. However, people are attributed to be using mental health services for the simple fact that the services are exposed to them currently and it is affordable (Ecks, 2016). Also some of the population who prefer and choose not to accept mental health services is in most cases attributed by the fact that they do have certain attitude and beliefs towards mental health treatment (Lund et al., 2018)..

(Gondek et al., 2017). The findings in the past as to only give a simple and basic direction in which the research that came after followed. The past research only tried to find the relationship that is there between acceptance and rejection of mental health services and different factors such as beliefs and attitudes basing these explanations on the social cognitive theory. The research done in the past discovered that things like attitudes and beliefs played a very significant role in deciding whether a person accepts or rejects mental health treatment, (Lund et al., 2018). Research done by Norman, 1986; Spradlin, 2012; Yoon, 2001) brought about these explanations forcefully. However, there are still certain things that are needed to be understood better, things such as how factors such as demographic and certain groups such as LGBT makes people to either accept or reject mental health services. These are why people refused to use mental health services were purely health related, in that, people refused to accept and take mental health services because they generally thought that it was not necessary. The researches in the past also to a smaller extent attributed the reason as to why people are rejecting mental health services is caused by demographic factors. Comment by Jennifer R. Seymour: I’m curious about what this references has to say and if it is related to what needs to go here. I don’t think it does. Comment by Jennifer R. Seymour: No it is not. OR is it? Do you have other research studies that say this? Not this study. Comment by Jennifer R. Seymour: Realllly? How do you know that? What reference? Comment by Jennifer R. Seymour: How do you know this? Ref?
This study will focus on the gap in research regarding the reasons people utilize or reject mental health treatment. The problem is that it is not known how mental health providers describe the strategies that influence individual decisions to utilize or reject mental health services at the beginning and when they are continuing treatment in south Texas.
This study will contribute to the body of literature by adding the perspective of the mental health professionals on what should be done to encourage mental health patients to continue their treatment plan. Comment by Jennifer R. Seymour: This is true.
Therefore, the identified and the methods that this research will use will be shared among the different mental health professionals both in this study and beyond and this will be helpful in handling the issues that might arise in the future and therefore making this whole process easier and understanding patients better.

The notion of the “problem space” is an approach GCU uniquely uses to support learning how to approach the identification of the gap. GCU has adapted the concept of the problem space from the fields of cognitive psychology and design (including interaction design, user experience design, and research and development (Card, Moran, & Newell, 1983; Colman, 2015; Euchner, 2019; Hora, 2016; Norman, 1986; Spradlin, 2012; Yoon, 2001). These disciplines and approaches share the premise that the problem space is composed of the thinking and set of key issues or components that produce a well-defined problem. For doctoral learners at GCU, a well-defined problem produces a tightly defined Problem Statement.

The topic, the problem statements that other researchers have defined, and the approaches that other researchers have taken, all constitute the “problem space” for a study. The problem space is a way to help you establish some boundaries for the literature review, so that you have a clear idea of what to include and what to exclude. What needs to be understood is the result of the analysis of the literature review within the problem space, and the problem statement expresses how the proposed study will address what needs to be understood.

Becoming deeply familiar with how a specific topic has been studied involves reading and synthesizing the literature related to the problem space, focusing in particular on the past five years. Lack of research on a topic or personal interest in an unresearched topic are not sufficient reasons to do a dissertation. Just because something has not been researched does not mean it should be. Therefore, the learner must be “well read” on their topic to identify ways their study will add to the existing body of knowledge on the topic. The learner should explain why the extant theories and empirical studies need further inquiry.

The problem space is thus comprised of identifying what is known and not yet understood about a topic, understanding how it has come to be known (the theories, designs, methods, instruments) and then figuring out what is not yet known. The result of this deep and systematic thinking results in identifying the problem to be addressed in the research study, and the resulting well-structured problem statement.
All learners must identify how they will focus their research to produce an original dissertation. This involves the difference between what is known in a field of research and what is not yet understood. This process involves reading the literature and becoming deeply familiar with how a specific topic has been studied, how the research is trending, and what approaches have been used to study it in to identify what still needs to be understood.
Practice-based research may initially define the problem based in a practice within an organization or setting. However, the approach to investigating the problem needs to follow scholarly research procedures. This means that the problem space needs to include literature that is scholarly in nature so that the proposed dissertation research will advance knowledge and practice. The literature review should include peer-reviewed articles from research-based journals as well as journals on professional practice and research-based industry journals.
There are a variety of ways to synthesize the literature. Below is a set of steps that may be used:
First, explore original literature on the topic. The topic should focus on an issue pertinent to the learner’s program of study to determine what has been discovered and what still needs to be understood.
Second, while exploring the original literature identify the broad topics and problems researched. Explore the evolution of the research on the problem. How did the focus change? What findings emerged from these studies?
Third, describe the research from the past 2 to 3 years to discover what has been discovered, what problems have been studied, and what still needs to be understood. Discuss the trends and themes that emerged. Studies that were published within the past 2-3 years will still be relevant (within the past 5 years) at the point of graduation.

Note: Problem space for the dissertation study should primarily come from the empirical research literature or studies dated within three to five years of the learner’s projected graduation date.
This is a recommendation, not a rule.

Dissertations can be used to support the problem space; however, one must supplement dissertation citations with citations from other peer-reviewed research on the topic.
Fourth, define the topic and problem statement by synthesizing the recent studies, including trends, and define what still needs to be understood.
While the verbiage in this section highlights a set of steps designed to help GCU doctoral learners identify what still needs to be understood for their study, there are other methods that can be used. These include using recommendations for future research from prior studies and literature reviews, adding to a broadly researched area through clearly targeted research, reframing problems to focus the research on identifying the solutions, and synthesizing areas of research to define a new or innovative area of research. This section must clearly identify the specific sources that form the basis for what will become the problem for the study. Comment by GCU: Learners can access further information on these strategies on the Doctoral Community Network website (https://dc.gcu.edu) under the Residency tab (on the left side of the Home page). Also, see https://dc.gcu.edu/blogs/faculty__staff_presentations/dr_june_maul_finding_the_gap_in_the_literature_1st_steps_to_your_dis.

In the last part of this section, the learner will describe how the study is situated within the problem space established in the previous discussion within this section. The learner should also describe how the study may add to the body of literature. Finally, the learner should discuss any potential practical or professional applications that might occur as an outcome or application of the study.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Identification of the Problem Space
(Minimum two-three pages)

The learner provides a detailed description of how the problem space has evolved over time, and the effects it has had on the research (research trends).

The learner summarizes the problem space, highlighting what has been discovered and what still needs to be understood related to the topic from literature or research dated primarily within the last five years.

The learner discusses and synthesizes the evolution of the research on the problem. Specifically:
· Identifies the key sources used as the basis for the problem space
· Identifies trends in research and literature.
· Identifies how the research focus has changed over the recent past (five years).
· Discusses key findings that emerged from recent studies.
· Discusses prior research and defined future research needs.

From the findings of research studies and evolution of recent literature on the topic, the learner defines the parameters for problem statement for the study.

The learner describes how the study will contribute to the body of literature.

The learner describes the potential practical or professional applications from the research.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Theoretical Foundations Comment by GCU: This section has been adapted from the
GCU e-book (2016); Chapter 2 by Dr. Renee Wozniak, and
Chapter 4. Background of the Problem, Developing the Theoretical Foundations, and Significance of the Study
By Dr. June Maul

The theoretical foundation of this paper is based on the cognitive theory of psychopathology. The theory was suggested by Aaron T. Beck and emphasizes that perception influences both positive and negative mental health status (DeYoung & Krueger, 2018). The model is ideal for the dissertation. It helps describe how an individual’s perception of situations or spontaneous thoughts on situations influences their emotional, behavioral, and psychological reactions towards mental health services. The theory emphasizes that distorted beliefs affect people’s understanding of themselves, their world, and the people that they interact with. Furthermore, distorted beliefs influence an individual’s information processing.
The theory focuses on perception considering that mental health is primarily perception and neural connections. If neural connections are right, then Tthe other factor influencing an individual’s views on mental health services is their perception. Perception refers to the understanding of the interpretation of a phenomenon. Perception is influenced by past events, culture, values, present circumstances, education, and preconceived notions (Rosli & Goh, 2020). By understanding the influences of perception, it is possible to understand the people’s view towards mental health services.
This theory is connected to this study with the concept of perceptions. A look at the difference in individuals’ acceptance and rejection of mental health services reveals that it is about individual perceptions. Over time, individual perceptions have been grouped together, and consequentially, beliefs around mental health have been formed. For example, members of the LBGT community believe that mental health services are meant to conform them to an identity that they do not agree to (Steele et al., 2017). The belief started with an individual’s perception, and the perception grew into the belief that supports the rejection of mental health services. According to Knight et al. (2018), perception is a cornerstone of people’s decisions to reject or accept mental health treatment. By basing the foundation of the study on the cognitive theory of psychopathology it is possible to come up with a reason that explains why there are individuals that openly accept mental health services as well as why there are individuals that reject mental health services. This is because the theory states that perception influences both positive and negative mental health status, which helps explain the role of perception in the seeking or rejection of mental health services.
By seeking to understand perceptions picked in the studies under review, it will be possible to explain why people have different views regarding mental health. Consequentially, it will be possible to contribute to the knowledge present on mental health and the seeking of mental health services. Basing the study on the cognitive theory of psychopathology, it will be possible to extend the theory in the study of mental health.
The theory used for the study build on the research questions. The study concern is on the perceptions that influence the acceptance and the rejection of mental health services. The questions seek not only to lead the researcher to the reasons around the rejection and acceptance of mental health services. This study will be directed by the cognitive theory of psychopathology, which will possibly extend the theory in mental health.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Theoretical Foundations
(Minimum two to three pages)

The learner discusses the theoretical foundation and, where appropriate, the extended conceptual framework that undergird and frame the study.

The learner identifies theory(ies) models, and/or concepts from seminal source(s) that provide the theoretical foundation to use in developing the research questions, identifying phenomena, and describing the sources of data.

The learner cites the appropriate seminal source(s) for each theory, model, or concept.

The learner includes a cogent discussion/synthesis of the theories, models and concepts, and justifies the theoretical foundation/framework as relevant to the problem statement for the study. The learner connects the study directly to the theory and describes how the study adds or extends the theory, model, or concept.

The learner’s discussion reflects understanding of the foundational and historical research relevant to the theoretical foundation.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Review of the Literature
Mental Health Infrastructure

The articles included in this section discuss causes of poor mental health infrastructure (Ecks, 2016; Johnson et al., 2018; Thompson, 2018; Karaye et al., 2019; Martin et al., 2016). Some articles focus on the lack of enough mental health institutions (Hester, 2017; Tran & Ponce, 2017), while other articles focused on reasons why people are unable to access mental health services (Kohn et al., 2018), unavailability of adequate staff (Johnson et al., 2018), and lack of transparency and trust in psychiatric treatment (Mongelli et al., 2020). There are an estimated 11,682 mental facilities in the U.S. and out of this, less than 2000 of the facilities are running 24/7. : The above statistics indicate that the nation has limited mental health infrastructure, contributing to poor access to mental health services.
Hester (2017) conducted a study aimed at finding out the effect that lack of sufficient mental health institutions had on military personnel’s ability to access mental health services. He focused on finding out why so many military personnel were committing suicide after coming from active combat. The study was an Army Study to Assess Risk and Resilience in Service members. To ensure no bias, he compared the data he found from the existing data on civilians collected by the American Mental Health Association. The findings of the study revealed that the mental health disparity is the most probable leading factor of high suicide rates amongst veterans, more so those who have been exposed to traumatic experiences. Based on the findings, Hester (2017) concluded that more servicemen needed to be screened for mental challenges before returning to civilian life, which can only be done by having more psychiatric units in the military. Furthermore, he found that there was need for a collaboration between non-profit mental health providers and public health providers.
Tran and Ponce (2017) conducted a survey aimed at finding out the number of people who needed mental healthcare and could access them. The study found that California had a population of 82,706 adults with mental health needs. The researchers used Multivariable logistic regression analysis of the data that they collected. The results of the study indicated that 70% of individuals with mental health complications had either not received any mental health service or that the service that they received was inadequate. Further study of the data revealed that mental health stigma and the cost of treatment prevented Californians from seeking mental health, and the infrastructure set in place could not be easily accessed.
Kohn et al. (2018) conducted community-based surveys to find out the reasons why people were unable to access mental health services. The study involved surveying 75,306 participants who were 15 years and above. The findings of the study revealed that mental health illness accounted for a tenth of the nations’ burden of diseases. Out of the identified population, more than a third could not access mental health services due to high costs poor infrastructure. Lack of insurance is one of the reasons why people could not access these services. Poor socioeconomic status, particularly for families in rural areas, made it difficult for them to access mental health services. The distance has also been found to be another reason why people were unable to utilize these services.
Martin et al. (2016) conducted a case study analysis of correctional centers to find out the number of correctional centers that offered mental health services. The analysis involved going through data provided by the Department of Corrections, where special emphasis was placed on going through the policy to screen inmates’ mental health upon admission. The analysis revealed that between 10% and 15% of inmates were erroneously classified in terms of their mental health, thereby reducing their chances of getting mental health services. The misdiagnoses were a result of poor mental health infrastructure in jails.
Johnson et al. (2018) conducted a study to find out whether the funds allocated towards mental health were sufficient to meet the needs of the people. The study revealed that hospitals that had psychiatric departments and units had their employees working long hours due to inadequate staffing, an indication that resources allocated to psychiatric wards were limited. The articles that they reviewed were drawn from peer-reviewed journals, national reports, and surveys. The review established that the availability of mental health services was compromised. The researchers recommend that more psychiatric employees be deployed to improve mental health services delivery.
Georgakopoulos and Pato (2020), conducted a study that studied the reason why many people were unable to access psychiatric treatment. The articles that they reviewed were drawn from peer-reviewed journals, national reports, and surveys. The researchers examined some of the barriers to behavioral healthcare. Based on the review it established that the lack of transparency and trust has often led to the withdrawal or revocation of resources and infrastructure allocated to mental health. The revoking of the infrastructure was triggered by the need to reduce wastage, but the effect of the revocation was limited access to mental health services in the nation.
Machado et al. (2018) carried out a study to find out the number of mental health related suicide cases among youths. The population was drawn from 5507 municipalities where the causes of suicides among youths were investigated. The study focused on individuals aged 14 to 22 years. Further investigations of the study revealed that the mental health needs of those in low income municipalities were not being met because of poor mental health infrastructure.
Ecks (2016) carried out a study that compared the number of mental health infrastructure globally compared to physical health infrastructure. The study focused on global mental health policies not older than 25 years. The study revealed that physical health is prioritized over mental health, shedding light on why there are fewer mental health infrastructures in the U.S. and globally. The study recommended that more attention needs to be given to mental health for global mental health to improve.
Karaye et al. (2019) conducted a study to determine the number of people who were conducting self-assessment mental tests on the internet. A 12-item Short-Form Health Survey (SF-12) was administered online to a sample of 3030 residents. Multiple linear regression models were used to identify predictors of self-rated health among the respondents. The survey revealed that U.S. gulf coast residents were using self-rating to assess their mental health as there were no facilities to aid in assessing their mental health. The study recommended that more mental health facilities needed to be set up in the gulf, considering the population at the U.S. gulf coast high-risk population; their constant contact with typhoons, hurricanes has traumatized many to the extent that their mental health has been compromised.
Castillo et al. (2019), studied the interventions that communities had in place to cater for those with mental health issues and improving the mental health of community members. The review revealed there were few effective community interventions to help with mental health. The research team reviewed the literature on seven topics: early psychosis, criminal justice, global mental health, collaborative care, school-based interventions, mental health promotion, and homelessness. Based on the review it was revealed that the majority of people in the US and Australia were calling for community interventions for mental health promotion as they could not access mental health services easily. The review established that more mental health infrastructures needed to be set up for mental health to improve.

Synthesis

The success of most health services is dependent on the availability of resources and infrastructure and mental health is not an exception to this. The majority of the studies and reviews analyzed are similar in that they confirm that the likely cause of mental health is poor infrastructure. The study by Johnson et al., 2018; Martin et al., 2016 and Ecks, 2016 are of a similar view that poor mental health infrastructure is undermining the delivery of mental health services. The studies cited poor infrastructure, few mental health practitioners, and poor knowledge of mental health as the three main things hindering mental health service delivery.
The success of most health services is dependent on the availability of resources and infrastructure and mental health is not an exception to this. The majority of the studies and reviews analyzed in this section are similar in that they confirm that the likely cause of poor mental health services is poor infrastructure. Several studies (Ecks, 2016; Johnson et al., 2018; Martin et al., 2016) are of a similar view that poor mental health infrastructure is undermining mental health services. The study by Karaye, Ross, and Horney (2019) is a good example of a study that confirms that the mental health institutions, as well as infrastructures not only in the state but in the nation, are not sufficient enough to meet the mental health needs of the population.
Six of the studies reviewed claim that the lack of enough mental health infrastructure is hampering mental health service delivery. The study by Karaye, Ross, and Horney in 2019 is a good example of a study that confirms that the mental health institutions, as well as infrastructures not only in the state but in the nation, are not sufficient enough to meet the mental health needs of the population. There was also a divergent view that there are enough mental health facilities and that there were other factors that were hindering access to mental health services. The identified factors were stigma, lack of resources, and the abuse of drugs. (Machado et al., 2018; Kohn et al., 2018; Tran and Ponce, 2017).
The following studies were very strong because of their large sample size (Castillo et al., 2019; Ecks et al., 2016; Mongelli, Georgakopoulos, and Pato 2020). Other studies such as Tran and Ponce 2017 and Martin et al., 2016 were strong because they did not have researchers’ triggered biases. Several studies were weak because of limitations. For example, (Machado et al., 2018); Johnson et al., 2018 and Kohn et al., 2018) were weak because of the limitation of researchers’ triggered bias.

Reasons for Lack of Access to Mental Health

The articles included in this section are on several subtopics that include the numerous reasons why people cannot access mental health services such as lack of financial capability (Chisholm et al., 2019; Fleury et al., 2019; Kohn et al., 2018; Calear et al., 2017). Other articles focus on personal beliefs and fears (Reynolds et al., 2020; Vreeman, McCoy &Lee, 2017) while others focus on travel distance barriers (Calear et al., 2017), poor health systems, poor organization, and poor professionals (Fleury et al., 2019; Bartolomei, 2016), stigma (Vreeman, McCoy, & Lee, 2017) and low-income (Chisholm et al., 2019).
There are various reasons that people cannot access mental health services. Top on the list is the lack of financial capability. The review looks at the factors and the reasons that make the accessing of mental health services difficult or impossible. An analysis of the studies reviewed revealed that the majority of the individuals or populations that had challenges in accessing mental health services were unable to due to forces or circumstances out of their control. Chisholm et al., 2019; Fleury et al., 2019; Kohn et al., 2018 and Calear et al., 2017 stated that the lack of finances, poor resources, and poor infrastructure were the primary reason why accessing mental health services was difficult. Surprisingly, some individuals opted to not get to access mental health services based on reasons that they could control or that they could navigate. The study findings by Reynolds et al. (2020) and Vreeman, McCoy, and Lee (2017) stated that access to mental health services was hampered by personal beliefs and fears which can be controlled.
Calear et al. (2017) carried out a study on whether male or female students’ adolescents had a greater ideation of suicide. The study consisted of a two-arm, cluster-randomized, controlled trial in eight high schools with the focus being on male students in either 11th or 12th grade. Data was collected pre-intervention, post-intervention and at three months follow up to establish whether the intervention suggested in the study was effective at reducing suicide rates and ideation. Based on the trial it was established that help-seeking stigma was the main reason as to why male adolescents were unwilling to access mental health services. The main limitation of the study was that it focused specifically on one gender. The overlooking of the female gender might have led to conclusions that do not necessarily represent society.
Approximately 38% of Americans, or 96 million, on several occasions, have waited longer than a week for mental health treatment services. Distance is another barrier in that about 46% of the population have experienced or knew someone who has had to travel for over one-hour roundtrip to seek treatment (Calear et al., 2017). Although many Americans have tried seeking mental health treatment, in addition to the 29% of the population who want to; many however, failed to seek the treatment for either themselves or loved ones due to lack of knowing where to go for the services. Statistics also indicate that 21% of adults in the US have tried to see a professional but were unable to do so because of reasons outside of their control (Calear et al., 2017).
Kohn et al. (2018), carried out community-based surveys to find out the reasons why people were unable to access mental health care. The study was carried out in Argentina, Brazil, The United States, Peru, Chile, Columbia, Canada, Mexico, and Guatemala. The study involved surveying 75,306 participants who were 15 years and above. The data collected included the weighted median and the mean treatment gap of moderate and severe mental illness. The data collected was analyzed by comparing it to the Global Burden of Disease rating. The findings of the study revealed that mental health illness accounted for a tenth of the nations’ burden of diseases. Out of the identified population, only a third cannot access mental health services due to high costs as well as poor infrastructure. According to (Kohn et al., 2018), the survey data indicated that women were at the highest risk of developing mental health issues due to drug abuse and sexual abuse and it also indicated that more women compared to men sought mental health services.
Fleury et al. (2019) conducted interviews to gather information on the perceived barriers to mental health. The researchers, through semi-structured interviews conducted on 49 emergency room stakeholders identified that the barriers to access to mental health services were poor health systems, poor organization, and poor professionals (Fleury et al., 2019). The main limitation of the study was that the researchers did not have measures in place to ensure that the interviewees answered truthfully. As a result, the findings may not have been as accurate as they should have been.
Bartlomei et al. (2016), carried out a qualitative study to find out the reasons behind poor access to mental health care services. He concluded that the lack of professional training, inadequate resources, and poor infrastructure led to poor access to mental health services. The researchers published their findings in reference to a study that they had conducted using a Likert scale on 135 care workers and mental health caregivers. The main limitation of the study is that the population that was studied on was too small and therefore the replication of the results of the study was hard to do using a large sample size.
In 2017, Vreeman, McCoy, and Lee presented their findings on a prior study assessing the challenges facing HIV affected youth as they accessed healthcare. The researchers reviewed 11,501 articles and publications where they focused on keywords. The words were HIV-related stigma, measurement of mental health problems, depression, and anxiety amongst HIV positive adolescents. The trio identified that the stigma around both HIV and mental health led to few HIV-adolescents seeking mental health services.
Reynolds et al. (2020), carried out a study assessing the challenges facing access to mental health care for the elderly. Through individual interviews of 15 adults aged between 61 and 81 years, Reynolds et al. (2020), identified why the access to mental health services was hard for the elderly. The researchers collected data through the audio-recordings of the interview sessions and analyzed the data through narrative methods. The researchers identified that the elderly were resistant to accessing the services due to the fear of being labeled psychotic, difficulty in understanding and navigating through the help-seeking process, and the lack of emotional knowledge on how to react to psychological treatment. The main limitation of the study was that the sample size was too small for it to be used as a representation of the elderly.
Chisholm et al. (2019), carried out a study aimed at finding out challenges to accessing to accessing healthcare to low class individuals. He conducted narrative and quantitative assessment and in-depth interviews in an attempt to understand the challenges in the accessing of mental health services. The researchers used a multi-method approach that consisted of three phases; narrative and quantitative assessment and in-depth interviews of low-income individuals in six sub-Saharan Africa and South Asian nations (Chisholm et al., 2019). From the study, the researchers identified that poor financial position limited access to mental health services. In addition, mental health services received significantly less funding compared to other health services.

Synthesis

An analysis of the studies reviewed revealed that the majority of the individuals or populations that have challenges in accessing mental health services are unable due to forces or circumstances out of their control. (Chisholm et al., 2019; Fleury et al., 2019; Kohn et al., 2018 and Calear et al., 2017) state that the lack of finances, poor resources, and poor infrastructure are the primary reason why accessing mental health services is difficult. Surprisingly, some individuals opt not to get to access mental health services based on reasons that they can control or that they can navigate. The study findings by (Reynolds et al. 2020) and (Vreeman, McCoy, and Lee, 2017) state that access to mental health services is hampered by personal beliefs and fears which can be controlled.
The following study was very strong because they did not have the researchers’ caused bias (Chisholm et al., 2019). Other studies such as (Vreeman, McCoy, and Lee, 2017 and Kohn et al., 2018) were strong because they had large sample sizes. Several studies were weak because of limitations. For example, (Reynolds et al. 2020 and Bartolomei et al., 2016) were weak because of the limitation of the small sample size.

People who do have access to Mental Health

The articles included in this section are on several subtopics including domestic abuse victims, and women with access to mental health services (Karystianis et al., 2018; Knight & Winterbotham, 2020; Ferrari et al., 2016; Moreau et al., 2018; Brunner et al., 2019). Other articles focus on highly educated women (Moreau et al., 2018), women veterans (Brunner et al., 2019), and older adults from urban areas who can easily access mental health services (Knight & Winterbotham, 2020). I included this topic because this dissertation addresses individuals that can easily access mental health services.
Ferrari et al. (2016) conducted a cross-sectional study to reveal accessibility to healthcare for domestic abuse victims. Based on a cross-sectional survey of 260 women, numerous facilities offer psychological help to women that have undergone domestic violence. The researchers collected data from the 260 women and used normal regression and logistic models for continuous and binary functions, respectively. According to the study, the easy availability of mental services for women was since women were identified as a population at high risk of mental instability due to trauma associated with domestic violence. The main limitation of the study was that the sample size was small for conclusions that represent the society to be made.
Karystianis et al. (2018), conducted a text mining study to establish whether it is possible to identify mental health dis s from unstructured text. In the process, they identified that individuals of domestic violence were slotted for mental health services once they reported abuse. The researchers used 200 domestic violence recorded events to arrive at the findings and the conclusions that they made. From the research, it was identified that depression was the most common mental dis amongst victims of domestic violence.
Moreau et al. (2018), carried out a survey with the aim of finding out who were more likely to seek out mental healthcare. Moreau and his researchers conducted semi-structured qualitative interviews with 40 key stakeholders at veteran affairs medical centers. The researchers used transcripts to summarize key themes from the study. The researchers established that despite the telemental health services being open to all, it was women who accessed the services the most. The main limitation of the study was that the sample size was too small for generalizations to be made.
Brunner et al. (2019), carried out a study to find out the population group with the easiest access to mental healthcare. According to Brunner et al. (2019), women veterans have easy access to mental health services based on the knowledge that they are a high-risk population of mental dis s based on the fact that they are women who are exposed to tough and at times traumatic experiences. The researchers were able to make the above conclusion after they used survey data on 419 patients at the department of veterans’ affairs clinics. From the participants, 59% of women reported that they accessed mental health services as soon as they needed it.
Knight and Wintebotham (2020) used surveys, focus groups, and in-depth interviews to collect information from adults from urban, regional, and remote areas to find out population groups with easy access to mental healthcare. The study revealed that another population that has fair access to mental health services is urban older adults.. The duo used surveys, focus groups, and in-depth interviews to collect information from 94 older adults from urban, regional, and remote areas. The study team used thematic analysis to analyze the data collected. From the study, it was established that older adults from urban areas easily accessed mental health services unlike other older adults primarily due to easy access and better mental health discipline. The study sample was too small for conclusions that can be replicated in most areas to be made.

Synthesis

From the analysis, two groups are identified to have relatively easy access to mental health services. The first group is women, and the other group is older adults. Based on the review, there are infrastructure and resources allocated to mental health to help out the identified groups due to their high vulnerability to mental illnesses or dis s. The above is evidenced by findings of studies done and published by (Karystianis et al. 2018; Knight and Winterbotham 2020; Ferrari et al. 2016; Moreau et al. 2018). Surprisingly, one article has a divergent view from the rest. Brunner et al. (2019) found out in their study that women veterans have access to mental health services due to the difficulty of the occupation. Surprisingly, male veterans have access to the same services, but they rarely utilize them in comparison to their female counterparts.
The following studies were very strong because they did not have researchers’ triggered biases (Karystianis et al. 2018 and Brunner et al. 2019). Several studies were weak because of limitations. For example, (Knight and Winterbotham, 2020; Moreau et al. 2018 and Ferrari et al. 2016) were weak because of the small study samples used.

Populations that Use Mental Health Services

The articles included in this section are on several subtopics including race (Chu et al., 2018), people with substance abuse issues (Gates et al., 2017). Others include prison inmates (Morrissey et al., 2016), and individuals with suicide ideation (Sareen et al., 2016). Other articles focus on individuals who are confused about their sexualities or sexuality challenges (Hughes et al., 2020) and abused children and women (Read et al., 2018); (Mengo & Gidycz, 2019). While another subgroup population includes military officers with traumatic experience (Russell et al., 2018). This topic is included because some populations have been identified to seek and use mental health services more than others.
Chu et al. (2018), conducted a study to find out the race in America that was most likely to seek out mental health services. The race most likely to seek out mental health services are the White people. On the other hand, the race that rarely seeks out mental health services is the Asian race. The findings are based on the 2008 military survey data that focused on the reports made on post-traumatic stress, depression, and other mental health complications. By analyzing the data through the race criteria, the researchers identified that white and blacks were the most open to seeking mental health services. The main limitation of the study was that the researchers did not explore further why there was a huge difference between white Americans and the other minority races.
Gates et al. (2017), conducted a cross-sectional descriptive study on correctional facilities to find out why people tend to seek out mental health services. From the results, it was revealed that some individuals seek mental health services because they have problems that they need help with such as substance abuse and suicidal ideation. Gates et al. (2017) studied individuals that were struggling with alcohol and substance abuse use in seeking mental health services. The study examined the population of state prisons where n=10,998. The focus of the study was on the association between substance use dis and mental health. The data for the study was collected from an electronic health record and an offender management system. The researchers used SAS 9.4 to conduct statistical tests on the collected data where they compared to race, gender, security levels, education, and types of mental health dis s. The findings of the study were that substance use and ill mental health were connected.
Further findings of the study revealed that inmates were open to seeking mental health services as the services were easily provided in correctional facilities. It was established that individuals struggling with substance use were open to mental health services. Another population that uses mental health services are people with suicide ideation (Sareen et al., 2016). Sareen and other researchers obtained data from 53477 respondents aged between 18 years and 60 years. The respondents consisted of civilians and military personnel. The researchers assessed the respondents’ lifetime and past-year prevalence of suicidal ideation. Based on the study, it was established, that majority of people that seek mental health services are individuals that have considered suicide or those that have attempted suicide. The identified population seeks mental health to help them reduce their ideation of suicide.
Hughes et al. (2020), studied the tendency of people with sexuality challenge to seek out mental health services. The researchers used a two-armed randomized controlled, open feasibility study to confirm that individuals who have identified that they have sexuality challenges use mental health services. A nested qualitative study was used to obtain the views of 100 participants. A further study revealed that those who were not sure of their sexuality or sexual preference preferred seeking mental health services for them to achieve insight into their challenges. The main limitation of the study was that it utilized a small sample size and for that reason, the results do not represent society.
Read et al. (2018), carried out a study to reveal why adults seek out mental health services. The researchers conducted a Systematic Reviews and Meta‐Analyses using PsycINFO geared at establishing the main reason why adults sought mental health services. The study revealed that another subgroup of people who seek mental health treatment are those who have been abused, often children and women. For example, the other major population that receives mental health services is children that have gone through abuse or that have been neglected. The researchers went through 42 999 medical files as part of their review where the search items were children who had been abused or neglected. From the review and analysis, the researchers identified those individuals who were abused or neglected as children the majority of the time sought mental health services as they believe that the abuse might have affected them psychologically.
Mengo & Gidycz (2019), conducted a study to establish which group of adults were most likely to seek out mental health services. They carried out a case study that revealed that adults who were abused also sought mental health services actively. Just as abused children, and women who have also been abused sought mental health services. Mengo and Gidycz carried out a case study and reviewed cases on 154 women who were victims of intimate partner violence. The study revealed that such women were psychologically affected by the abuse to the extent that they sought mental health services. The women consider mental health services as a way of redeeming their mental status considering that they have been made to feel inadequate. The study revealed that women who have experienced intimate partner violence are likely to seek out mental health services as compared to men that are victims of intimate partner violence. The main limitation of the study was that it utilized a small sample size and for that reason, the results do not represent society.
Morrissey et al. (2016), carried out a study to establish where it was most likely to find a mental healthcare facility. The researchers conducted a quasi-experiment that revealed that a location where mental health treatment is offered such as prisons. According to Morrissey et al., (2016), recovering convicts also seek mental health services. Morrissey and his fellow researchers conducted a quasi-experiment on 895 inmates with severe mental illnesses. The outcomes were estimated via propensity-weighted logit models. The researchers were interested in confirming whether the expediting of Medicaid enrollments of inmates with mental illness helped to reduce recidivism. As the researchers conducted the study, they identified that inmates that thought they were mentally ill actively sought mental health services, an indication that they wanted to resolve any mental health complications that may have contributed to them committing crimes and offenses.
Russell et al.(2018), reviewed military data to establish the veterans and active duty personnel that were more likely to seek out mental health services. From the study, the researchers revealed that one of the large populations that seek mental health services is military officers who have suffered a traumatic experience in active combat. Russell and his team of researchers reviewed military data of officers who had taken part in active combat as far back as in World War II. According to the article, military personnel are exposed to stigmatizing events and situations which often lead to mental health complications. The study as well revealed that over the years, military personnel have become aware of the effects of war to the extent that after they come out of active combat sites, they seek mental health services. The majority of military personnel seek mental health services to make a smooth transition back into civilian life, to gain the ability to easily interact with civilians and for them to live normal lives. The main limitation of the study was that it did not utilize a control sample to assess whether the number of individuals that had undergone traumatic experiences but had never needed mental health services exceeded those that needed the services.

Synthesis

Seven studies had convergent views. The convergent view was that exposure to traumatizing events leads certain populations to seek mental health services. According to Mengo & Gidycz, (2019), adults abused as children often seek mental health services for them to do away with the psychological harm caused by the abuse. Sareen et al., (2016), confirmed the view that trauma leads people to seek mental health services. Studies by Sareen et al., (2016), Mengo & Gidycz, (2019), Read et al., (2018), and Hughes et al (2020), identified that individuals who had suicide ideation sought mental health services for them to gain control of their minds as they considered themselves unable to master their minds.
Surprisingly, based on three studies reviewed there are populations that do not seek mental health services to improve their health, but they do so improve their interactions with other society members. The three studies (Russell et al., 2018; Morrissey et al., 2016; Gates et al., 2017), emphasize that the populations that seek mental health services are populations that are seeking to improve their interactions with other society members. The three articles focus on populations exposed to harsh conditions. The population includes military personnel and convicts.
The following studies were very strong because they did not have researcher triggered biases (Morrissey et al., 2016; Sareen et al., 2016 and Gates et al. 2017). Several studies were weak because of limitations. For example, (Mengo & Gidycz, 2019 and Hughes et al 2020) were weak because of the small study samples used.

Populations that Reject Mental Health Services.

The articles included in this section are on several subtopics of those that reject mental health services including minorities such as the LGBT community (Su et al., 2016), transgender community (Rider et al., 2018). The Amish population (Miller-Fellows et al., 2018) and the immigrant population and refugees (Silove, Ventevogel & Rees, 2017) and (Bas-Sarmiento et al., 2017). Others reject mental health services due to high costs and poor insurance coverage barriers (Kohn et al., 2018) and (Calear et al., 2017). The other articles focus on athlete sponsorships (Moreland, Coxe & Yang, 2018) and adult trauma victims (Kantor, Knefel, & Lueger-Schuster, 2017).
In the United States, 42% of the population believes that cost and poor insurance coverage are the top barriers that prevent them from accessing mental health care (Kohn et al., 2018). While only 25% reported that they make decisions between using mental health treatment or paying for daily necessities (Calear et al., 2017). Calear and a team of researchers in 2017 conducted a two-arm, cluster-randomized, controlled trial aimed at establishing whether indeed males are less likely to seek mental health services compared to females or not. The study focused on young men aged between 11 and 18 years and it revealed that young men were not open to the idea of getting mental health services. Data was collected pre-intervention, post-intervention, and at 3-month follow-up on male students in either 11th or 12th grade in eight schools. The study findings revealed that stigma around mental health as well as the patriarchal structure made it harder for young men compared to women to seek mental health. The study revealed that young men are amongst the population rejecting mental health services.
Miller-Fellows et al. (2018), conducted an ethnographic study to find out a group in Ohio that was most likely to reject the idea of seeking out mental health services. It was established that the Amish population in Ohio was not going for mental health exams and they were not open to mental health services. Through a survey on mental health, the government through the ministry tried to create a culturally competent mental health service. Despite the introduction and implementation of the service, the population is yet to fully accept mental health services as evidenced by a follow-up analysis of the records.
According to Su et al. (2016), conducted a study on possible population groups to reject seeking out mental health services. Based on the results of an online survey, it was established that members of the Lesbian community are known to reject mental health services mainly due to stigma. The study relied on the information collected from 767 respondents of which 91 identified as transgender whereas the rest were non-transgender respondents. The study used multivariate logistic regression analysis, chi-square, or bivariate t-tests to examine differences in reported depression symptoms, discrimination, suicide attempts, and self-acceptance of the LGBT community. According to the conclusions of the survey, lesbians fear rejection and victimization due to their sexual preference and as a result, avoid getting mental health services for both mild and severe mental complications.
Bas-Sarmiento et al. (2017), conducted a systematic review on population groups most likely to reject seeking mental health services. Using the Scopus, Science Direct, PubMed, Cuiden, Cochrane, ISI, and PsycINFO databases, they revealed that another population that avoids getting mental health assistance is the majority of the immigrant population. The researchers reviewed 817 studies and identified 21 that best fit the description of their study. Based on the findings of the study, the population rejects mental health services as mental health complications are not viewed as normal in the immigrant population. Due to the stigma around mental health complications, many of them are afraid and unwilling to seek mental health services for fear of victimization.
Rider et al. (2018), carried out a study on the likelihood of members of the transgender community agreeing to seek out mental health services. Rider and a team of researchers surveyed 80 929 respondents. Chi-squares and multiple analysis of covariance tests were used in the analysis of the data collected. The survey was intended on identifying the view of teenagers as concerns mental health services. The results of the survey revealed that teenagers that identified with the transgender community and those that did not conform to the gender they were born with were against mental health services. They rejected mental health services as they viewed the services would outwardly reject what they believed in. The study confirms that the transgender community rejects mental health services.
Silove, Ventevogel & Rees (2017), conducted a review to establish the likelihood of refugees seeking mental health services. The study revealed that refugees, more so African refugees, are more likely to reject mental health services. According to the review, refugees are against mental health services due to two main reasons. First, they fear that if they are found not to be mentally fit, they may not receive help from those helping them. Secondly, they fear the victimization that comes with mental illness or challenges.
Kantor, Knefel, and Lueger-Schuster (2017), conducted a systematic review to analyze the likelihood of adult trauma victims to seeking mental healthcare services. The study confirmed that adult trauma victims more so men do not welcome the idea of seeking mental health services. According to a systematic review conducted by the research team of five online databases, individuals who have experienced traumatic experiences such as rape, and physical violence are against seeking mental health services. The search strategy was based on three main terms: barriers and/or facilitators, trauma, and MHS use. 1612 papers and studies were found to match the search criteria. A standardized eligibility assessment based on eligibility criteria was used in the review and analysis of the identified papers and studies. According to the findings of the studies, the situation is worse for men who completely shy away from getting any kind of help. The majority of the time, adults reject mental health services due to shame. They are ashamed of sharing what they went through and how it has affected them psychologically.
Another group that refrains from getting mental health assistance is collegiate athletes for fear of losing their athletic sponsorships (Moreland, Coxe & Yang, 2018). The analysis used a socio-ecological framework, which considered how collegiate athletes perform and study. 21 articles were identified as they met the criteria of the study. Conceptualizations and operationalizations of mental health services utilization were carried out as well. Moreland, Coxe, and Yang carried out the case study analysis and the case revealed three main points. The first was that college athletes did not consider themselves to be under the threat of mental health complications. Secondly, athletes that felt that were mentally unfit, they opted to hide out to secure their sponsorships. Lastly, college athletes opted for substance and alcohol abuse as a way to mask and deal with any mental complication that they may be going through.
Lipari et al. (2017), conducted a national survey to establish the reaction of people diagnosed as abusers of alcohol and substances to mental health services. The study revealed that individuals that are diagnosed with substance abuse and alcohol abuse reject mental health services. The researchers combined the 2012–2014 National Survey on Drug Use and all state levels among adults aged 18 or older to conclude. According to the findings of the study, they mainly reject the services as the services would most likely indicate that their mental states do not allow them to consume alcoholic drinks (Lipari et al., 2017). The fear of being forced to stay away from alcohol causes them to reject any form of mental health service.
Salaheddin & Mason, (2016), used a cross-sectional study to study the population group that was more likely to reject mental health services. The research confirmed that young people are amongst the population that reject mental health services. The researchers used thematic analysis to analyze Qualitative feedback collected from the anonymous questionnaire that they administered that measured help-seeking preferences, psychological distress, and barriers to accessing help. From the study, four reasons were identified that made it hard for young people to seek mental health services. The first reason was the belief they will be stigmatization (Salaheddin & Mason, 2016). The second reason was the preference for self-reliance. The third reason was difficulty in expressing concerns. The last reason was that they had difficulty identifying with mental illnesses or complications. According to the recommendations of the study, there is a need to demystify mental illness. The study as well recommended that there should be more awareness of mental health services more so targeting young people.

Synthesis

An analysis of the studies reviewed revealed two main things. The convergent view of most of the studies was that the populations that reject mental health services do so due to the stigma around mental complications. The majority of populations that reject mental health do it for fear of being victimized. Immigrants and refugees reject mental health services for fear of being victimized by their community members. The majority of immigrant communities and refugees view mental illness as anomalies that are not acceptable. It is for that reason that most of them reject mental health services. The studies that accept the above convergent view are Kantor, Knefel and Lueger-Schuster, (2017), Silove, Ventevogel & Rees, (2017), Bas-Sarmiento et al., (2017), Calear et al., (2017) and Miller-Fellows et al., (2018).
There is a divergent view that mental health services are rejected as they are intended to conform to those identified to need it. The above statement can be confirmed through the studies that state that the LGBT community and college athletes reject mental health services. For the LGBT community, they reject mental health services as they reject the view that sexuality is determined by one’s genes and not the state of mind.
They reject the services as they believe that they are meant to change their views on sexuality and sexual preferences. On the other hand, college athletes reject mental health status as it would rule them out of athletic scholarship opportunities as well as dent their future aspirations in sports. The studies that are in line with the divergent view include Moreland, Coxe & Yang, (2018), Rider et al., (2018), and Su, et al., (2016).
Several populations are known to outrightly reject mental health services. Some of the populations include minorities and members of the LGBT community. The reviewed studies were on individuals and groups that reject mental health services with the primary aim of establishing why they reject the services. An analysis of the studies reviewed reveals two main things. The convergent view of most of the studies is that the populations that reject mental health services do so due to the stigma around mental complications. The majority of populations that reject mental health do it for fear of being victimized. The studies that accept the above convergent view are Kantor, Knefel and Lueger-Schuster, (2017), Silove, Ventevogel & Rees, (2017), Bas-Sarmiento et al., (2017), Calear et al., (2017) and Miller-Fellows et al., (2018).

Reasons for Use of Mental Health Services

The articles included in this section are on several subtopics focus on young people that are more receptive to mental health services (Lal, Nguyen, & Theriault, 2016) and (Orlowski et al., 2016). Other articles include involuntary mental health admissions (Smith et al., 2020). The remaining articles focus on those that have been incarcerated (Han et al., 2017), Adolescent with substance abuse issues (Ali et al., 2019) and (King et al., 2018).

To make the literature review possible, studies were searched on online databases. The databases that were searched included Scopus, Science Direct, PubMed, Cuiden, Google Scholar, Cochrane, ISI, GCU database, and PsycINFO. Six key phrases were used in the study and the key phrases are similar to the six subsections of chapter 2. The phrases were reasons for rejection of mental health services, reasons for lack of access to mental health, mental health infrastructure, reasons for use of mental health services, populations that reject mental health services, populations that use mental health services, people who have access to mental health.
Lal, Nguyen, and Theriault in 2016, carried out a study to establish which age cohort was more receptive to mental health services. From the study, it was established that young people are more receptive to mental health services compared to the aged. The study involved the use of a qualitative approach where 17 participants aged between 21 years and 35 years were recruited for a thematic study on mental health. Individuals aged between 18 and 30 years are open to studying mental health as well as going for mental health status check. Their drive for mental health status is out of increased awareness of health. On the other hand, the aged are against mental health for fear of victimization and also because of the fear and stigma around mental illness. Lastly, the use of online services made it easier for young people to seek mental health services.
Smith et al. (2020), extracted publicly available data on involuntary admissions to study the trend in involuntary admissions to mental health facilities. The researchers learned that there has been an increase in the number of involuntary admissions to mental health facilities from 2008 to date. The researchers used a regression analysis to compare predicted rates and observed admission rates. The explanation of the rise of admissions has been due to high substance abuse as well as many mental illness diagnoses. The articles’ findings confirm that mental health services are sought to help those suffering from mental dis s as well as those with substance abuse challenges.
Orlowski et al., (2016), carried out a qualitative study to analyze whether people who had access to telehealth sought medical care more than those accessing face to face health services. The researchers conducted semi-structured interviews with 10 people who were aged between sixteen and twenty-two years. The researchers analyzed the data they collected through inductive thematic analysis. Based on the studies, it was concluded that youth were accessing mental health services much more than before as they could do it at the comfort of their homes through technology that made it possible for a face-to-face remote clinic visits.

Han et al. (2017), conducted a survey to find out whether people affected by substance abuse also used mental health services to get access to the drugs. According to a survey carried out by the research team on 72,600 citizens who have never been incarcerated, there is a huge population of individuals that seeks mental health services to access opioids for both use and abuse. The research team analyzed the data collected through thematic analysis. Based on the findings, there is a huge population that feigns mental illnesses to access opioids and other prescription drugs.
Ali et al., (2019), carried out a research study to find the characteristics of adolescents that seek mental healthcare services. He used a multinomial logistic regression model survey to understand the characteristics of adolescents that seek mental health services. The researchers utilized national data available from 2012 to 2015 and concluded that the reason why mental health services are accessed is because they provide an opportunity for other forms of health services to be availed. The findings of the study revealed that the majority of the adolescents that sought mental health services in educational settings were adolescents that did not have any other health means other than public health. Through mental health services in schools, such learners could access other health services easily.
King et al. (2018), conducted a study to find out the main reasons as to why people sought mental health care. He used an online survey and learned that tobacco addiction and depression were the main reason that people sought mental health services. The researchers conducted an online survey that had 2370 respondents from eleven colleges in Virginia and North Carolina (King et al., 2018). They analyzed the data collected by comparing it using a depression score rating. Based on the findings it was established, that young adults seek mental health services when dealing with tobacco depression and when they are depressed.

Synthesis

Analysis of the populations that seek mental health services reveals that the population seeks mental health services because of love. The populations love themselves enough to want to secure their health. The populations love their loved ones and those around them enough to secure their health by securing their mental health. According to King et al. (2018), tobacco abusers and depressed people seek mental health services to recover health. Ali et al., (2019) provides evidence that through seeking mental health services, young learners from poor backgrounds can access other health services. According to Orlowski et al., (2016), mental health services are currently being sought for more than in the past as more people are aware of the value of mental health to the overall body health. The desire to know whether mental health services are sought out for good only pushes the need for the below review.
An analysis of the studies under review reveals that the majority of the times that people seek mental health services is because they have poor mental health or that their general health is compromised. According to King et al. (2018), tobacco abusers and depressed people seek mental health services to recover health. Ali et al. (2019) provides evidence that through seeking mental health services, young learners from poor backgrounds can access other health services. According to Orlowski et al. (2016), mental health services are being sought for currently than in the past as more people are aware of the value of mental health to the overall body health. Another reason, according to Smith et al. (2020), is that there has been an increase of involuntary mental health admission due to poor mental health as well as substance abuse. Surprisingly, some individuals seek mental health services for abuse. According to Han et al., (2017), some individuals feign mental illness to access opioids for recreational use.
The following studies were very strong because they utilized large study sample sizes King et al. (2018), Han et al. (2017) and Smith et al. (2020). One study was identified as weak because of a limitation. For example, Ali et al. (2019) were weak because of researcher triggered bias.

Reasons for Rejection of Mental Health Services

In this section, the articles included focus on several subtopics that include self-stigma and fear of discrimination (Carrara and Ventura, 2018) and (Luitel, et al., 2017); others focus on beliefs and perceptions of mental health (Choudhry, 2016), the unemployed population (Staiger et al., 2017) and the African American minority communities (Memon et al., 2016),
Carrara and Ventura (2018) carried out a study to figure out the primary reasons as to why people reject mental health services. The researchers used a literature review to and found out that self-stigma and fear of discrimination are the primary reasons that people reject mental health services. The duo reviewed 149 pieces of literature on mental health. Of the 149 articles, 9 were found to be the most ideal considering the researchers were studying the effects of stigma on mental health services. The findings of the study confirmed that stigma and fear of rejection caused people to stay away from seeking mental health services even when they needed it the most.

Choudhry et al. (2016), carried out a study to reveal the beliefs and perceptions held by people concerning their mental health. The researchers used a systematic review and a meta-analysis of qualitative data to carry out a systematic review and a meta-analysis of qualitative data on beliefs and perceptions of mental health. The analysis involved going through 15 publications. The articles were analyzed using the thematic analysis method. The results of the studies revealed that the huge population that rejected mental health did it to avoid being rejected by the community due to the negativity around mental illness.
Staiger et al. (2017), conducted qualitative semi-structured individual interviews to find out why unemployed people were unwilling to seek out mental health services. The study revealed that the unemployed population rejects seeking mental health services for fear that negative mental health diagnosis can hamper their opportunities to get employment opportunities. The researchers conducted qualitative semi-structured individual interviews with 15 unemployed individuals. The analysis of the data collected was done using qualitative content analysis. Results from the study indicated that individuals perceived to have mental illnesses were treated significantly differently than other unemployed individuals when applying for employment.
Luitel et al. (2017) conducted a quantitative study to study why people were reluctant to seek out mental health services. The study revealed that the fear of being perceived as crazy and weak made people fear and reject mental health services. In addition, the perception that mentally ill people are incapable of handling themselves as well as handling their finances makes people reject mental health services. The findings were a result of a quantitative study conducted on 1983 adults (Luitel et al., 2017). A three-stage sampling technique was employed for the study to determine why people were not opened to seeking mental health services. The researchers compared the barriers to access to care with the effects of the barriers. In the end, it was established that the negative effects of confirmed mental illnesses drove people away from wanting to know their mental health status.
Memon et al. (2016), conducted a Qualitative study in Southeast England to establish the barriers to mental health care to Black people and other minority groups. The study established that there are two main barriers to mental health services amongst blacks and other minority communities. The researchers recruited 26 adults both male and female from the black and minority registry. They used thematic analysis to identify the key themes to the barrier of mental health services delivery. Based on the findings of the study, it was concluded that the inability to accept mental health challenges as a health concern caused the study group to reject mental health services. In addition, the stigma around poor mental health negatively affected the perception of mental health services.

Synthesis

Based on the analysis of the studies, it is possible to identify that the main reason that people reject mental health services is because of the stigma around mental illnesses. The majority of individuals believe that a positive diagnosis of a mental dis makes a person a misfit that leads to rejection by community members. According to Carrara and Ventura, (2018), self-stigma and fear of discrimination are the primary reasons that people reject mental health services. Luitel et al. (2017) published that the fear of being perceived as crazy and weak made people fear and reject mental health services. According to Memon et al. (2016), the stigma around poor mental health affects negatively the perception of mental health services. Surprisingly, some individuals reject mental health services as they fear positive diagnosis can deny them income-generating opportunities. According to Staiger et al. (2017), the unemployed population rejects seeking mental health services for fear that negative mental health diagnosis can hamper their opportunities to get employment opportunities.
Not everyone is open to the idea of knowing their mental health status. Some individuals believe that mental illnesses are curses and for that reason would not subject themselves to tests that would implicate them. The majority of individuals believe that a positive diagnosis of a mental dis makes a person a misfit that leads to rejection by community members. According to Carrara and Ventura, (2018), self-stigma and fear of discrimination are the primary reasons that people reject mental health services. Luitel et al., 2017 published that the fear of being perceived as crazy and weak made people fear and reject mental health services. To improve mental health, it is appropriate that the perceptions around mental health are known for them to be demystified. The review looks at the main reasons why mental health is rejected.
The following studies were very strong because they did not have researcher triggered biases Luitel et al. (2017) and Memon et al. (2016). Several studies were weak because of limitations. For example, Staiger et al. (2017 and Choudhry et al. (2016) were weak because of small sample sizes.

Methodology and Instrumentation/Data Sources/Research Materials.
In the mental health infrastructure section, there were four main methods used to conduct the studies under review. Three of the tools were used a similar number of times while one method was only used once. The first tool used was the case study method. Hester (2017) conducted a case study where he focused on finding out why so many military personnel are committing suicide after coming from active combat sites. Martin et al. (2016) conducted a case study analysis that involved going through data provided by the Department of Corrections where special emphasis was placed on going through the policy on the screening inmates’ mental health upon admission. Machado et al. (2018), conducted a robust multivariable negative binomial regression study on 5507 municipalities where the study focused on individuals aged 14 and 22 years. The
The second tool that was used was the survey method. Tran and Ponce (2017) reviewed survey data from 2011 and 2014 and were able to identify that California had a population of 82,706 adults with mental health needs. Kohn et al. (2018) Conducted a community-based survey of 75,306 participants who were 15 years and above. Karaye, Ross, and Horney in 2019 conducted a 12-item Short-Form Health Survey (SF-12) that was administered online to a sample of 3030 residents.
The third tool that was used was the discursive review method. Johnson et al., (2018) conducted a discursive review of articles drawn from peer-reviewed journals, national reports, and surveys. Castillo et al. (2019) conducted a literature review of community interventions geared at improving mental health. Mongelli, Georgakopoulos, and Pato (2020) conducted an article review where the articles were drawn from peer-reviewed journals, national reports, and surveys.
The last tool that was used was the ethnography study method. Ecks in 2016 conducted an ethnographical study that revealed that mental health infrastructure in the world is limited compared to physical health infrastructure. The study focused on global mental health on policies not older than 25 years.
Based on the review, the case study method, the survey method, and the discursive review method are used widely in the study of mental health infrastructure.

Reasons for Lack of Access to Mental Health section

In the reasons for the lack of mental health section, there were five methods used to conduct the studies under review. The first tool used was the randomized controlled trial: Calear et al. (2017) conducted a two-arm, cluster-randomized, controlled trial in eight high schools with the focus being on male students in either 11th or 12th grade. The second tool used was the survey method: Kohn et al. (2018) conducted a community-based survey that involved surveying 75,306 participants who were 15 years and above; Bartolomei et al. (2016) surveyed 135 care workers and mental health caregivers.
The third tool used was the interview method: Fleury et al. (2019) conducted semi-structured interviews on 49 emergency room stakeholders; through individual interviews of 15 adults aged between 61 and 81 years, Reynolds et al. (2020), identified why the access to mental health services is hard for the elderly. The fourth tool used was the literature review method: Vreeman, McCoy, and Lee (2017) conducted a review study where they reviewed 11,501 articles and publications where they focused on keywords.
The fifth tool uses was a mixed-method approach: in 2019, Chisholm and six other researchers used a multi-method approach that consisted of three phases; narrative and quantitative assessment and in-depth interviews of low-income individuals in six sub-Saharan Africa and South Asian nations in an attempt to understand the challenges in the accessing of mental health services amongst low-class individuals.
An analysis of the methods used reveals that the interview method is the most used when studying the reasons for lack of access to mental health.

People who do have access to Mental Health Section

In the people who have access to the mental health section, there were three methods used to conduct the studies under review. The first tool used was the survey method: Ferrari et al. (2016) conducted a cross-sectional survey on 260 women and used normal regression and logistic models for continuous and binary functions respectively in the analysis of the study; Brunner et al. (2019) conducted a survey on 419 patients at the department of veterans’ affairs clinics to establish which population access mental health services in the department; Knight and Winterbotham in 2020 used surveys, focus groups, and in-depth interviews to collect information from 94 older adults from urban, regional, and remote areas.
The second tool used was the text mining study method: Karystianis et al. (2018) conducted a text mining study to establish whether it is possible to identify mental health dis s from unstructured text and in the process identified that individuals of domestic violence were slotted for mental health services once they reported abuse. The third method used was the interview method: Moreau et al. (2018) conducted semi-structured qualitative interviews with 40 key stakeholders at veteran affairs medical centers.
An analysis of the method used reveals that the survey method is the most used in the study of people who have access to mental health.

Populations that Use Mental Health Services Section

In the population that uses the mental health section, there were six methods used to conduct the studies under review. The first tool used was the survey method: Chu et al. (2018) used 2008 military survey data that focused on the reports made on post-traumatic stress, depression, and other mental health complications to understand the populations that use mental health services; Sareen et al. (2016) surveyed 53477 respondents aged between 18 years and 60 years. The researchers assessed the respondents’ lifetime and past-year prevalence of suicidal ideation. The second tool used was the cross-sectional descriptive study: Gates et al. (2017) conducted a cross-sectional descriptive study on correctional facilities where the total population studied was 10,998.
The third tool used was the nested qualitative study: Hughes et al. (2020), conducted a nested qualitative study to obtain the views of 100 individuals who had identified that they had sexuality challenges use mental health services. The fourth tool used was the mixed approach method: Read et al. (2018) conducted Systematic Reviews and Meta‐Analyses using PsycINFO geared at establishing the main reason why adults sought mental health services. The researchers went through 42 999 medical files as part of their review where the search items were children who had been abused or neglected.
The fifth tool used was the case study method: Mengo & Gidycz (2019) carried out a case study and reviewed cases on 154 women who were victims of intimate partner violence. The study revealed that such women were psychologically affected by the abuse to the extent that they sought mental health services; Russell et al. (2018) conducted a case study by reviewing military data of officers who have taken part in active combat as far back as in World War II. The sixth tool used was the quasi-experiment method: Morrissey et al. (2016) conducted a quasi-experiment on 895 inmates with severe mental illnesses where the researchers were interested in confirming whether the expediting of Medicaid enrollments of inmates with mental illness helped to reduce recidivism.
An analysis of the review reveals that the most preferred study method in the study of the population that uses the mental health services section is the survey method.

Populations that Reject Mental Health Services section

In the populations that reject the mental health services section there were six methods used to conduct the studies under review. The first tool used was the randomized controlled trial: Calear et al. (2017) conducted a two-arm, cluster-randomized, controlled trial aimed at establishing whether indeed males are less likely to seek mental health services compared to females or not. The study focused on young men aged between 11 and 18 years and it revealed that young men were not open to the idea of getting mental health services. The second tool used was an ethnographic study: Miller-Fellows et al. (2018) conducted an ethnographic study that established that the Amish population in Ohio was not going for mental health exams as well as they were not open to mental health services.
The third tool used was a survey: Su et al. (2016) conducted an online survey on respondents who self-identified as bisexual, gay, lesbian, and/or transgender persons aged 19 years and above from Nebraska and they identified that members of the Lesbian community reject mental health services mainly due to stigma. Rider et al. (2018) conducted a surveyed on 80 929 respondents where the survey was intended on identifying the view of teenagers as concerns mental health services; Lipari et al. (2017) combined the 2012–2014 National Survey on Drug Use and all state levels among adults aged 18 or older to conclude on the population that primarily rejects mental health services. The fourth tool used was a systematic review: Bas-Sarmiento et al., (2017) conducted a systematic review using the Scopus, Science Direct, PubMed, Cuiden, Cochrane, ISI, and PsycINFO databases. Based on the findings of the study, immigrants reject mental health services as mental health complications are not viewed as normal in the immigrant population; Kantor, Knefel, and Lueger-Schuster (2017) conducted a systematic review in an attempt to understand why individuals who have experienced traumatic experiences such as rape, and physical violence are against seeking mental health services.
The fifth tool used was an interview: Silove, Ventevogel & Rees, (2017) interviewed refugees in an attempt to understand why refugees are against mental health services. The sixth tool used was the case study analysis method: Moreland, Coxe & Yang, (2018) conducted a case study analysis to understand why college athletes avoid seeking mental health services even when they need it. The seventh tool used was the cross-sectional study method: Salaheddin & Mason (2016) conducted a cross-sectional study conducted using 45 participants where it was revealed that young people are amongst the population that reject mental health services.
An analysis of the review reveals that the most preferred study method for the study of a population that rejects the mental health services section is the survey method.

Reasons for the Use of Mental Health Services section

In the reasons for the use of the mental health services section, there were four methods used to conduct the studies under review. The first tool used was the thematic study method; Lal, Nguyen, and Theriault in 2016 conducted a thematic study where 17 participants aged between 21 years and 35 years were recruited for a thematic study on mental health.
The second tool used was the case study analysis method: Smith et al. (2020) conducted a case study analysis in an attempt to understand the number of involuntary admissions to mental health facilities from 2008 to date.
The third tool used was the semi-structured interview method: Orlowski et al. (2016) conducted semi-structured interviews with 10 people who were aged between sixteen and twenty-two years to establish the effectiveness of telehealth in mental health services provision.
The fourth tool used was the survey method: Han et al. (2017) surveyed 72,600 citizens who have never been incarcerated to establish the use of mental health services; Ali et al. (2019), used a multinomial logistic regression model to analyze survey data to understand the characteristics of adolescents that seek mental health services; King et al (2018) conducted an online survey that had 2370 respondents from eleven colleges in Virginia and North Carolina to understand the role of drugs in the accessing of mental health services.
An analysis of the review reveals that the most preferred study method for the reasons for the use of the mental health services section is the survey method.

Reasons for Rejection of Mental Health Services section

In the reasons for the rejection of the mental health services section, there were five methods used to conduct the studies under review. The first tool used was the literature review method: Carrara and Ventura, (2018), conducted a literature review of 149 pieces of literature on mental health. The second tool used was the systematic review and a meta-analysis of qualitative data: Choudhry et al. (2016) carried out a systematic review and a meta-analysis of qualitative data on beliefs and perceptions of mental health. The analysis involved going through 15 publications.
The third tool used was the semi-structured interview: Staiger et al. (2017) conducted qualitative semi-structured individual interviews with 15 unemployed individuals; Memon et al. (2016) conducted a Qualitative study in Southeast England. The researchers recruited 26 adults both male and female from the black and minority registry. The fourth tool was a survey: Luitel et al. (2017) conducted a quantitative study conducted on 1983 adults.
An analysis of the review reveals that the most preferred study method for the reasons for the rejection of the mental health services section is the interview method.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Review of the Literature
(Approximately 30 pages)

The learner assures that this section of Chapter 2 should be approximately 30 pages. (Thirty pages reflects a typical literature review length and is a recommendation, not a rule). The purpose of the minimum number of pages is to ensure that the overall literature review reflects a foundational understanding of the theory or theories, literature and research studies related to the topic. A well-written comprehensive literature review that reflects the current state of research and literature on the topic is expected and will likely exceed 30 pages. Literature reviews are updated continuously. This is an ongoing process to dissertation completion.

Describes the phenomena being explored in the study discussing the prior research that has been done on the phenomena.

Themes or Topics:
The learner discusses and synthesizes studies related to the dissertation topic. May include (1) studies focused on the problem from a societal perspective, (2) studies describing and/or relating the exploring related phenomena (qualitative),, (3) studies on related research such as factors associated with the themes, (4) studies on the instruments used to collect data, (5) studies on the broad population for the study, and/or (6) studies similar to the study. The themes presented, and research studies discussed and synthesized in the Review of the Literature demonstrates understanding of all aspects of the research topic, the research methodology, and sources of data.

The learner structures the literature review in a logical , including actual data and accurate synthesis of results from reviewed studies as related to the learner’s own topic. The learner provides synthesis of the information not just a summary of the findings.

The learner includes in each major section (theme or topic) within the Review of the Literature.e an introductory paragraph that explains why the particular topic or theme was explored relative to the overall dissertation topic.

The learner includes in each section within the Review of the Literature a summary paragraph(s) that (1) compares and contrasts alternative perspectives on the topic and (2) provides a synthesis of the themes relative to the research topic discussed that emerged from the literature, and (3) identifies how themes are relevant to the dissertation topic and research methodology.

The learner provides additional arguments for the need for the study that was defined in the Background of the Study section.

The learner ensures that for every in-text citation a reference entry exists. Conversely, for every reference list entry there is a corresponding in-text citation. Note: The accuracy of citations and quality of sources is verified by learner, chair, and content expert. Comment by Jennifer R. Seymour: Free refworks.com will check for you

The learner uses a range of references including founding theorists, peer-reviewed empirical research studies from scholarly journals, and governmental/foundation research reports.

The learner verifies that all references are scholarly sources NOTE: Websites, dictionaries, publications without dates (n.d.), are not considered scholarly sources and are not cited or present in the reference list.

The learner avoids overuse of books and dissertations. Comment by GCU: When citing books and dissertations this implies that you have read the entire book or dissertation. Be mindful of this as you select sources. Dissertations are not considered peer-reviewed research, so limit the number of referenced dissertations to 3-5 total.

Books:
Recommendation: No more than 10 scholarly books that present cutting edge views on a topic, are research based, or are seminal works.

Dissertations:
Recommendation: No more than five published dissertations should be cited as sources in the manuscript. (This is a recommendation, not a rule).

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Problem Statement Comment by GCU: Levels of headings must accurately reflect the organization of the dissertation. For example, this is a level 2 heading, and has been “styled” as Heading 2.

The problem is that it is not known how mental health providers describe the strategies that influence patient decisions to utilize or reject mental health services at onset of possible treatment, and during treatment, in south Texas. Without an understanding of the reasons for use or rejection, it is unlikely that successful interventions would enable more people to utilize mental health services. This study will look at the strategies mental health providers use to help participants begin to and continue to use mental health services.
The overall population from which the participants come are the mental health providers such as psychiatrists and therapists. In the United States there are approximately 667,000 mental health professionals and majority of them are aged between 27 and 50 years (Grohol, 2019). The target population was purposively selected to include mental health providers from south Texas due to convenience and interest in this specific location given current statistics on mental health use. After surveying the counseling and psychiatrist offices in south Texas, 4 offices were selected to recruit participants. The reasons why these 4 were included in the recruitment pool are there is a minimum of 125 employees working in the least of the offices. The total of 500 potential participants is likely to enable the researcher to obtain 20 participants which is less than 10% response rate.
It should be noted that particularly among the minority population of Hispanic-Americans, African Americans, and Asian-American families. Economic data from the city shares that 68% of Hispanics face financial challenges due to a limited level of education that limits the job opportunities, contributing to most of them living on a low average income (Herzog et al., 2016). Statistics show that African and Hispanic-American minorities are traditionally known to have poorer primary care access than Caucasian-Americans (SAMHSA, 2018). These ethnicities are found in significant numbers in south Texas.

The importance of addressing this problem is because an individual’s mental health depends on their use or rejection of mental health treatment. Knowing the positive reasons people take advantage of services may help bring additional people in need of mental health services. Knowing the barriers may lead to policies or programs that can overcome the obstacles. Lack of mental health treatment has dire implications in south Texas, including lost productivity, unemployment, job absenteeism, and lack of community involvement (Mental Health Workforce in Texas, 2016).
The scope of this problem is international but for this study it is of particular importance in south Texas because of a lack of sufficient mental health professionals to meet the need. Experts in the region state that insufficient local mental healthcare professionals contribute to the hardships being experienced by the police and medical professionals, which puts public safety at risk. Physicians believe that the number of mental health patients increases with time more than the current status and is attaining the level of a national epidemic (Albert, 2019). This is the trend as the number of people in need of mental healthcare services keeps increasing, the number of people qualified to provide help keeps declining (Scripps Media, 2020).
Understanding the barriers may lead to policies or programs that can overcome the barriers. Lack of mental health treatment has dire implications in south Texas include lost productivity, unemployment, job absenteeism, and lack of involvement in the community (Mental Health Workforce in Texas, 2016). This is of particular importance in south Texas because of a lack of sufficient mental health professionals to meet the need. Experts in the region state that insufficient local mental healthcare professionals contribute to the hardships being experienced by the police and medical resources, which puts the public’s safety at risk.
It should be noted that this problem does not address the issue of those with lack of insurance. The problem is even broader beyond this study because there are many people in need of mental healthcare without insurance coverage. For example, Hispanics’ low-income level and occupational characteristics are associated with low rates of health insurance cover. According to research by the Texas 2018 Mental Health National Outcome Measures (NOMS): SAMHSA Uniform Reporting System, 21.6% of African Americans in south Texas lack healthcare insurance, while the Hispanic or Latino population’s access stands at 26.3%, the reason is directed to low-income levels (SAMHSA, 2018; Printz, 2015). Asian-Americans are considered under-represented in key government, and lack of representation positions contributes to poor healthcare access. Only 0.8% of Asian Americans access have healthcare insurance that helps them access medical care services, including mental health (SAMHSA, 2018; Gor et al., 2019). The demographic characteristics of persons served by the State Mental Health Authority indicate (Table 1).

Table 1.

Insurance rates for different ethnicities

Uninsured Population, Race and Ethnicity

Overall Rates of Uninsured, %

American Indian or Alaska Native

0.3%

Asian

0.8%

Black or African American

21.6%

Native Hawaiian or other Pacific Islander

0.1%

White

72.8%

Hispanic or Latino

26.3%

Source: https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/Texas-2018.pdf

This problem statement is based on what needs to be understood as defined by the Problem Space, and also what was identified in the Literature Review. Specifically, the problem statement is that it is not known how mental health providers describe the strategies that influence patient decisions to utilize or reject mental health services at onset of possible treatment, and during treatment, in south Texas. The Problem Space defined the cause of the problems being seen in the mental service providers as being mainly caused by the different factors that people with mental issues have, some of these factors include demographic issues, financial issues and even attitudes and beliefs that they and the people around them do have.

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Problem Statement
(Minimum three or four paragraphs or approximately one page)

The learner states the specific problem for research with a clear declarative statement.

The learner describes the population of interest. The population of interest includes all individuals that could be affected by the study problem..

EXAMPLE: The population of interest might be all adults in the United States who are 65 or older. The target population is a more specific subpopulation from the population of interest, such as low-income older adults ( ≥ 65) in AZ. Thus, the sample is selected from the target population, not from the population of interest.

The learner discusses the scope and importance of addressing the problem.

The learner develops the Problem Statement based on what needs to be understood as defined in the Problem Space and the Review of the Literature.

10 Comment by Jennifer R. Seymour: Need to add

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

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Reviewer Comments:

Summary
An analysis of the literature review reveals that most of the time that people seek mental health services is because they have poor mental health or that their general health is compromised. The convergent view is that exposure to traumatizing events as well as the exposure to drug and substance abuse leads certain populations to seek mental health services (Martin et al., 2016). From the analysis, two groups are identified to have relatively easy access to mental health services. The first group is women, and the other group is older adults. Based on the review, there are infrastructure and resources allocated to mental health to help out the identified groups due to their high vulnerability to mental illnesses or dis s. Comment by Jennifer R. Seymour: Need to add references to this whole section.
An analysis of the studies reviewed reveals that the majority of the individuals or populations that have challenges in accessing mental health services are unable due to forces or circumstances out of their control. An example of such circumstances is poor infrastructure. The study by Johnson et al. (2018), Martin et al. (2016) and Ecks, (2016) are of a similar view that poor mental health infrastructure undermines the delivery of mental health services.
Further analysis of the studies under review revealed that the populations that reject mental health services do so due to the stigma around mental complications. The majority of individuals that reject mental health services believe that a positive diagnosis of a mental dis makes a person a misfit that leads to rejection by community members. According to Carrara and Ventura, (2018), self-stigma and fear of discrimination are the primary reasons that people reject mental health services. According to Memon et al. (2016), the stigma around poor mental health negatively affects the perception of mental health services. Surprisingly, some individuals reject mental health services as they fear positive diagnosis can deny then income-generating opportunities. According to Staiger et al. (2017), the unemployed population rejects seeking mental health services for fear that negative mental health diagnosis can hamper their opportunities to get employment opportunities.

Based on the literature review three main strategic points or themes emerged. The first theme was on the negative perception of mental health services. The majority of the studies reviewed indicated that many people stayed away from getting mental health services for fear of being rejected and looked down upon due to the stigma around poor mental health. The second theme was that there is a poor allocation of mental health infrastructure. Despite mental health being as valuable as either type of health’s, mental health had little infrastructure allocated to it as evidenced by a few public mental health institutions. The last theme was that mental health services were mainly accessed by the female gender. Due to the patriarchal society, the majority of men refrain from getting mental health services for fear of being termed weak and unhealthy.
The Problem Space that is still needed to be understood is the effects that the beliefs and attitudes as explained in the social cognitive theory explain and affects the way in which people or patients accept or reject mental health services. Comment by Jennifer R. Seymour: The learner summarizes the problem space and the what still needs to be understood and how it informs the problem statement.

The theory of social cognitive theory informs the research questions trying to give the research a direction by trying to understand the different believes and attitude that do affect the way people do accept or reject utilizing mental health services.by
Comment by Jennifer R. Seymour: The learner identifies the theory(ies) or model(s) describing how they inform the research questions.
The case for this study is based on the literature review findings that Further analysis of the studies under review reveals that the populations that reject mental health services do so due to the stigma around mental complications. Most individuals that reject mental health services believe that a positive diagnosis of a mental dis makes a person a misfit that leads to rejection by community members. According to Carrara and Ventura, (2018), self-stigma and fear of discrimination are the primary reasons that people reject mental health services. Comment by Jennifer R. Seymour: The learner builds a case (argument) for the study in terms of the value of the research and how the problem statement emerged from the review of literature.
According to Memon et al. (2016), the stigma around poor mental health negatively affects the perception of mental health services. Surprisingly, some individuals reject mental health services as they fear positive diagnosis can deny then income-generating opportunities. According to Staiger et al. (2017), the unemployed population rejects seeking mental health services for fear that negative mental health diagnosis can hamper their opportunities to get employment opportunities. The problem statement is a logical extension of the literature review findings that people are rejecting mental health services and it is not known what strategies mental health professionals use to get them to begin and continue mental health treatment.

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Chapter 2 Summary
(Minimum one to two pages)

The learner synthesizes the information from all prior sections in the Literature Review using it to define the key strategic points for the research.

The learner summarizes the problem space and the what still needs to be understood and how it informs the problem statement.

02 Comment by Jennifer R. Seymour: Need to do

The learner identifies the theory(ies) or model(s) describing how they inform the research questions.

02 Comment by Jennifer R. Seymour: Need to do

The learner builds a case (argument) for the study in terms of the value of the research and how the problem statement emerged from the review of literature.

The content of this section reflects that learners have done their “due diligence” in synthesizing the existing empirical research and writing a comprehensive literature review on the research topic.

The learner summarizes key points in Chapter 2 and transitions into Chapter 3.

02 Comment by Jennifer R. Seymour: Easy to do

The chapter is correctly formatted to dissertation template using the Word Style Tool and APA standards. Writing is free of mechanical errors.

0 Comment by Jennifer R. Seymour: headings

All research presented in the chapter is scholarly, topic-related, and obtained from highly respected, academic, professional, original sources. In-text citations are accurate, correctly cited and included in the reference page according to APA standards.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Chapter 3: Methodology

Introduction
The purpose of this qualitative descriptive study is to examine how mental health providers describe the strategies they use to influence individuals’ decision to utilize or reject mental health services in south Texas. The mental health providers will be asked to share for the strategies they use to encourage patients to accept treatment at the start of treatment and to continue treatment. The study will employ a qualitative study that will target mental health providers within south Texas and document provider strategies impacting utilization of mental services available in the state.
Mental health is a serious issue in south Texas. There was a high need for this research in south Texas. One reason is because this region receives the second-largest allocation of governmental funds for mental health in the United States (Mista et al. 2017). The large allocation is because there is a documented high need for mental health services in south Texas (Kohn, et al., 2018). This means that there are significant funds available, and therefore greater possibility for people to accept or reject mental health treatment. Texas (2017) asserts that people suffering from mental illness still face problems despite the huge costs that are directed towards healthcare. Understanding the strategies providers use that lead people to use or reject this available mental health may help policymakers to get people the services they need (Kohn, et al., 2018).
This study will examine the gap: there is a need to understand why people choose to utilize or reject mental health services (Lund, et al., 2018), specifically what are the strategies that providers use to support beginning and continuing treatment. The successful use of mental health treatment has been called social inclusion. This is also recommended by Hall, Kakuma, Palmer, Minas, Martins & Kermode (2019), who stated that, promoting social inclusion of people with mental illness is a key goal of human rights and global mental health programs. The intent is to achieve people-centered mental health care, and interventions to promote social inclusion aimed at minimizing the impact of attitudinal, structural, and behavioral drivers of social exclusion. There is good evidence that supported employment programs for people with mental illness and interventions to reduce mental health stigma (e.g., mental health education, direct contact with people with mental illness) are effective in high income countries (Hall, et al., 2019. p. 20 – 22).
This chapter will be organized into the following sections: research methodology, research design and research population, instrumentation and sources of data, data analysis, and ethical considerations and limitations of the methodology. The research methodology will detail the approach that the study is utilizing. The research design covers the structure of the research. The research population details the population that will be involved in the study. On the other hand, the ethical considerations section holds all the ethical concerns that were addressed in the conducting of the research. The last section, the limitation and de-limitations contains all the information on the limitations of the study with special emphasis being placed on the research methodology.

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Chapter 3 Introduction
(Minimum two to three paragraphs)

The learner begins by restating the Purpose Statement for the study.

The learner provides a re-orienting summary of the research focus from Chapter 2 and outlines the expectations for this chapter.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Purpose of the Study

The purpose of this qualitative descriptive study is to examine how mental health providers describe the strategies that influence individuals’ decision to utilize or reject mental health services at the beginning and when they are continuing treatment in south Texas. The mental health providers will be asked for strategies they will use to encourage patients to accept and do not reject treatment at the beginning of the treatment process and when treatment is continuing. The study will employ a qualitative methodology that will target mental health providers within south Texas and document factors impacting the utilization and non-utilization of mental services available in Texas. This study will be carried out by conducting Zoom interviews with mental health providers regarding the strategies they use for encouraging participants to accept mental health treatment at the beginning and when they are continuing treatment. Data will be analyzed qualitatively and reported. Comment by Daniel Smith: Awkwardly worded… Comment by Daniel Smith: a qualitative methodology?

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Purpose of the Study
(Minimum one or two paragraphs)

This section begins with one sentence that identifies the research methodology, design, problem statement, and geographic location. This is presented as a declarative statement: “The purpose of this qualitative [design] study is to … [include the Problem Statement] at a [setting/geographic location].”

The learner introduces how the study will be carried out.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Research Questions
The phenomenon of interest is the mental health professionals’ strategies for encouraging patients to begin and continue treatment, including when they are trying to reject treatment. The following research questions will help to guide this qualitative study: Comment by Jennifer R. Seymour: updated.

Note: During and after intake the practice is to try to convince people to begin services. Clinicians help with this process.

Accepting Mental Health Support

· RQ 1: What strategies do mental health providers use to encourage patients to begin using mental health services? Comment by Daniel Smith: How do they identify strategies, or what are the startegies?
· RQ 2: What strategies do mental health providers use to encourage patients to continue
using mental health services?

Reject Mental Health Support

· RQ 3: What strategies do mental health providers use to encourage when patients try to reject beginning to use mental health services?
· RQ 4: What strategies do mental health providers use to encourage patients who try to reject to continue using mental health services?
·

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Research Questions
(Minimum one to two pages)

The learner establishes the research questions, and defines the phenomenon/a

The learner describes the nature and sources of necessary data to answer the research questions (primary versus secondary data, specific people, institutional archives, Internet open sources, etc.).

The learner describes the data collection methods, instrument(s) or data source(s) to collect the data for each research question.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Rationale for a Qualitative Methodology
A qualitative methodology (Colorafi and Evans, 2016) will be used in this study. Qualitative methodology is the most appropriate methodology that provides rich data and is not bound by limitations. Qualitative methods will help provide evidence from the interview with participants who have experienced giving primary data (Kim et al., 2017). Hence, qualitative methodology will address the problem statement, problem space, and it can answer the research questions by focusing on the mental health providers’ perspectives regarding an individual accepting, attempting to reject, or continuing mental health treatment.
A quantitative methodology was not conducive for this study because the doctoral investigator is not seeking to quantify a problem by generating numerical data (Leedy & Ormrod, 2014). This type of methodology measures independent and dependent variables that could be generalized results from a larger sample population (Leedy & Ormrod, 2014). The data collection methods are structured and utilize online or paper surveys, longitudinal studies, and systematic observations (Leedy & Ormrod, 2014).
Qualitative methodology is the most appropriate method to use in this study because it is mainly exploratory (Leedy & Ormrod, 2014). The information found will provide the doctoral investigator a greater understanding of the underlying reasons for continuing or rejecting mental health services. Furthermore, the study’s findings could help develop hypotheses for potential quantitative research (Leedy & Ormrod, 2014). In this study, the doctoral investigator will be using semi-structured techniques such as interviews and focus groups.

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Expanded Rationale for a Qualitative Methodology
(Minimum one to two pages)

The learner defines and describes the chosen methodology.

The learner provides a rationale for choosing a qualitative methodology, based on what still needs to be understood from the problem space, problem statement, and research questions.

The learner provides a rationale for the selected the methodology based on empirical studies on the topic. Comment by Jennifer R. Seymour: Need to do.

The learner justifies why the methodology was selected as opposed to alternative methodologies.

The learner uses authoritative source(s) to justify the selected methodology.
Note:

Do not use introductory research textbooks (such as Creswell or internal GCU research course e-books) to justify the research design and data analysis approach.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Rationale for Research Design

The design for this research will be a qualitative descriptive study. This design is the most appropriate design for addressing the problem statement. It is not known how mental health providers describe the factors influencing individual decisions to utilize or reject mental health services in south Texas. Furthermore, it is appropriate for the research questions because it allows the participant to express the points in length by choosing their own words. Open-ended questions may allow a broader understanding of the problem than close-ended questions.
The doctoral investigator will use a qualitative descriptive design. Kim et al. (2017); Colorafi and Evans (2016); Brazier et al. (2014) describe qualitative-descriptive research as useful and suited for researchers because it can be used with a variety of theoretical approaches, sampling techniques, and data collection strategies. However, (Bradshaw et al., 2017) states that qualitative descriptive research is categorical for inquiry, making it appropriate in handling the research questions in an organized manner; it is also less interpretative. The methodology is categorical to identify, analyze, and report patterns on the mental health topic. In addition, Seixas et al. (2017) illustrated that qualitative description methodology does not require a conceptual framework to render the technique as useful in producing a valued result and end-product by allowing the retrieval of information from participants about their experiences using it to build organization management systems.
Sandelowski (2000) stated that qualitative descriptive studies are methods of choice when a phenomenon is well known and desired. Similarly, qualitative researchers can, as an option to choose from a growing number of designs of theoretically and technically sophisticated methods. The author concluded that even though descriptive research is viewed as a lower-level form of inquiry yet, it has been able to influence some researchers that were conducting qualitative research to believe that qualitative descriptive studies help in reaching the goal of a comprehensive summary of experiences or events in the everyday provisions of those events. The descriptive qualitative research through the thematic analysis where an inductive method is used is appropriate for the study since it has no previous studies dealing with the phenomenon, the method is best in answering the research questions where the researcher does not have an expected answer (Seixas et al., 2017).
Ostad-Ali et al. (2015) described how a qualitative-descriptive method is used in elementary schools to evaluate students’ achievements towards improving quality learning and promoting the level of mental health in teaching-learning environments. The authors described how the raised hypothesis was used to investigate the teachers’ perspectives on descriptive and quantitative methods. They used the survey sampling method and multi-stage cluster sampling method, and a questionnaire to compare the qualitative (descriptive) method of evaluation with the quantitative evaluation method to explore teachers’ viewpoints. Based on teachers’ perspective, they concluded that for many years, quantitative evaluation has been having adverse effects on families and students’ mental health; hence, the descriptive method must match the phenomenon’s content to avoid the negative effects.

Similarly, Stevens and Palfreyman (2012), described how qualitative methods may be used to develop descriptive system preferences. They assert that a qualitative method can ensure that a phenomenon being measured has appropriate language, content validity, and responsiveness to change. In their conclusion, they were able to illustrate the use of qualitative methods by presenting different cases of study, generic and condition specific and were able to discover the strengths above the weaknesses in the approach. The descriptive research design is appropriate because it identifies the characteristics and correlations in the study (Colorafi & Evans, 2016). The research method is appropriate for the study because it is used to analyze non-quantified topics and issues. This method is suitable for the phenomena as it will allow mental health practitioners to describe factors limiting the utilization of mental healthcare throughout in south Texas.
The population for this study is all (approximately 100) mental health providers in south Texas. This study sample will include four clinics and about ten mental health providers. Mental health providers must have at least two years of experience to participate in the study. The study population for the research will be psychiatrists, psychologists, and therapists. The association used in this study has the type of members that can answer the research question. The initial sample generation will involve getting a list of mental health providers from each of the clinics’ websites. The doctoral investigator will ask the clinics to cooperate via an invitation email with the informed consent form to their staff on behalf of the researcher. Participants will include people who are members of Mental Health Organizations including:
· Mental Health America (MHA)
· National Institute of Mental Health (NIMH)
· National Alliance on Mental Health (NAMI)
· National Institute of Environmental Health Sciences (NIEHS)
The data collection instruments will include a researcher-created interview protocol that will be field-tested with two mental health professionals the doctoral investigator knows. The data will not be included in the results. It will also include a researcher-created focus group protocol that will be evaluated by an expert panel of two mental health professionals. To collect the data, the doctoral investigator will invite employees within the researcher’s organization who are willing to participate in the study, especially those meeting the criteria and 20 participants. Participation is voluntary, and participants can choose to be withdrawn from the study at any time. Once the sample is selected, the researcher will use Zoom video conference calls to conduct the interviews and retrieve the data. Data will be collected in one-hour interviews. The focus group will might include the first six volunteers from the original participants in the interviews in a group Zoom meeting to discuss the focus group questions. If more are needed, they will be recruited. Comment by Daniel Smith: Same participants as interviews? Comment by Jennifer R. Seymour: yes Comment by Daniel Smith: What if they do not want to participate? They have to make that decision – state simply that they might overlap or that they will always overlap.

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Research Design
(Minimum one to two pages)

The learner identifies the research design for the study. The learner provides the rationale for selecting the research design supported by empirical and methodological references.

The learner justifies why the design was selected as the best approach to collect the needed data, as opposed to alternative designs.

The learner uses authoritative source(s) to justify the design.
Note:
Do not use introductory research textbooks (such as Creswell) to justify the research design and data analysis approach.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Population and Sample Selection

The overall population from which the participants come are the mental health providers such as psychiatrists and therapists. In the United States there are approximately 667,000 mental health professionals and majority of them are aged between 27 and 50 years (Grohol, 2019).
The target population was purposively selected to include mental health providers from south Texas due to convenience and interest in this specific location given current statistics on mental health use. The geographical location for the study is the southern Texas region, unfortunately, there is an unequal number of adults experiencing mental health problems. The numbers have increased from 9.4% in 2015 to 11.8% in 2018 (Understanding Houston, 2021). It has been reported that a higher percentage of adults’ report 14 days or beyond of undergoing poor mental health (Understanding Houston, 2021). Unfortunately, the populations being the most affected are Blacks, Hispanics, and Asian-Americans. Many of this population affected are between 30-44 years of age (Understanding Houston, 2021). These statistics illuminate the need for this proposed study to address mental health providers’ perceptions regarding the factors that influence their patients to seek or continue mental health services. Economic data from city shares that 68% of Hispanics face economic challenges due to limited level of education that limits them to acquire job opportunities contributing to most of them living in a low average income (Herzog et al., 2016). Statistics show that African and Hispanic-Americans minorities are traditionally known to have poorer access to primary care than the Caucasian-Americans (SAMHSA, 2018). While the pattern changed a little due to the Affordable Care Act (ACA), yet the disparity is still high. The Hispanics low-income level and occupational characteristics are associated to low rates of health insurance coverage. According to research by the Texas 2018 Mental Health National Outcome Measures (NOMS): SAMHSA Uniform Reporting System, 21.6% of African Americans in south Texas lack healthcare insurance, while the Hispanic or Latino population’s access stands at 26.3%, the reason is directed to low-income levels due to their occupational characteristics (SAMHSA, 2018), (Printz, 2015).
Purposive sampling will be done of mental health professionals who counsel patients for at least 3 years. This will be part of the informed consent, and they will be asked before scheduling the interview if they have served patients for at least 3 years. After surveying the counseling and psychiatrist offices in south Texas, 4 offices were selected to recruit participants. The reasons why these 4 were included in the recruitment pool are there is a minimum of 125 employees working in the least of the offices. The total of 500 potential participants is likely to enable the researcher to obtain 20 participants which is less than 10% response rate. The actual study sample will include 20 psychiatrists and counselors from 4 mental health institutions in the United States.
To obtain site authorization the researcher has sent emails to the chief executive officers of the 4 mental health institutions identified for the study requesting permission to conduct research in their organizations. Site permission has been granted. The sample size of 20 participants is appropriate for the university guidelines for a qualitative descriptive study and if more are needed to obtain saturation then they will be recruited.

The confidentiality measures will be described as not collecting the names of the participants and using pseudonyms for them in all documents including transcripts, data analysis, and reporting. The data will be safeguarded in password protected files and a password protected backup USB drive to protect the information. The study participation requirements will be listed as people who are mental health professionals and meet with patients in counseling settings.
The geographic location for the interview will be Zoom interviews. The participants will be recruited by having the human resources department or secretary of the mental health institution forward an email from the researcher that describes the study, asks for participation, defines the $25 stipend Amazon e-card, and includes the informed consent document.
The sample will meet the requirements for qualitative descriptive from GCU in that 20 people will be recruited with a minimum number of 10 participants in the final study. Data saturation will be sought meaning that the data being gleaned is producing no new themes or content, and there is repetition. If new data is emerging after 10 participants, then additional participants will be sought in to reach data saturation. The data collected from the interviews must consist of five pages of single-spaced pure data. If the minimum sample size of 10 is not met at the 12 4 institutions, there are 10 additional institutions in south Texas that I will seek site authorization from in to recruit a sufficient number of participants. There are two back up plans which include expanding to additional sites. The first will expand to two more sites. The next plan will expand to another two to four sites depending in the numbers that are needed. The strategies to account for attrition include expanding to 10 additional sites available, but the potential sample is likely sufficient with a minimum of 125 at each of the 4 sites for a total of 500 participants. The sample will meet the requirements for qualitative descriptive from GCU in that 20 people will be recruited with a minimum number of 10 participants in the final study. The data collected from the interviews must consist of five pages of single-spaced pure data. If the minimum sample size of 10 is not met at the 4 institutions, there are 10 additional institutions in south Texas that recruitment can be expanded to.
This study will use a combination of purposive and convenience sampling. The convenience is that these locations are nearby. The purposive is that they are mental health providers who work with clients who have access to mental health care and choose to accept or reject it. The criteria for selecting the participants will include Individuals that directly deal with mentally ill individuals, individuals with over 3 years of experience in mental health in the public sector. These will be included in the initial recruitment email and asked over the phone before the participant is accepted into the study.

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Population and Sample Selection
(Minimum one to two pages)

The learner defines and describes the population of interest (the group to which the results of the study would be generalized or applicable) (such as police officers in AZ).

The learner defines and describes the target population from which the sample ultimately is selected (such as police officers in AZ who belong to the police fraternal association).

The learner defines and describes the study sample, who are the individuals who will volunteer or be selected from the target population and are the final source of data, and the final group from whom complete data will be collected.

NOTE: There is no such thing as a sample population, there is only a “sample.” that is taken from the target population or the population.

The learner describes the required sample size to secure adequate qualitative data as based on the literature related to the design indicated in the previous section and provides the rationale for how this size was derived.

The learner defines and describes the sampling procedures (such as convenience, purposive, snowball, etc.) supported by scholarly research sources.

For a purposive sample, the learner identifies the screening criteria (“purposes”) and how the participants will be screened (e.g., demographic questionnaire, expert knowledge of topic, screening questions such as years of experience in a position).

The learner defines and describes the sampling strategy and the process for recruiting individuals to comprise the sample. The learner provides a compelling argument that the target population is large enough to meet the target sample size by defining the “sample frame” (the subset of the target population from which the sample will be drawn).

The learner discusses the primary plan to obtain the sample (plan “A”) as well as two back up plans to use if plan “A” does not provide the minimum target sample size.

The learner describes the process used to obtain site authorization to access the target population and sample frame. This includes the information required to obtain this authorization, such as a description of confidentiality measures, the limits of study participation requirements, and geographic specifics, for example.

The learner includes evidence of site authorization in an appendix prior to submission for peer review.

If public data sources or social media are used to collect data, and no site permission is required, the learner provides a rationale and evidence for why these sources can be used without this permission.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Sources of Data
There are two sources of data including 20 Zoom interviews and a Zoom focus group of 6-8 people that also participated in the Zoom interviews. These will be collected by the researcher. They will be analyzed qualitatively.

Research Data
Comment by GCU: APA Level 3 heading
Research Data Source #1. The Zoom interviews will consist of 12 open-ended questions that are found in the Appendix XX. This interview was created by listing the research questions and generating questions that would allow the participants to answer the research questions. The interview guides will each be evaluated by an expert panel of three therapists who will not participate in the study. Comment by GCU: APA Level 4 heading. Comment by Jennifer R. Seymour: We need to do this before AQR.
Research Data Source #2. The Zoom focus groups will consist of 4 open-ended discussion questions that participants will discuss. This interview was created by listing the research questions and generating questions that would allow the participants to answer the research questions. The interview guides will each be evaluated by an expert panel of three therapists who will not participate in the study. Comment by Jennifer R. Seymour: We need to do this before AQR.

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Sources of Data Comment by Jennifer R. Seymour: Need to do this section

Describe the interview questions. Add the Appendix letter.
(Minimum one to three pages)

The learner provides a detailed discussion of the sources to be used to collect the research data that will be used to address the research questions. The required details include:
1. How the instrument was developed and constructed.
2. Interview questions must be aligned with the research design and collect the information to address the research questions and problem statement.

If the learner’s research data will come from an electronic database (archival, or secondary data), they provide the following information:
1. Identify the database and indicate exactly how the data will be obtained or accessed.
2. Confirm that the database actually contains data on the phenomenon or case that are needed to address the research questions.
3. Identify the source of the data (e.g., agency, website, etc.), and indicate how the data will physically be obtained and in what format.

The learner includes an outline of the structure of the database in Appendix E, e.g., labels for the rows and columns.

If permission to use the database is required, evidence of this permission also is included in Appendix E.

The learner provides a detailed discussion of the instrumentation and/or research materials to be used to collect any additional data, such as data to be used for participant screening/selection and/or demographic data.

For screening/selection instruments, the learner explains how the instruments work, and exactly how the information obtained relates to participant selection.

For demographic data, the learner describes why it is necessary and how it will be used. The main use of demographic data is to provide a profile of the sample, and the specific demographic information collected will be relevant to the proposal topic.

The learner includes a copy of all instruments, questionnaires, surveys, interview protocols, observation protocols, focus group protocols, or other research materials in Appendix E. For any instruments or research materials that require “permission to use,” Appendix E includes evidence of having obtained such permission. A protocol for data collection such as an interview or focus group or observation is more than a set of interview questions, It should provide the detailed process the learner will use to collect the data including their introduction and description of the process, the location, the physical set-up, the technologies to be used for holding and recording the meeting, the interview questions, additional probing questions, and/or facilitation and data collection techniques used in these approaches. A detailed protocol enhances the learner’s ability to defend the study.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Trustworthiness
Trustworthiness in research shows the extent to which the findings can be replicated as well as how credible the research findings are (Maxwell, 2017). For a research to be termed trustworthy it must demonstrate that it is free from bias through the methods it has used in both data collection and analysis. In addition, it must show that the research has a direct impact on an existing population. The research findings or recommendations may be transferred to another population other than that which is under study if they are sufficiently similar. In other words, other researchers focusing on a particular topic should be able to replicate the findings of a study that is considered trustworthy.
To build on the trustworthiness of qualitative studies, there are two main things that can be done. The first thing is getting an outsider to review and examine the research process, preferably a credible individual. Whenever a third party is introduced to a research process the research has to be conducted in a manner that is simple enough for the third party to understand and to explain if there is a need. For the trustworthiness of the research, an outsider will be brought in. The third party must be a psychiatrist by profession, and they must have made research publication in the mental health industry.
The second way in which trustworthiness is built in qualitative research is through the recording of the research process. Recording allows other parties to examine whether the research was conducted correctly and offers an opportunity for the research to be replicated (Shenton, 2004). To ensure trustworthiness in the study, the researchers will record all data collection and data analysis processes. All interviewees will be recorded after they consent to the process.
Credibility refers to the quality of being trusted and believed in. In checking for the credibility of the research, methodological triangulation will be used (Thomas, 2017). Different data collection methods will be used to check the consistency of the findings. One threat to the credibility of the study is the study population. The study population primarily consists of mental health service providers and for that reason the data collected from them may be based on the profession’s point of view. The researchers will utilize an open-ended interview session to drive the bias out if it is picked during the session.
Transferability refers to the generalization of research findings. For generalization purposes, data will be collected from a diverse population to ensure that the findings are transferable to as many different populations as possible. One of the main threats to transferability is poor data collection methods (Sherif, 2018). If biased data collection methods are used then it is not possible for the results to be replicated and for the research findings to be generalized. To ensure that the above threat is minimized, the researchers will document the context of the participants so that it is clear who else may be similar or not.
Dependability refers to the reliability and consistency of research findings (Shenton, 2004). In establishing dependability, the study will be used to ensure that it has as little bias as possible and that it is reliable. A dissertation advisor will review all documents. In addition, the whole research process will be documented in a research paper that details the data collection process as well as the analysis process. From the paper which will act as a report, researchers will offer a sequence of events that can be replicated to confirm the research findings.
Confirmability in qualitative research refers to the degree in which research findings can be corroborated or confirmed by other people (Fusch, Fusch & Ness, 2018). In establishing the research confirmability, an audit trail will be established. The audit trail will detail the data collection methods and procedures as well as the research methodology.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

TRUSTWORTHINESS

(Minimum two to four paragraphs or approximately one page)

1. Defines the concepts of credibility, transferability
2. Credibility: discusses how the study represents the participants’ experiences
3. Transferability: discusses how the study’s findings may be applicable to policy, practice, future research

1. Describes the threats to the credibility and transferability of the study inherent in the study design, sampling strategy, data collection method/instruments, and data analysis
2. Addresses how these threats will be minimized

Defines concepts of dependability and confirmability

Dependability: discusses how the study documents research procedures. Provides detailed research protocols.

Confirmability: discusses how the study could be confirmed or findings corroborated by others.

Describes the threats to dependability and confirmability of the study inherent in the study design, sampling strategy, data collection method/instruments, and data analysis.

Addresses how these threats will be minimized.

Appendices must include copies of instruments, materials, qualitative data collection protocols, codebook(s), and permission letters from instrument authors (for validated instruments, surveys, interview guides, etc.)

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, correct punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Data Collection and Management
The data collection process will begin by writing a letter to the dean requesting for permission to conduct the research. The proposal for the research will then be presented to the Institutional review board (IRB) for approval. The IRB will approve the study and the researchers will recruit the participants to take part in the study. The sample population for this study will include psychiatrists and therapists. There will be two forms of data collection: interviews and one focus group. The interviews will take place first and then the focus group will be held. Member checking will occur once data is collected and coded, the codes for each person will be sent to them with a table through email. The emailed table will include the codes for that person, a definition of the codes, and short excerpts of the transcripts to support the code. Participants will be asked if they disagree with any of the codes, or in other words if the researcher misinterpreted what the participants was trying to say. Codes will be revised based on this feedback before thematic analysis begins. Comment by Jennifer R. Seymour: The learner describes the procedures for the actual data collection at a level of detail that would allow execution of the study by another researcher. This will include (but not be limited to) how each instrument, measurement technique, or data source will be used, how and where data will be collected, and how data will be recorded.

The learner includes a sequence of actions or step-by-step procedures to be used to carry out all the major steps for data collection. This includes a workflow and corresponding timeline, presenting a logical, sequential, and transparent protocol for data collection that would allow another researcher to conduct the study.

Data from different sources may have to be collected in parallel (e.g., paper-and-pen surveys for teachers, corresponding students, and their parents AND retrieval of archival data from the school district). Provides detailed description of data collection process, including all sources of data and methods used, such as field tests, interviews, member checking, observations, surveys, and expert panel review. Note: The collected data must be sufficient in breadth and depth to answer the research question(s) and interpreted and presented correctly, by theme, research question and/or instrument. sequence is acceptable.

Recruitment.
For the recruitment of the participants of the study, I will have the secretary forward an email from me to all the participants. The email will highlight what the study is about and the role that they will be playing in the study. The informed consent document will be included. Once the identified parties have consented to the study, the researcher will communicate over email or phone with the sample group and allocate everyone a specified time that they will be interviewed. Comment by Jennifer R. Seymour: Describes the procedures for obtaining participant informed consent and for protecting the rights and well-being of the study sample participants.

Collection.
The data will be collected by interviewing 20 respondents that are members of focus groups from 4 mental health organizations within south Texas. The interviews will involve 20 respondents from the selected organizations. The respondents will respond to questions that are going to be asked in the interview session. A separate Zoom will be held with a group of 6-8 of the same participants, whomever volunteered first, to have a group discussion of 4 different focus group questions. Comment by Daniel Smith: You use 6-8 participants but earlier used at least 10 per the GCU rubric?
A consent form will be sent using DocuSign and obtained with signature. The selected participants will submit the consent forms and complete the interview using Zoom. Data will be collected on Zoom which for a Business account provided computer generated transcripts. These transcripts will be reviewed and listened to and cleaned up for computer errors such as the computer transcribing the word label as ladel. Transcripts once cleaned will be uploaded into MaxQDA for analyses. As indicated above, member checking will occur once data is collected and coded, the codes for each person will be sent to them with a table through email. Comment by Jennifer R. Seymour: Describes how raw data are prepared for analysis (i.e., transcribing interviews, conducting member checking, downloading from SPSS and checking for missing data).

The transcripts and data analysis files will be saved in a password protected file on the computer and on a password protected USB drive as a backup. They will be saved for 3 years and then destroyed electronically and physically for the USB drive by smashing it. Comment by Jennifer R. Seymour: Describes (for both paper-based and electronic data) the data management procedures adopted to maintain data securely, including the length of time data will be kept, where it will be kept, and how it will be destroyed

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Data Collection and Management
(Minimum one to three pages)

The learner describes the procedures for the actual data collection at a level of detail that would allow execution of the study by another researcher. This will include (but not be limited to) how each instrument, measurement technique, or data source will be used, how and where data will be collected, and how data will be recorded.

The steps include acquisition of site authorization documents, IRB approval, and the procedures for obtaining participant informed consent and protecting the rights and well-being of the participants.

The learner includes copies of the relevant site authorizations, participant informed consent forms, recruitment announcements/materials (e.g., posters, e-mails, etc.) in appropriate appendices.

The learner describes the data management procedures for paper-based and/or electronic data. This includes, for example, data security procedures and how and when data will be destroyed.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Data Analysis Procedures

Accepting Mental Health Support

· RQ 1: What strategies do mental health providers use to encourage patients to begin using mental health services?
· RQ 2: What strategies do mental health providers use to encourage patients to continue
using mental health services?

Reject Mental Health

Given that the patients have access to mental health services for all the above questions, the below interview questions listed in Appendix F will be used as part of the interview protocol. The interview questions will each be answered by the responses to interview questions. There are three interview questions per research question for a total of 12 questions. Appendix F also captures the four questions that will be used in the focus group there are four questions, one for each research question. Comment by Jennifer R. Seymour: Describes in detail the relevant data collected for each stated research question and/or each variable within each hypothesis (if applicable).

At the initial cleaning stage, individual interviews will be conducted, recorded, and transcribed verbatim. The Zoom program will transcribe the data automatically, and then it will be read and cleaned up for minor changes. The next step will involve the researcher repeatedly reading and listening to the content to get familiarized with it. As such, the researcher will gain deeper and better familiarization with the contents; he will also identify the answers to those questions asked as well as identify the themes. Member checking will be conducted by emailing tables to each participants that lists their codes, the code definitions, and excerpts of the transcript supporting that code to see if there is anything the researcher misinterpreted. Adjustments to coding will be made based on participant responses as needed. Each participant’s transcripts will have a file in a password protected folder on the researcher’s harddrive. These transcripts will be uploaded into MaxQDA for analyses. The files will be saved in MaxQDA and backed up on the researchers’ hard drive in a password protected folder. These will be backed up on password protected USB drive which will be destroyed after 3 years, and the computer files will be deleted as well. Comment by Jennifer R. Seymour: Describes how raw data are prepared for analysis (i.e., transcribing interviews, conducting member checking, how all sources of data will be organized. and checking for missing data).
Describes (for both paper-based and electronic data) the data management procedures adopted to maintain data securely, including the length of time data will be kept, where it will be kept, and how it will be destroyed

The data collected will be grouped into three categories. The first category is the person from which data was collected. The second category will be the method used for data collection. The third category will be the contents of the data collected. Through the categorization it will be possible to collect evidence that supports that the quantity, and the quality of the data is sufficient to answer the research questions.
A thematic analysis (Nowell et al., 2017) will be used to analyze the data collected. This was chosen because it is a common analysis technique for qualitative data with a clear set of steps to follow. According to Nowell et al., (2017), thematic analysis emphasizes the identification, analysis and interpretation of patterns of meaning within qualitative data. The researcher particularly will use MaxDQA in organizing and visualizing data. The researcher followed six steps in analyzing and visualizing the data collected (Nowell et al., 2017). Stage 1 will involve familiarizing with the data collected. Stage 2 will involve generating codes regarding the significant ideas discovered in the data and identification of data and combining pertinent data relating to each code. This is where each research question is aligned to the interview question, and therefore the codes will align with the research questions. Stage 3 will allow the researcher to review codes and to understand those that could be developed into acceptable themes. Comment by Jennifer R. Seymour: Describe evidence of qualitative analysis approach, such as coding and theming process, which must be completely described and include the analysis /interpretation process. Clear evidence from how codes were combined or synthesized to create the themes must be presented.
The next step will involve reviewing and refining the themes and determining if there are any of them that need to be removed, combined, or if they can be broken down into additional themes. The fifth step involves defining and naming the themes after refining them (Nowell et al., 2017). Themes will be generated when there are a significant number of codes related to it that emerge from the data that answers the research questions. In the next stage the researcher will generate a report. Once the researcher is familiar with the data by reading through the data and looking for patterns, he will develop a detailed description of the phenomenon from the synthesis of the data which is outlined in the discussion section of this study.
This thematic analysis is justified because it will allow the identification of the common strategies that mental health practitioners use to support patients to begin or continue their treatment, which are the research questions. The research questions are aligned with the interview questions that will be analyzed, thus organizing the data and the data analysis. Thematic analyses as described above in detail will allow the researcher to note when three or more participants are using the same strategies and to note that as a theme. For each interview, transcripts will be generated with only the participant’s comments (no researcher or questions) and a minimum of 5 single-spaced pages will be necessary to allow it to be used as data for the study per university guidelines. In the end, results of the themes identified for each of the research questions will be written in Chapter 4 by research question with explanations of themes and excerpts of transcripts to support the themes. Comment by Jennifer R. Seymour: Provides evidence that quantity and quality of data is sufficient to answer the research questions. This must be present in this section or in an appendix including data samples.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Data Analysis Procedures
(Minimum one to three pages)

The learner restates the problem statement or purpose statement, along with the research question(s)

Describes how raw data are prepared for analysis (i.e., transcribing interviews, conducting member checking, how all sources of data will be organized. and checking for missing data).
Describes (for both paper-based and electronic data) the data management procedures adopted to maintain data securely, including the length of time data will be kept, where it will be kept, and how it will be destroyed

Describe evidence of qualitative analysis approach, such as coding and theming process, which must be completely described and include the analysis /interpretation process. Clear evidence from how codes were combined or synthesized to create the themes must be presented.

Provides evidence that quantity and quality of data is sufficient to answer the research questions.

The learner provides description of how the results will be reported.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Ethical Considerations

The Belmont Principles propose three moral principles which include respect for persons, beneficence, and justice (Fisher, 2017). These are defined below and an example of how his study will adhere to them is given. Comment by Jennifer R. Seymour: The third ethical standard that will be enforced is the research and publication standard that emphasizes that consent should be gotten from the participants before any publication of the research is done.

It is important to remember that the research will be aimed at benefiting the stakeholders just as the principles of beneficence and nonmaleficence dictate (Kosinski et al., 2015). In addition, the Belmont Principles are incorporated into the American Psychological Association Code of Ethics and reflect an expectation of research that maximizes benefit for science, humanity, and research participants while avoiding and minimizing risk and harm (Fisher, 2017). In honoring the APA principles in human research, the study will have to obey the APA principle of following informed-consent rules. There are three standards that are going to be enforced in this study. The first standard is the human relation standard. The second standard that will be enforced is the privacy and confidentiality standard. The standard was put in place to ensure that the rights more, so privacy and confidential rights of people are observed. The third ethical standard that will be enforced is the research and publication standard that emphasizes that consent should be gotten from the participants before any publication of the research is done.
The human relation standard focuses on ensuring that there is no discrimination in the study and that the best approaches are used when interacting with humans to make them as comfortable as possible. In this study, the interviewer will seek to be kind, open, and courteous to all participants of all races, ethnicities, and genders. The privacy standard will be observed through the use of informed consent and pseudonyms for participants and locations. The final standard of consent before publication will be achieved by informed consent procedures as well.
There is a process for informed consent. First IRB must approve the informed consent form. The informed consent form will be emailed with recruitment. The informed consent form will be reviewed on the phone with the researcher and signed using DocuSign by the participant. The rules state that all participants in the study should be made aware of the purpose of the research and the expected research duration. In addition, the participants should also be made aware of any foreseeable factors that may influence their willingness to participate in the study as well as the limits of the confidentiality of the research that the participants will participate in (Khodyakov et al., 2016). Comment by Jennifer R. Seymour: Describes the procedures for obtaining informed consent and for protecting the rights and well-being of the study sample participants.
Other ethical considerations are important to this process. Ethical approval for this study will first be obtained from the university, after which the data collection will commence. It is important that consent is gotten from the participants as well as the institutions that they work for to avoid unnecessary litigation as well as to be in line with ethical demands of human research (Dickert, 2019). In to protect the participants and their well being several measures will be taken. No person outside the research team should have access to the collected data. Before the commencement of the study, the researcher will seek authorization from all the relevant bodies including the IRB for approval. The researcher will also seek authority from the University board to conduct the research. All the data collected will be purely used for research purposes and remain confidential. The data will remain free to withdraw from respondents from the study. No personal name or organizational names that may bring conflict of interest in the research will be included. The research will remain in the custody of the University will all rights reserved. Additionally, only relevant data was collected by the researcher, solely for the study. The researcher will remain clear of any subjectivity in analyzing the data and also in preventing anything that will be harmful to the participants.
Participants will not be coerced to participate, but they will be given a small $25 Amazon e-gift card emailed to them as incentives for participating in the research. Participants will be seen on Zoom by the researcher so they will not be anonymous, but their information will all remain confidential with discretion and pseudonyms. Their actual names will only exist on their DocuSign forms, and nowhere else. In this way, their privacy will be protected. They will be given contacts that they can use in case they have any questions. The researcher does not work for any of the institutions, nor know any of the potential participants, which minimizes the potential for conflict of interest. Comment by Jennifer R. Seymour: Addresses key ethical criteria of anonymity, confidentiality, privacy, strategies to prevent coercion, and any potential conflict of interest
The data obtained will remain stored on the researcher’s personal computer with the password encrypted on the file where the documents are kept. The data will only be managed and accessed by the people who do have the required clearance. The data will be stored in the computers as long as possible and in any case when the data will be needed to be destroyed then the data will be simply erased form the computer systems. The relationship developed between the researcher and the respondents will only be used to provide information for the study and not for any other purposes. The data will be destroyed after three years from both the computer file and the backup password protected USB drive which will be physically destroyed with water.

Figure 3.

IRB Alert

Please be aware that GCU doctoral learners may not screen, recruit, or collect any data until they receive Institutional Review Board (IRB) approval and obtain a signed D-50 form. IRB review occurs after the proposal is approved by AQR and the proposal defense is completed. Learners are responsible for knowing, understanding, and following the IRB submission and review processes. Screening, recruiting participants, and collecting data in advance of IRB approval is a serious research ethical violation, with legal and federal regulatory implications to the University. If a learner chooses to screen, recruit study participants, or collect data in advance of obtaining IRB approval (IRB approval letter and D-50 form), they will be subject to serious academic disciplinary action by the Institutional Review Board and Code of Conduct committee. This may include collecting new data or requiring the learner to start over with a new research study. In addition, the Code of Conduct committee will issue a disciplinary action that may include warning, suspension, or dismissal from the program.

NOTE: Learners should NEVER proceed with any aspect of participant screening, recruiting, interacting with participants, or collecting data in advance of receiving the IRB approval letter and the signed D-50 form. The chairs and committee members are trained on these requirements; however, the learner is ultimately responsible for understanding and adhering to all IRB requirements as outlined in the University Policy Handbook and Dissertation Milestone Guide.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

ETHICAL CONSIDERATIONS

(Minimum three to four paragraphs or approximately one page)

Provides a discussion of ethical issues, per Belmont Report and IRB guidelines, related to the study and the study population of interest. Includes citations.

Explains which principles / issues are relevant to the study.

Identifies the potential risks for harm that are inherent in the study.

Describes the procedures for obtaining informed consent and for protecting the rights and well-being of the study sample participants. Includes statement in Informed Consent on who has data access including chair, committee members, IRB and peer reviewers, college representative.

Addresses key ethical criteria of anonymity, confidentiality, privacy, strategies to prevent coercion, and any potential conflict of interest.

Describes the data management procedures adopted to store and maintain paper and electronic data securely, including the minimum 3-year length of time data will be kept, where it will be kept, and how it will be destroyed.
Explains plan to implement each of the principles/issues that are relevant the study data management, data analysis, and publication of findings.

Note:
Learners are required to securely maintain and have access to raw data/records for a minimum of three years. If asked by a committee member, IRB reviewer, peer reviewer or CDS representative, learner must provide all evidence of data including source data, Excel files, interview recordings and transcripts, evidence of coding or data analysis, or survey results, etc. No dissertation will be allowed to move forward in the review process if data are not produced upon request.

Includes copy of site authorization letter (if appropriate), IRB Informed Consent (Proposal) and IRB Approval letter (Dissertation) in appropriate Appendices.
All approvals, consent forms, recruitment, and data collection materials are mentioned in the Data Collection section and included in appropriate appendices (with appropriate in-text references).

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Assumptions, and Delimitations

This section identifies the assumptions and specifies the delimitations of the study. The learner should define the terms using citations from the literature, and then list the assumptions and delimitations. The learner should provide a rationale and appropriate citations for all statements.

Assumptions

An assumption is a self-evident truth. This section lists what is assumed to be true about the information gathered in the study. State the assumptions being accepted for the study which may be methodological, theoretical, or topic-specific. Provide a rationale for each assumption. Additionally, identify any potential negative consequences of the assumptions for the study. For example, the following assumptions were present in this study:
It is assumed that survey participants in this study were not deceptive with their interview answers, and that the participants answered questions honestly and to the best of their ability. Provide an explanation to support this assumption.
It is assumed that this study is an accurate representation of the current (health, economic, education) situation in rural southern Arizona. Provide an explanation to support this assumption.

Delimitations

The study had the following Delimitations:
1. Due to convenience and university policies, there will be a small sample size of 20 participants. The consequence is that, it negatively influences the transferability of research findings because of limited participants (Hesse et al., 2019). To minimize the impact of the small sample size I will attempt to reach saturation when no new topics are arising in new interviews.
2. The participants included in this study were healthcare providers in south Texas. As a result, this study did not involve healthcare providers from other parts of the United States. The consequence is that it might not be transferable. To minimize this the participants and their work environment will be described to allow readers to assess if the findings transfer to their context.

Delimitations are decisions or choices made by the researcher (or stakeholders) to establish the boundaries (or limits) of the study (e.g., location and duration), which could affect the quality of the research. Identify the delimitations of the research. Provide a rationale for each delimitation and discuss associated consequences for the transferability and applicability of the findings. Address delimitations pertaining to different aspects or scope of the study. Note that “Limitations” due to challenges in the conduct of research should be described in Chs.4 & 5.)

Examples of Delimitations. The following examples illustrate how learners can state delimitations present in their study.
1. Lack of funding delimited the scope of this study. Provide an explanation to support this delimitation.
2. The survey of high school students was delimited to only rural schools in one county within southern Arizona, limiting the demographic sample. Provide an explanation to support this delimitation.
3. Case study design was delimited to one single case instead of multiple cases for comparison.
4. Data collection methods were delimited to interviews, questionnaires, and archival document reviews, excluding classroom observations due to school policy.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Assumptions, Limitations, and Delimitations – Methodological
(Minimum three to four paragraphs)

The learner provides a separate subsection for assumptions and delimitations.

The learner states the assumptions being accepted for the study and provides a rationale for making each assumption.

The learner also discusses associated consequences for the transferability and applicability of the findings.

The learner identifies the methodological delimitations of the study and provides a rationale for each delimitation.

The learner discusses associated consequences for the transferability and applicability of the findings.

The learner discusses strategies to minimize and/or mitigate the potential negative consequences of methodological assumptions, limitations, and delimitations.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Summary
The number of People suffering from mental dis s continues to increase in the United Sates. This is despite the spirited efforts to improve access to mental health services. There are numerous factors that influence health seeking behaviors among people in the United States (Platt et al., 2018).
It was not known what strategies by therapists influences an individual’s decision begin or continue to utilize mental health services in the United States. A qualitative research methodology will be used in this study to help in answering the research questions. This is partially because most previous studies that sought to determine the factors affecting health seeking behaviors among people experiencing mental conditions use quantitative research methodology. Such studies focused extensively on the numerical and statistical elements of the study overseeing important relationships (Kapadia et al., 2017). In contrast, a qualitative descriptive research design was adopted for this study. Qualitative descriptive is the most appropriate design for this study because it helps to describe how mental health providers use strategies to encourage people to begin and continue mental health services (Kim et al., 2017).
Data collection followed all standard procedures beginning with seeking approval from the IRB. Data analysis was conducted using thematic analysis. Various ethical considerations were observed throughout the study. The researcher also ensured that all the research processes do not harm the respondents in any way either physically, emotionally or any other way. The privacy of respondents was also respected in the study.
Chapter two discussed the various literature that support the acceptance and the rejection of mental health services with the intention of identifying why people do so to improve mental health. Chapter three presented the methodology including data collection and data analysis. Chapter four presents the findings of the study. It begins by discussing the research questions and problem statement of the study. The themes and relationships that emerged from the data collected are presented in this chapter. Tables, charts, and figures are also presented in this section. Chapter five provides discussion of the findings outlined in chapter four. Chapter five also presents significance of the study and its implication to practice. Finally, recommendations for future studies are provided at the end of the chapter.

In this section the learner summarizes the key points Chapter 3. The learner demonstrates an in-depth understanding of the overall research design and analysis techniques. The learner concludes the Chapter 3 summary with a discussion that transitions the reader to Chapter 4.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Chapter 3 Summary
(Minimum one to two pages)

The learner summarizes key points presented in Chapter 3 using authoritative, empirical sources/citations. Key points include (for example):
· Methodology/design
· Population
· Sample size/selection
· Instrumentation/Sources of Data
· Data collection
· Data analysis

The learner concludes Chapter 3 with a transition discussion to focus for Chapter 4.

The learner writes this section in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Chapter 4: Data Analysis and Results

Introduction
The purpose of this chapter is to provide the reader with a concise summary of the study and a presentation of the results. In this section of Chapter 4, the learner should briefly restate the research problem, the methodology and design, the research question(s), and phenomena, and then offer a statement about what will be covered in this chapter. Chapter 4 should present the results of the study as clearly as possible, leaving the interpretation of the results for Chapter 5. Make sure this chapter is written in past tense and reflects how the study was actually conducted. Any change to the sampling approach, instrumentation, data collection procedures or data analysis must be noted in this chapter. After the research study is complete, make sure this chapter reflects how the study was actually conducted in comparison to what was proposed in Chapter 3. These changes should also be discussed as limitations of the study (in appropriate sections of Chapters 4 and 5).

This chapter typically contains the analyzed data, often presented in both text and tabular, or figure format. To ensure readability and clarity of findings, structure is of the utmost importance in this chapter. Sufficient guidance in the narrative should be provided to highlight the findings of greatest importance for the reader. Most researchers begin with a description of the sample and the relevant demographic characteristics presented in text or tabular format. Ask the following general questions before starting this chapter:
1. Is there sufficient data to answer each of the research question(s) asked in the study?
2. Is there sufficient data to support the conclusions made in Chapter 5?
3. Is the study written in the third person? Never use the first person.
4. Are the data clearly explained using a table, graph, chart, or text?
5. Visual organizers, including tables and figures, must always be introduced, presented and discussed within the text first. Never insert them without these three steps. It is often best to develop all the tables, graphs, charts, etc. before writing any text to further clarify how to proceed. Point out the salient results and present those results by table, graph, chart, or other form of collected data.

Important Changes and Updates to Information in Chapters 1-3. Comment by GCU: This is a required section.
In this required section, the learner discusses changes made to the original research plan presented in Chapters 1-3. Furthermore, learner discusses implications of these changes, including changes to the sample, data collection, design, data analysis, etc. For example, if target sample size was not achieved using plans A, B and C, the learner must address the ramifications on the breadth and depth of the analyses, and study findings. Based on peer review and/or committee recommendations, the learner may choose to update Chapters 1-3 to reflect what actually occurred OR clearly present the important changes that occurred between the original plan and what actually occurred in this section and also in the Study Limitations section of Chapter 4. Changes to the research plan must also be addressed in Chapter 5 under strengths and weaknesses section.

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INTRODUCTION (TO THE CHAPTER)

(Minimum two to four paragraphs or approximately one page)

Provides a summary of the study including research problem, methodology, design, research questions and phenomena.

Provides an orienting statement about what will be covered in the chapter.

Learner discusses important changes between original plan presented in the proposal (Chapters 1-3) and what actually occurred.
Learner updated Chapters 1-3 to reflect what actually occurred OR clearly presents the important changes that occurred between the original plan and what actually occurred in this section and in the Study Limitations section of Chapter 4

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Preparation of Raw Data for Analysis and Descriptive Data

Preparation of Raw Data for Analysis
Within this subsection, the learner describes how all raw data were prepared for analysis. This should include transcription process, member checking, and any other preparation activities. Describe how data were prepared for uploading to MAXQDA or other qualitative software program, if relevant. For example:
Define how to organize the data (some options: by participant, by source)
Set up system for pseudonyms (create a table in separate document showing real names and associated pseudonym). We advise names (John, Mary), rather than numbers (P1, P2) in qualitative studies to maintain the sense of personhood and presence in a natural setting (not a lab), which is consistent with a qualitative approach
Organize other sources of data (sociograms, photographs, images, copies of hand coded data, collected documents, etc.)
Transcribe all interview and focus group data
Send copies of transcripts to participants to “member check” (check that the transcript shows what they meant; they can add clarification if so desired)
Upload raw data to MAXQDA or other qualitative software program (Note GCU provides MAXQDA to all learners at no cost)

Upload raw data to a new folder in the LDP (either create a new 07 Data folder or into a new folder in the 05 Folder). [NOTE: GCU faculty are required to maintain all confidentiality pledged by learner]
Once the learner has prepared the data, the learner then provides a narrative summary (description per next section) of the population or sample characteristics and demographics of the participants in the study.

Descriptive Data
This section describes the dataset that was produced from data collection activities. This should include the number of participants and corresponding descriptive information regarding the demographic data (such as gender, age, and ethnicity) and research data. It should also include tables showing each data collection method, which participants joined each, and pertinent information such as duration of interviews or focus groups, and number of pages of transcript, measured as complete single-spaced pages, Times New Roman 12 pt. font (see Table 3. Keep in mind that all descriptive or demographic information must pertain directly to the study and must be included in the informed consent for participants to understand what personal data is being collected about them. Ensure this data cannot lead to anyone identifying individual participants in this section or identifying the data for individual participants in the data summary and data analysis that follows. It is important that key demographic and descriptive data are provided. It is also acceptable to put most of this in the appendix if the chapter becomes too lengthy.
For numbers, equations, and statistics, spell out any number that begins a sentence, title, or heading – or reword the sentence to place the number later in the narrative. In general, use Arabic numerals (10, 11, 12) when referring to whole numbers 10 and above, and spell out whole numbers below 10. There are some exceptions to this rule:
If small numbers are grouped with large numbers in a comparison, use numerals (e.g., 7, 8, 10, and 13 trials); but, do not do this when numbers are used for different purposes (e.g., 10 items on each of four surveys).
Numbers in a measurement with units (e.g., 6 cm, 5-mg dose, 2%).
Numbers that represent time, dates, ages, sample or population size, scores, or exact sums of money.
Numbers that represent a specific item in a numbered series (e.g., Table 1).
A sample table in APA style is presented in all tables in this template, see, for example, Table 6. Be mindful that all tables fit within the required margins, and are clean, easy to read, and formatted properly using the guidelines found in Chapter 5 (Displaying Results) of the APA Publication Manual 7.0 (2019). Comment by GCU: Each table must be numbered in sequence throughout the entire dissertation (Table 1, Table 2, etc.), or within chapters (Table 1.1, Table 1.2 for Chapter 1; Table 2.1, Table 2.2 for Chapter 2, etc.).

Table 6.

Example of a Clean, Easy-to-Read Table Comment by GCU: Tables cannot be split between two pages and cannot be over one manuscript page in length. To stop a table from splitting between pages, insert a page break above the table. If the table is still too long, it should be placed in an Appendix, where it can break across pages; use a repeating header.

Participant

Setting

Interview

Duration

# Transcript Pages (Time New Roman, Font size 12, single spaced)

Participant 1

Main office

Date

65 minutes

Participant 2

Zoom conference

Date

72 minutes

Participant 3

Zoom conference

Date

50 minutes

etc.

…

MEAN

N/A

62.3 minutes

18.3

TOTAL

N/A

187 minutes

Table 7.

Example of Clean, Easy-to-Read Table for Focus Group Data

Participant

Group

Participation Length

Contributions

Initial Codes Produced

Participant 1

Group 1

48 min.

Participant 2

Group 1

48 min.

etc.

…

Participant 3

Group 2

67 min.

Participant 4

Group 2

67 min.

etc.

…

TOTAL

N/A

115 minutes

Table 8.

Example of Case Unit Profiling (in Narrative)

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PREPARATION OF RAW DATA AND DESCRIPTIVE DATA

(Number of pages as needed)

Describes how raw data were prepared for analysis.

Provides a narrative summary of the population or sample characteristics and demographics.
Presents the “sample (or population) profile,” may use descriptive statistics for the demographics collected from or retrieved for the actual sample or population.

Includes a narrative summary of data collected (e.g., examples of collected data should be included in an Appendix.)

Uses visual graphic organizers, such as tables, histograms, graphs, and/or bar charts, to effectively organize and display coded data and descriptive data. For example:
Discuss and provide a table showing number of interviews conducted, duration of interviews, #pages transcript; #observations conducted, duration, ; #pages of typed-up field notes, ; # of occurrences of a code, ; network diagrams, ; model created, etc.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Data Analysis Procedures
This section presents a description of the process that was used to analyze the data. Data analysis procedures can be framed relative to each research question. Data can also be organized by chronology of phenomena, by themes and patterns, or by other approaches as deemed appropriate by design and for a qualitative study. This section should specify the procedures that were specifically carried out to ensure the reader understands how the analytic process was conducted.

Reflexivity Protocol
For learners who implemented some sort of reflexivity protocol (such as bracketing or peer debriefing) to track and manage biases, please be sure to clarify how this protocol fit sequentially with respect to the data analysis strategy. For instance, did you record and organize your bracketing notes before/after each data collection event – and hence before the data analysis process even began – or did you wait to record your bracketing notes before/after each cycle of analytic coding (tracking your bias during the conceptual development of codes, categories, and themes)? What was the logic for your approach?

Data Analysis Steps

Describe in detail the data analysis procedures. The analytic procedures must be aligned to the design; they are not generic. Start discussion of data analysis procedures by identifying and describing the analytical approach (e.g., thematic analysis, phenomenological analysis, narrative analysis). Describe analytic process. For example: for thematic analysis provide a description of how codes were developed, how clusters of codes or categories were developed, how these are related to themes. Provide examples of codes and themes with corresponding quotations, demonstrating how codes were synthesized or clustered or combined and developed into themes. For phenomenological analysis identify the specific type of phenomenological design and the specific data analysis approach used. That approach might involve providing transformation procedures, the transformation process, how phenomenological constituents were developed, how these are related to the general phenomenological structure of the experience. Provide examples of phenomenological constituents with corresponding quotations, demonstrating how constituents were discovered among phenomenological transformations. Provide evidence of analytic elements in text or an Appendix. Include graphic organizers to demonstrate analytic steps.

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DATA ANALYSIS PROCEDURES

(Number of pages as needed)

Describes in detail the data analysis procedures.
Coding procedures must be tailored to the specific analytical approach; they are not generic.
Start discussion of data analysis procedures by identifying and describing the analytical approach (e.g., thematic analysis, type of phenomenological analysis).
Describes coding process, description of how codes were developed, how categories or clusters of codes were developed, how these are related to themes. Provide examples of codes and themes with corresponding quotations, demonstrating how codes were developed or synthesized into themes. Provides evidence of initial and final codes and themes in text or an Appendix.
Detail the specific kinds of analytic units appropriate to the design and analytic approach.

Explains and justifies any differences in why data analysis section does not match what was approved in Chapter 3 (if appropriate).

Discusses the reflexivity protocols used (such as bracketing and peer debriefing) and how these protocols complement the data analysis strategy.

Describes approaches used to ensure trustworthiness for qualitative data including expert panel review of questions, field test(s)/ practice interviews, member checking, and triangulation of data, as appropriate.

Justifies how the analysis aligns with the research question(s), and how data and findings were organized by chronology of phenomena, by themes and patterns, or by other approaches as deemed appropriate.
Develops a description of the phenomenon by synthesizing the data across the research questions. The synthesis approach used to develop the description of the phenomenon should be specific to the design used,

. Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Results

Presenting the Results
This section, which is the primary section of this chapter, presents an overview and analysis of the data in a nonevaluative, unbiased, organized manner that relates to the research question(s). List the research question(s) as they are discussed to ensure that the readers see that the question has been addressed. Answer the research question(s) in the that they are listed by drawing on the thematic results and (if relevant) descriptive statistics. Learners can organize data in several different ways for qualitative studies including by research question, by themes and patterns for thematic analysis, or by other approaches deemed appropriate for the study, such as by the general phenomenological structure with a list of all constituents. The results must be presented without implication, speculation, assessment, evaluation, or interpretation, as the discussion of results and conclusions are left for Chapter 5. Refer to the APA Style Manual (2020) for additional lists and examples.
The results do not merely include using themes to answer research questions, It is important to develop a description of the phenomenon that is specific to the design based on synthesizing the data cross the research questions and data analysis. For a qualitative descriptive design, this involves providing a detailed description of the phenomenon through a narrative and visuals. For a case study, this involves producing a case study summary that can include narrative and visuals. For grounded theory it can include the creation of a theory, visual model, or process flow. For a narrative, depending upon the narrative approach selected it might include developing a single story that synthesizes the stories from all of the participants. For phenomenology this final description varies based on the type of phenomenological design selected.
For learners who implemented a reflexivity protocol (such as bracketing or peer debriefing) to track and manage biases, the beginning of this section is an ideal place to synthesize those reflexivity notes into a composite of your preconceptions prior to data collection and analysis, as well as how those preconceptions may have biased your study. This step typically requires the learner to take a step back and think contemplatively about initial expectations for the data and results, and then compare these expectations with the actual perspectives provided by the participants (or the meanings derived from them). The narrative at the beginning of Chapter 4-Results offers a good place to summarize any major preconceptions that might have colored the data analysis.
For qualitative studies, it is important to provide a complete, that is, holistic, picture of the analysis conducted and of the coding used to arrive at a set of themes or conclusions about the subject. In qualitative studies, if thematic analysis is used, the questions are examples of what to ask, and are not comprehensive:
1. What themes emerged across all data sources and how were those themes identified?
2. Does the learner provide examples that the themes exist from multiple, well-specified and described, sources of data?
3. What topics were mentioned most often?
4. What issues were most important to the people in the study?
5. How do the participants view the topic of research?
6. How can the categories identified in the data be ed into meaningful, grounded theories?
After completing the first draft of Chapter 4, ask these general questions:
7. Are the findings clearly presented, so any reader could understand them?
8. Are the findings presented with a narrative thread, which provides a “storyline” to coherently connect the data that has been analyzed?
9. Are all the tables, graphics or visual displays well-organized and easy to read?
10. Are the important data described in the text?
11. Is factual data information separate from analysis and evaluation?
12. Are the data organized by research questions or by themes?
Make sure to include appropriate graphics to present the results. Always introduce, present, and discuss the visual organizers in narrative form prior to the visual organizer placement. Never insert a visual organizer without these three steps.
A figure is a graph, chart, map, drawing, or photograph. Do not include a figure unless it adds substantively to the understanding of the results or it duplicates other elements in the narrative. If a figure is used, a label must be placed under the figure. As with tables, refer to the figure by number in the narrative preceding the placement of the figure. Make sure a table or figure is not split between pages.
Here is an example of how a table might be set up to visually illustrate results:

Table 9.

Initial Codes

Code

Column A

Description of Code

Column B

Examples from Transcript

Name of Code 1

Description of code

Provide multiple examples from transcripts

Name of Code 2

Description of code

Provide multiple examples from transcripts

Name of Code 3

Description of code

Provide multiple examples from transcripts

Note
. Adapted from: Sampling and Recruitment in Studies of Doctoral Students, by I.M. Researcher, 2010, Journal of Perspicuity, 25, p. 100. Reprinted with permission. Comment by GCU: Permission must be obtained to reprint information that is not in the public domain. Letters of permission are included in the appendix.

Figure 4.

Diagram of a Blank Sociogram

Criterion

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RESULTS

(Number of pages as needed)

Data and the analysis of that data are presented in a narrative, non-evaluative, unbiased, organized manner.

In thematic analysis, the researcher should address saturation and the distribution of themes that emerged when themes were not present in all data sets. Qualitative, thematically-analyzed data may be organized by theme, participant and/or research question.

In phenomenology the research should address the stability of the structure based on each constituent being essential, not merely frequent.

Note, this addresses volume and quality of the data collected as germane to the phenomenon under study, not to population representativeness.

Results of analysis are presented in appropriate narrative, tabular, graphical and/or visual format. If using thematic analysis, coding and theming process must be clearly evident in the results presentation. Integration of quotes in the results presentation to substantiate the stated findings and build a narrative picture is required.

For a case study design, include a summary of the case (how did the analysis inform the case?).

Learner describes thematic findings mostly in own words in narrative form as if they are telling their story or summarizing their experiences, and then use selected quotes (ideally one or few sentences, no longer than one paragraph) to illustrate.

The outcome of the reflexivity protocol is reported in a way that helps the reader distinguish the learner’s preconceptions from the perspectives (and meanings) shared by participants. This discussion should touch on major preconceptions that may have biased the data analysis and what was done to mitigate these biases.

As appropriate, tables are presented for initial codes, themes and theme meanings, along with sample quotes.

Sufficient quantity and quality of the data or information appropriate to the research design is presented in the analyses to answer the research question(s). Evidence for this must be clearly presented in this section and in an appendix as appropriate.
Note: AQR reviewer may request to review raw data at any time during the AQR process. Additional data collection may be required if sufficient data is not present.

· Qualitative data analysis is fully described and displayed using techniques specific to the design and analytic method used.
· Data sets are summarized including counts AND examples of participant’s responses for thematic analysis. For other approaches to qualitative analysis, results may be summarized in matrices or visual formats appropriate to the form of analysis.
· Findings may be presented as themes using section titles for thematic analysis, as stories for narrative designs, as models or theories for grounded theory, and as visual models or narrative stories for case studies.

Appendices must include qualitative data analysis that supports results in Chapter 4 as appropriate (i.e. source tables for coding and theming process or codebook, if not included directly in Chapter 4).

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Limitations

Limitations are flaws or shortcomings with the study that either the researcher has no control over because they are inherent in the methods selected (e.g., sampling bias), or that are due to mishaps in the conduct of research (e.g., missing data). No study is free of limitations. It is important to acknowledge as many limitations as deemed pertinent in to reflect integrity and transparency in the conduct of research. This section discusses limitations that emerged based specifically on data collection and data analysis, and how the interpretation of results may be affected by the limitations. State limitations that are inherent in the data sources, instruments, data collection methods, and/or data analysis approach, and address also additional limitations pertaining to shortcomings in how the data was collected, the amount or quality of the data collected, and/or how the data was analyzed. The learner should provide a rationale for each stated limitation and discuss associated consequences for transferability and applicability of the findings. Tie back the limitations to the anticipated limitations discussed in Chapter 1.
For example: The following limitations were present in this study:
The study was limited to 10 teachers and four administrators, thus making the results less transferable;
The study was limited to novice participants whose insights about the organization were partial and restricted.

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LIMITATIONS

(Minimum one to two pages)

Lists limitations that emerged based specifically on data collection and data analysis, and how the interpretation of results may be affected by the limitations.

Discuss associated consequences for the transferability and applicability of the findings.

Discuss the current limitations in relation to the anticipated limitations originally presented in Chapter 1.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Summary
This section provides a concise summary of what was found in the study. It briefly restates essential data and data analysis presented in this chapter, and it helps the reader see and understand the relevance of the data and analysis to the research question(s). Finally, it provides a lead or transition into Chapter 5, where the implications of the data and data analysis relative to the research question(s) will be discussed. The summary of the data must be logically and clearly presented, with the information separated from interpretation. For qualitative studies, summarize the data and data analysis results in relation to the research question(s). Finally, provide a concluding section and transition to Chapter 5.

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SUMMARY

(Minimum one to two pages)

Presents a clear and logical summary of data analysis approach.

Summarizes the data and data analysis results in relation to the research questions.

Discusses limitations that emerged based on data collection and data analysis and how the interpretation of results may be affected by the limitations.

Provides a concluding section and transition to Chapter 5.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Chapter 5: Summary, Conclusions, and Recommendations

Introduction and Summary of Study
Chapter 5 is perhaps the most important chapter in the dissertation manuscript because it presents the researcher’s contribution to the body of knowledge. For many who read research literature, this may be the only chapter they will read. Chapter 5 typically begins with overview of why the study is important and how the study was designed to contribute to our understanding of the research topic within the context of the problem space identified in Chapter 2. The remainder of the chapter contains a summary of the overall study, a summary of the findings and conclusions, recommendations for future research and practice, and a final section on implications derived from the study.
No new data should be introduced in Chapter 5; however, references should be made to findings or citations presented in earlier chapters. The researcher can articulate new frameworks and new insights derived from the synthesis of study results. The concluding words of Chapter 5 should emphasize both the most important points of the study, study strengths and weaknesses, and directions for future research. This should be presented in the simplest possible form, making sure to preserve the conditional nature of the insights. Study findings should not be misinterpreted, exaggerated, or personalized.

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INTRODUCTION and SUMMARY OF STUDY

(Minimum two to four paragraphs or approximately one page)

Provides an overview of why the study is important and how the study was designed to contribute to our understanding of the topic.

Provides a transition, explains what will be covered in the chapter and reminds the reader of how the study was conducted.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Summary of Findings and Conclusion

Overall Organization
This section of Chapter 5 is organized by research question(s), and it conveys the specific findings of the study. The section presents conclusions made based on the data analysis and findings of the study and relates the findings back to the literature in Chapter 2. Significant themes/findings are compared and contrasted, evaluated, and discussed in light of the existing body of knowledge. The significance of every finding is analyzed and related back to Chapter 2 discussion of the Problem Spaces and ties the study together. The findings are also bounded by the research study parameters described in Chapters 1 and 3, are supported by the data and theory, and directly relate to the research question(s). No unrelated or speculative information is presented in this section. Conclusions represent the contribution to knowledge and fill in what still needs to be understood in the knowledge as evidenced in the literature. They should also relate directly to the problem space. The conclusions are major generalizations, and an answer to the research problem developed in Chapters 1 and 2. This is where the study binds together. In this section, personal opinion is permitted, as long as it is backed with the data, grounded in the study results presented in Chapter 4, and synthesized/supported within the existing research literature presented in Chapter 2.

Reflection on the Dissertation Process
The learner should end this section by discussing what they have learned throughout the dissertation process. This includes what changed in the learner’s understanding as they went through the research process. This also includes a thoughtful reflection on what was accomplished.
The use of reflective practices during the dissertation is when the researcher thinks about and reflects on their process. (Finlay, 2002). Reflexivity is important when there are challenges in the data reporting due to changes from the plan to the execution of the research project. The purpose of this added section is to provide the reader with a clearer understanding of what you learned through the process of conducting this research.

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SUMMARY OF FINDINGS AND CONCLUSIONS

(Minimum three to five pages)

Organizes Chapter 5 using the same section titles as Chapter 4, by research question(s) or by themes. Significant themes/ findings are compared and contrasted, synthesized and discussed in light of the existing body of knowledge covered in Chapter 2

Summarizes study findings. Compares, contrasts and synthesizes study findings in context to prior research on the topic (Chapter 2). Provides a cogent discussion on how the study is aligned to and/or advances the research on the topic.

Illustrates that findings are bounded by the research study design described in Chapters 1, 2 and 3.

Illustrates how findings are supported by the data and theory, and how the findings directly align to and answer the research question(s).

Discusses transferability of findings and relates each of the findings directly to the Background of the Study section of Chapter 1 and Identification of the Problem Space in Chapter 2.

Refrains from including unrelated or speculative information in this section.

Provides a conclusion to summarize the findings, referring back to Chapters 4 and 2, and tying the study together.

The learner reflects back on his/her dissertation process, what changed in understanding of research and the process.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Implications
This section should describe what could happen because of this research. It also is an opportunity to inform the reader what the research implies theoretically, practically, and for the future. Additionally, it provides a retrospective examination of the theoretical framework presented in Chapter 2 considering the dissertation’s findings. A critical evaluation of the strengths and weaknesses of the study and the degree to which the conclusions are credible given the methodology, research design, and data, should also be presented. The section delineates applications of new insights derived from the dissertation to solve real and significant problems. Implications can be grouped into those related to theory or generalization, those related to practice, and those related to future research. Separate sections with corresponding headings provide proper organization.

Theoretical Implications
Theoretical implications involve interpretation of the dissertation findings in terms of the research question(s) that guided the study. It is appropriate to evaluate the strengths and weaknesses of the study critically and include the degree to which the conclusions are credible given the method and data. It should also include a critical, retrospective examination of the framework presented in the Chapter 2 Literature Review section considering the dissertation’s new findings.

Practical Implications

Practical implications should delineate applications of new insights derived from the dissertation to solve real and significant problems. These implications refer to how the results of the study can be applied in professional practice.

Future Implications

Two kinds of implications for future research are possible: one based on what the study did find or do, and the other based on what the study did not find or do. Generally, future research could look at different kinds of subjects in different kinds of settings, interventions with new kinds of protocols or dependent measures, or new theoretical issues that emerge from the study. Recommendations should be included on which of these possibilities are likely to be most fruitful and why.

Strengths and Weaknesses of the Study

This section includes a critical evaluation of the strengths and weaknesses of the study. Strengths and weaknesses pertain to the how the researcher conducted the study, and which a researcher would want to repeat or avoid in future studies. For example, a strength a study might be the collection of ample, rich, “thick” data that supported an analysis of data that produced specific insights that contributed to the advancement of scientific knowledge. A weakness in a study might be the anticipated sample size was not obtained, the researcher did not provide sufficient probing or follow-up questions, thus limiting depth of query and final dataset. This section is a critical evaluation and reflection on the degree to which the conclusions are credible given the methodology, research design, and data analysis and results.

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IMPLICATIONS

(Minimum one to four pages)

Theoretical implications.
Provides a retrospective examination of the theoretical foundations presented in Chapter 2 in light of the dissertation’s findings.

Connects the findings of the study back to the conceptual framework and the study results are discussed in context to how the results advance a practitioner’s knowledge of that theory, model or concept

Practical Implications and Future Implications.
Connects the study findings to the prior research discussed in Chapter 2 and develops practical and future implications for research based on new insights derived from the research and how the results advance practitioners’ knowledge of the topic and how the results may influence future research or practice.

Strengths and Weaknesses.

Indicates all limitations of the study, critically evaluates the strengths and weaknesses of the study, and the degree to which the conclusions are credible given the methodology, research design, and data analysis and results.
Learner reflects on the study and discusses what they would have continued or changed should they do this again

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format.

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Recommendations
This section allows the learner to add recommendations for future study based on the results of their authentic dissertation research. In this section, summarize the recommendations that result from the study. Each recommendation should be directly linked to a conclusion described in the previous section.

Recommendations for Future Research

This section should present recommendations for future research, as well as give a full explanation for why each recommendation is being made. Additionally, this section discusses the areas of research that need further examination or addresses what needed to be understood or new research opportunities the study found. The section ends with a discussion of “next steps” in forwarding this line of research. Recommendations relate back to the Problem Space and literature offered in Chapter 2.

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RECOMMENDATIONS FOR FUTURE RESEARCH

(Minimum one to two pages)

Lists a minimum of four to six recommendations for practitioners and for future research.

Identifies and discusses the areas that need further examination, or that will address what needed to be understood, that the study found.

Provides recommendations that relate back to the study significance and advancing scientific knowledge sections in Chapter 1 and theoretical foundation section in Chapter 2

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Recommendations for Future Practice

This section outlines recommendations for future practice based on the results and findings of the study, as well as, a full explanation for why each recommendation is being made. It provides a discussion of who will benefit from reading and implementing the results of the study and presents ideas based on the results that practitioners can implement in the work or educational setting. Unrelated or speculative information that is unsupported by data is clearly identified as such. Recommendations should relate back to the study problem space discussion in Chapter 2.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

RECOMMENDATIONS FOR FUTURE PRACTICE

(Minimum three to four paragraphs or approximately one page)

Lists two to five recommendations for future practice.

Discusses who will benefit from reading and implementing the results of the study.

Discusses ideas based on the results that practitioners can implement in the work or educational setting.

Omits unrelated or speculative information that is not unsupported by data.

Provides recommendations that relate back to the study significance section in Chapter 1.

The Chapter is correctly formatted to dissertation template using the Word Style Tool and APA standards. Writing is free of mechanical errors.

All research presented in the Chapter is scholarly, topic-related, and obtained from highly respected academic, professional, original sources. In-text citations are accurate, correctly cited and included in the reference page according to APA standards.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Holistic reflection on the Problem Space

In this section, the learner provides an overview of what the learner drew from the problem space, and how the study was relevant and contributed to what needed to be understood.

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

HOLISTIC REFLECTION ON THE PROBLEM SPACE.

(Minimum three to four paragraphs or approximately one page)

Provides an overview of what the learner drew from the problem space

Discusses how the study was relevant and contributed to what needed to be understood.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

References Comment by GCU: See APA 7.0 Edition for specific reference to formatting instructions. For more information on references or APA Style, consult the APA website: at http://apastyle.org

List all authors up to 20 authors (APA 7th Edition) Comment by GCU: This page must be entitled “References.” This title is centered at the top of the page. All text should be in 12-point Times New Roman font and double-spaced.

The Reference list should appear as a numbered new page following Chapter 5 and preceding the Appendices. The title of the section “References” should be styled as Heading 1.

The Reference list provides necessary information for the reader to locate and retrieve any source cited in the body of the text. Each source mentioned must appear in the Reference list. Likewise, each entry in the Reference list must be cited in the text.

The citations in the Reference list should be styled using the “Refs” style.

NOTE: The “Refs” style has been set up as a hanging indent of 0.5” and be double-spaced. Examples of common references are provided below.
Abuse, S. (2013). Mental Health Services Administration. Results from the, 2, 013.
Allport, G. W. (1954). The nature of prejudice. Addison-Wesley. Comment by GCU: After completing the Reference list, it is important to cross-reference the in-text citations with the items in the Reference list to be certain that all in-text citations are in the Reference list and all items in the Reference list have an in-text citation. Using the Ctrl-F function helps to search for references within the dissertation.

Armstrong, J. (2010). Naturalistic inquiry. In N. J. Salk (Ed.), Encyclopedia of research design (pp. 880-885). SAGE.
Barzun, J., & Graff, H.F. (1992). The modern researcher: A classic work on research and writing completely revised and brought up to date. Harcourt Brace Jovanovich.
Baxter, P. and Jack, S. (2008). Qualitative Case Study Methodology: Study Design and Implementation for Novice Researchers. The Qualitative Report 13(4):544-559
Brands, H. W. (2000). The first American: The life and times of Benjamin Franklin. Doubleday.
Brown, P.A. (2008). A review of the literature on case study research. Canadian Journal for New Scholars in Education 1(1).

Cabell’s Directory of Publishing Opportunities. (2000, continually updated).
Calabrese, R. L. (2006). The elements of an effective dissertation & thesis: a step-by-step guide to getting it right the first time. Roman & Littlefield Education.
Chess, P.S. (2017). Chapter 3: Validity and reliability in qualitative research. In Grand Canyon University (Ed.), GCU doctoral research: Advanced qualitative research methods. http://lc.qa.gcumedia.com/res855/gcu-doctoral-research-advanced-qualitative-research-methods/v1.1/#/chapter/3
Colman, A.M. (2015). Well-structured problem (well-defined problem). A dictionary of psychology (4th edition). Oxford University Press. DOI.org:10.1093/acref/9780199657681.001.0001
Englander, M. (2012). The Interview: Data Collection in Descriptive Phenomenological Human Scientific Research. Journal of Phenomenological Psychology 43: 13–35
Englander, M. (2019). Phenomenological Psychological Interviewing. The Humanistic Psychologist. Advance online publication. doi.org/10.1037/hum0000144
Epstein, J. L. (1987). Parent Involvement: What Research Says to Administrators. Education and Urban Society, 19(2), 119–136. https://doi.org/10.1177/0013124587019002002Euchner, J. (2019) Problem framing. Research-Technology Management, 62:2, 11-13, https://doi.org:10.1080/08956308.2019.1563433
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39, 175-191.
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149-1160.
Finlay, L. (2002). Negotiating the swamp: the opportunity and challenge of reflexivity in research practice. Qualitative Research, 2(2), 209–230. https://doi.org/10.1177/146879410200200205
Furnham, A., & Swami, V. (2018). Mental health literacy: A review of what it is and why it matters. International Perspectives in Psychology, 7(4), 240-257. https://econtent.hogrefe.com/doi/abs/10.1037/ipp0000094

Grand Canyon University. (Ed.). (2015). GCU doctoral research: Foundations and theories. http://lc.gcumedia.com/res850/gcu-doctoral-research-foundations-and-theories/v1.1/#/home
Grand Canyon University (Ed.). (2016). GCU doctoral research: Quantitative and qualitative research concepts. http://lc.gcumedia.com/res866/gcu-doctoral-research-quantitative-and-qualitative-research-concepts/v1.1/#/home
Grand Canyon University. (2017a). GCU doctoral research: Advanced qualitative research methods. http://lc.qa.gcumedia.com/res855/gcu-doctoral-research-advanced-qualitative-research-methods/v1.1/#/home
Grand Canyon University. (2017b). GCU doctoral research: The dissertation process. http://lc.gcumedia.com/res885/gcu-doctoral-research-the-dissertation-process/v1.1/#/home
Groenewald, T. (2004). A phenomenological research design illustrated. International Journal of Qualitative Methods, 3(1). http://www.ualberta.ca/~iiqm/backissues/3_1/pdf/groenewald.pdf
Guba, E. G. (1981). Criteria for assessing the trustworthiness of naturalistic inquiries. Educational Communication and Technology Journal, 29, 75–91.
Guest, G., Bunce, A., Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods 18(1), 59-82
Gondek, D., Edbrooke‐Childs, J., Velikonja, T., Chapman, L., Saunders, F., Hayes, D., & Wolpert, M. (2017). Facilitators and barriers to person‐centred care in child and young people mental health services: A systematic review. Clinical psychology & psychotherapy, 24(4), 870-886.
Hacker, D., Somers, N., Jehn, T., & Rosenzweig, J. (2008). Rules for writers. Bedford/St. Martin’s.
Hora, M. T. (2016). Navigating the Problem Space of Academic Work: How Workload and Curricular Affordances Shape STEM Faculty Decisions About Teaching and Learning. AERA Open. https://doi.org/10.1177/2332858415627612
Jones, M., and Alony, I. (2011). Guiding the use of grounded theory in doctoral studies—an example from the Australian film industry. International Journal of Doctoral Studies 6.

Koivu, K.L., and Damman, E.K., (2015). Qualitative variations: the sources of divergent qualitative methodological approaches. Qual Quant 49:2617–2632; DOI.org: 10.1007/s11135-014-0131-7
Krysik, J. L & Flynn, J. (2013). Research for effective social work practice (3rd Ed.). Routledge.
Laub, J. (1999). Assessing the servant organization: Development of the servant organizational leadership assessment (SOLA) instrument (Doctoral Dissertation, Florida Atlantic University). Available from ProQuest Dissertation and Theses Database. (UMI No. 9921922)
Li, W., Yang, Y., Liu, Z. H., Zhao, Y. J., Zhang, Q., Zhang, L., … & Xiang, Y. T. (2020). Progression of mental health services during the COVID-19 outbreak in China. International journal of biological sciences, 16(10), 1732.
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. SAGE
Mason, M. (2010). Sample size and saturation in PhD studies using qualitative interviews. Forum: Qualitative Research 11(3).
Maxwell, Joseph A. (2017). Qualitative research design: an interactive approach. Sage.

Merriam-Webster’s Collegiate Dictionary Eleventh Edition. (2014). ISBN-13: 978-0877798095, ISBN-10: 0877798095. Comment by GCU: NOTE: If the author is not named, list the reference by the title.
Nock, A. J. (1943). The memoirs of a superfluous man. Harper & Brothers.
Noor, K.B.M. (2008). Case Study: A Strategic Research Methodology. American Journal of Applied Sciences 5(11): 1602-1604
Norman D.A. (1986). Cognitive engineering. In: Norman D.A. and Draper S.W. (eds.) User-centered system design: New perspectives on Human-Computer Interaction. Lawrence Erlbaum Associates.

Publication Manual of the American Psychological Association. (2020). American Psychological Association. (7th edition) ISBN-13:978-1433832178; ISBN-10:1433832178
Powell, B. J., McMillen, J. C., Proctor, E. K., Carpenter, C. R., Griffey, R. T., Bunger, A. C., … & York, J. L. (2012). A compilation of strategies for implementing clinical innovations in health and mental health. Medical care research and review, 69(2), 123-157.
Reissman, C.K. (2005). Narrative analysis. In Narrative, Memory, and Everyday Life. University of Huddersfield, Huddersfield, pp. 17.
Rohner, R. P., & Britner, P. A. (2002). Worldwide mental health correlates of parental acceptance-rejection: Review of cross-cultural and intracultural evidence. Cross-Cultural Research, 36(1), 16-47.
Rutledge, B. (2015). Leader empowering behavior and burnout in nurses: A quantitative study (Doctoral dissertation). Retrieved from Dissertations & Theses @ Grand Canyon University. (Order No. 3732870)
Shenton, A. K. (2004). Strategies for ensuring trustworthiness in qualitative research projects. Education for Information, 22, 63-75.
Spradlin, D. (2012). Are you solving the right problem? Harvard Business Review. September.
Stickley, T., Wright, N., & Slade, M. (2018). The art of recovery: outcomes from participatory arts activities for people using mental health services. Journal of Mental Health, 27(4), 367-373.

Squires, D. A., & Kranyik, R. D. (1995). The comer program: changing school culture. Educational Leadership, 53(4), 29-32.
Strunk, W. I., & White, E. B. (1979). The elements of style. Macmillan Publishing, Inc.
Yoon, Wan C. (2001). Identifying, Organising and Exploring Problem Space for Interaction Design. IFAC Proceedings 34(16) (Elsevier)

Criterion

*(Score = 0, 1, 2, or 3)

Learner Score

Chair Score

Methodologist Score

Content Expert Score

Quality of Sources & Reference List
For every in-text citation a reference entry exists; conversely, for every reference list entry there is an in-text citation. Uses a range of references including founding theorists, peer-reviewed empirical research studies from scholarly journals, and government/foundation research reports. The majority of all references must be scholarly, topic-related sources. Websites, dictionaries, and publications without dates (n.d.) are not considered scholarly sources and should not be cited or present in the reference list. In-text citations and reference list must comply with APA 7th Ed.

Ensures that for every in-text citation a reference entry exists. Conversely, for every reference list entry there is a corresponding in-text citation. NOTE: The accuracy of citations and quality of sources must be verified by learner, chair and committee members.

Uses a range of references including founding theorists, peer-reviewed empirical research studies from scholarly journals, and government /foundation research reports.

Verifies that approximately 75% of all references are scholarly sources within the last 5 years. The 5-year time frame is referenced at the time of the proposal defense date and at the time of the dissertation defense date. This is a recommendation, not a requirement.

Note:
Websites, dictionaries, publications without dates (n.d.), are not considered scholarly sources and are not cited or present in reference list.

Avoids overuse of books and dissertations.

Books:
Recommend a maximum of 10 scholarly books that present cutting edge views on a topic, are research based, or are seminal works. Note: when a book is cited this implies the learner has read the entire book.

Dissertations:
Recommend a maximum of 5 published dissertations. Note: dissertations are not considered peer -reviewed; and therefore, should be cited judiciously.

Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, sentence structure, punctuation, and APA format

*Score each requirement listed in the criteria table using the following scale:

Reviewer Comments:

Appendix A.
Ten Strategic Points Comment by GCU: FORMATTING TIP: after the Appendix Title use SHIFT + RETURN to create a “soft return.” This will ensure the title and subtitle have the same heading style (e.g., Heading 1), and will ensure the subtitle automatically shows up in the TOC. See note below the TOC in this Template. Comment by GCU: The final version of the 10 strategic points should be included here (you can paste in the table that up until now was at the top of this document).

You should move the table here just prior to submitting for Form and Format review.

My Degree: Ph.D.

Program Emphasis: Industrial & Organizational Psychology

Ten Strategic Points

Comments or Feedback

Broad Topic Area Final Topic

Factors Affecting Utilization of Mental Health in Southern Texas
Factors Influencing Individuals’ Decision to Utilize Mental Health in south Texas

Lit Review
(Theoretical Framework (Theory)

Gaps

Themes

All Citations

Gaps

A. De Luca, Blosnich, Hentschel, King, & Amen (2016). The authors indicate that mental health has emerged as one of the critical areas of focus in recent times, and for a long time, it had been sidelined. However, with the realization that most health conditions are related in one way or another to a mental dis , this area is now been studied extensively, and more attention has been given to patients.

B. Mental health professionals point to insufficient mental healthcare resources in the United States as one of the major factors contributing to the rising suicide rate in the country. Nevertheless, these professionals noted that emergency providers paly major role at forefront of the problem and may also play significant role in its prevention. The experts reiterated the necessity for providers to possess the skills required for managing patients at lower suicide risk levels, especially in settings in which such patients do not enough access to behavioral healthcare providers and that the providers need to be accustomed to suicide risk, especially when there are widely publicized high-profile instances of suicide.

C. According to Kohn, et. al, (2018), emphasize the gap in mental health treatment in the American Region when examined through the prevalence of mental health dis s, use of mental health services, and the global burden of disease. Statistical data from community-based surveys of mental dis s in the various countries in America including Argentina, Brazil, Canada, Chile, and the United States etc. were utilized. The World Mental Health Survey published data were used in estimating professional the treatment gap. For Canada, Chile, and Guatemala, the treatment gap was calculated from data files. The mean, median, and weighted treatment gap, and the 12-month prevalence by severity and category of mental dis were estimated for the general adult, child-adolescent, and indigenous populations. Disability-adjusted Life Years and Years Lived with Disability were calculated from the Global Burden of Disease study. Mental and substance use dis s accounted for 10.5% of the global burden of disease in the Americas (Kohn, Ali, Puac-Polanco, Figueroa, López-Soto, Morgan, & Vicente, 2018).

D. Wang, & Xie, (2019) Emphasizes the need to eliminate the prevalence of mental health service utilization among many adults in the United States. The authors examined the links between mental health service utilization, health insurance coverage, mental health problems and drug abuse, and the health disparities among communities. In 2013. the authors in conjunction with the National Survey on Drug Use and Health performed a research with 37,424 adults’ respondents, with the outcome that only 5,434 adults were receiving mental health services. The outcome of the research indicated statistics of overall prevalence of mental health services utilization to be around 15%, with the female and the aging population experiencing major depressive episodes, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use. Insured African Americans, Asians and Hispanics, and married were negatively associated with mental health service utilization. Adults with varying types of insurances having disparities in accessing mental health services. (Wang, & Xie, 2019).

Theoretical Foundation

The theoretical framework for this research study is the Albert Bandura’s Social Cognitive Theory, which examines the context of health promotion and disease prevention. It helps to describe how motivations in health and behaviors are influenced by the interaction of people’s beliefs, environment, and behaviors (Morin, 2019).

Literature Review

A. Empathic Approach: Emphasized the issues of utilized and underutilized mental health resources and non-institutionalized adults as behavioral risk factors in Southern Texas. Mental health professionals point to insufficient mental healthcare resources in the United States as one of the major factors contributing to the rising suicide rate in the country. Nevertheless, these professionals noted that emergency providers play major roles at the forefront of the problem and may also play significant roles in its prevention. The experts reiterated the necessity for providers to possess the skills required for managing patients at lower suicide risk levels, especially in settings in which such patients do not enough access to behavioral healthcare providers and that the providers need to be accustomed to suicide risk, especially when there are widely publicized high-profile instances of suicide. (Morrisville, North Carolina: AHC Media LLC, 2018).

Professional Development:

Job Satisfaction: Mental health has recently emerged as a critical area of interest as it had been sidelined for years. Due to this realization, the illness is now been studied extensively, and more attention has been given to patients. It has been suggested that most of the chronic conditions and terminal illnesses lead to mental dis s in patients. For many reasons, mental health is now among the priorities of medical practice (De Luca et.al. 2016).

Problem Statement

It is not known how mental health providers describe the factors influencing individuals’ decision to utilize mental health services

Research Questions

RQ1: How do mental health providers describe the influence of self-efficacy on individuals’ decision to utilize mental health services?
RQ2: How do mental health providers describe the influence of behavioral capacity on individuals’ decision to utilize mental health services?
RQ3: How do mental health providers describe the influence of expectations on individuals’ decision to utilize mental health services?

Population

Target Population

Sample

· Location – Southern, Texas. USA
· Target Population:
· Mental Health providers with membership of Mental Health Association in south Texas
· Behavioral Hospitals
· Psychiatrists
· Therapists

Sample:
· The sample will be in south Texas of the United States
· Out of a population of 12 Mental Health Providers
· Questionnaire: Minimum of 120
· Interviews: Minimum of 40 Mental Health providers
.

Describe Phenomena (qualitative) or Define Variables/Hypotheses (quantitative)

To understand why the people living in southern Texas are not effectively utilizing mental health services
· There is a high rate of mental health conditions in southern Texas
· Individuals living in south Texas utilizes very low budget allocation on funding of mental health care
· Cost is a factor impacting the population’s utilization of mental health services

Methodology & Design

Qualitative Descriptive Study

Purpose Statement

The purpose of this qualitative descriptive study is to examine how mental health providers describe the factors influencing individuals’ decision to utilize mental health services in south Texas

Data Collection Approach

Mental health providers with membership in Mental Health Associations will be the main participants in the study based on 5 years’ experience and the willingness to be interviewed
· Visits to mental health providers
· Informed & signed consent will be obtained from participants
· Interview with mental health providers recorded on tape
· Sampling Method: Purposeful Sampling
· Sources: Interviews & Questionnaires: Notes will be taken; interviews will be tape recorded and documented properly
· Data will be Collected using a Google form
· Mental health providers/participants names will be removed from the data
· Data will remain stored on the researcher’s computer with password encrypted.

Data Analysis Approach

Descriptive Statistics
Demographic information
Years of experience Comment by Daniel Smith: Different font
According to Braun and Clarke (2006), the following procedures are recommended for thematic analysis:
· Ensure that researcher is familiar with the data by reading through the data and looking for patterns
· Followed by the researcher beginning coding through identifications of the data and combining pertinent data that relates to each code
· Data will be collected and analyzed for the study.
· Descriptive statistics will be used in summarizing acquired data.
· Coding will be used to address questions asked and the transcribed interviews and coded data will be stored on a backup USB thumb drive
· A narrative summary will be developed.

Appendix B.
Site Authorization

This is a required Appendix for Level 2 Proposal Review; Level 4 IRB Review and Level 5 Dissertation Review.

If no site authorization is required, provide a statement stating that, and explain why not site authorization was needed.

Preliminary Site Authorization. At the proposal development stage, preliminary site authorization as evidenced by an email from the appropriate organizational personnel is acceptable, until a formal site authorization letter is obtained. Site authorization letters must be on letterhead of the organization providing permission and signed by the individual authorized to grant such permission per requirements below.

Formal Site Authorization. Prior to IRB submission the learner must obtain formal site authorization to include:
Written on organization letterhead
Dated within the last 12 months
Signed by an authorized representative of the site
Clearly indicate activities for which researcher has obtained authorization. This is very important. The authorization should clearly indicate EXACTLY what authorization is being granted. For example: recruiting by email during work hours, interviewing primary teachers during their planning hours, distributing an electronic survey to staff members, granting access to email, etc.
Site authorization information aligns exactly with recruitment materials, informed consent document, and the IRB application
To review sample site authorization letter template please refer to GCU’s IRB Research Center on the DC Network: (
https://dc.gcu.edu/documents/irb_documents__iris/irb_forms_templates_updated_jan_2018
)
For purposes of confidentiality, site authorization letters will be deleted from this appendix by the Form and Format reviewer (Level 7 Review – just prior to dean’s signature) and the following text will be inserted: Site authorization(s) on file at Grand Canyon University.

Appendix C.
IRB Approval Letter

INFORMED CONSENT FORM

INTRODUCTION

The title of this research study is, “Factors Influencing Individuals’ Decision to Utilize Mental Health in South Texassouth Texas”
I am James Dada, a doctoral student under the supervision of Dr. Jennifer Seymour at Grand Canyon University. The purpose of this qualitative descriptive study is to examine how mental health providers describe the factors influencing individuals’ decision to utilize mental health services in South Texassouth Texas. Your participation in this study will be very helpful in understanding the implications of mental health.

KEY INFORMATION

This document defines the terms and conditions for consenting to participate in this research study.
·

How do I know if I can be in this study?

· You can participate in this study if you are:
· Competent individual 18 years of age and above
· You cannot participate in this study if you:
· A minor below 18 years
·

What am I being asked to do?

If you agree to be in this study, you will be asked to:
·

What

every participant will complete a questionnaire regarding their mental health status and whether or not they visit the mental health facility and the reasons why they may not be visiting the mental health facilities.

When

upon receipt of the questionnaire, the participant will be required to answer all the questions without assistance and in not more than 1 hour.

Where

this is an online study that will be conducted via social media platforms.

How

the extent of participation in this study is completing an online questionnaire that consists of 25 questions.

Audiotaping: (If applicable)

I would like to use a voicerec to record your responses. You cannot still participate if you do not wish to be recorded. The Nuremberg Code will be strictly followed to protect the participants.

Videotaping:(If applicable)

I would like to use a video camera to record your actions. Because this tape will show who you are, these extra steps will be taken: from the moment we collect the results, it will be handled in a safe and careful manner. The information will be sealed and labeled with all movements vigilantly documented. The personal identifying information will be destroyed after three years.

You (can, or, cannot) still participate if you do not wish to be recorded. The data that will be collected in this study will be kept confidential unless the law requires disclosure. The research result may however be used in presentations, publications and/reports

Who will have access to my information?

(myself, and my dissertation chair.)

Participation is voluntary. However, you can leave the study at any time, even if you have not finished, without any penalty or loss of benefits to which you are otherwise entitled. If you decide to stop participation, you may do so by: you may decline any part of the questionnaire without withdrawing from the entire study by just typing the word SKIP If so, I will use, the information I gathered from you.

Any possible risks or discomforts?

There are no known or anticipate risks that are associated with participation in this study.

Any direct benefits for me?

No.

Any paid compensation for my time?

no compensation will e granted for participation in this study.

How will my information and/or identity be protected

all personal identifiers will be removed before sharing the datasets to ensure that the identities of the participants cannot be determined by the people who will see the data. The master list that is linking the personal identifiers to the data will not be destroyed. This means that it will be easier linking with the participants. The list will however be stored securely.

PRESENTATION OF INFORMATION COLLECTED

The data collected will be grouped by individual observations of variables. The frequency distribution of these groups will be a convenient mean of analyzing the data

NEW INFORMATION

Sometimes during a study, we learn new information. This information may come from our research or from other researchers. If new information might relate to your willingness to participate, I will give you that information as soon as possible.

ADDITIONAL COSTS FOR ILLNESS OR INJURY

If you are injured as a result of your participation in this study, treatment will be available to you here: (Better Health clinic Austin). Additional resources are: (Betterhealth.amantine.gmail.com). Costs that arise from injury or emergency treatment must be paid by you.

TERMINATION OF PARTICIPATION

I may stop your participation, even if you did not ask me to, if: (may not seem to be competent).

If you decide to stop participation, you may do so by: (signing a cancellation form).If so, I (will not use) the information I gathered from you.

PRIVACY AND DATA SECURITY

Will researchers ever be able to link my data/responses back to me?

The master list that is linking the personal identifiers to the data will not be destroyed and therefore the participants can be reached if need be

Will my data include information that can identify me (names, addresses, etc.)?

No.

Will researchers assign my data/responses a research ID code to use instead of my name?

There will be a research code that will be used to identify the participants which is only known by the original researcher

If yes, will researchers create a list to link names with their research ID codes?

“N/A”

If yes, how will researchers secure the link of names and research ID codes? How long will the link be kept? Who has access? Approximate destroy date?

“N/A”

How will my data be protected (electronic and hardcopy)? Where? How long? Who will have access? Approximate destroy or de-identification date?

The data will be kept in the facility’s database or three years upon which the PII will be destroyed. The original researcher will access the information.

Where and how will the signed consent forms be secured?

the forms will be handled just like any other confidential data and will be securely protected.

FUTURE RESEARCH

Once identifiers (name, address, etc.) are removed from these data (identifiable private information or identifiable bio-specimens, whichever is applicable) collected for this study,(the de-identified information or bio-specimen, whichever is applicable)could be used for future research studies or distributed to other investigators for future research studies without additional informed consent from you or your legally authorized representative.

STUDY CONTACTS

Any questions you have concerning the research study or your participation in the study, before or after your consent, will be answered by ([email protected])

If you have questions about your rights as a subject/participant in this research, or if you feel you have been placed at risk, you can contact the Chair of the Human Subjects Institutional Review Board, through the College of Doctoral Studies at
[email protected]
; (602) 639-7804.

VOLUNTARY CONSENT

PARTICIPANT’S RIGHTS

· You have been given an opportunity to read and discuss the informed consent and ask questions about this study.
· You have been given enough time to consider whether or not you want to participate.
· You have read and understand the terms and conditions and agree to take part in this research study;
· You understand your participation is voluntary and that you may stop participation at any time without penalty.

Your signature means that you understand your rights listed above and agree to participate in this study

____________________________________________________ ____________________________
Signature of Participant or Legally Authorized Representative Date

INVESTIGATOR’S STATEMENT

“I certify that I have explained to the above individual the nature and purpose, the potential benefits and possible risks associated with participation in this research study, have answered any questions that have been raised, and have witnessed the above signature. These elements of Informed Consent conform to the Assurance given by Grand Canyon University to the Office for Human Research Protections to protect the rights of human subjects. I have provided (offered) you a copy of this signed consent document.”

(Your signature indicates that you have ensured the participant has read, understood, and has had the opportunity to ask questions regarding their participation)

Signature of Investigator______________________________________ Date_____________

Appendix D.
Informed Consent

This is a required document for Level 5 Review and published in the final dissertation manuscript.
The IRB Research Center contains the most recent Informed Consent Template. It is essential that learners use the current Informed Consent template to comply with new federal regulations. Important Note: IRB applications submitted using older versions of the Informed Consent Template will require revisions.
The current informed consent form is located on the DC Network (https://dc.gcu.edu/documents/irb_documents__iris/irb_forms_templates_updated_jan_2018).

Appendix E.
Copy of Instrument(s) and Permission Letters to Use the Instrument(s)

This is a required Appendix. Each separate instrument should be located within this Appendix, and should reflect the name of the instrument, protocol or scoring method, along with any letters of permission, if pertinent. Note that many researchers who conduct qualitative studies do not use instruments or protocols from other studies, unless they have been revised to address the indicated Problem Space and research, since qualitative studies are highly contextualized and specific. If instrument authorization is needed for a qualitative study, refer to the following requirements:
Should be from an author or administrator of the organization
A written letter, e-mail, or a screenshot of the email correspondence is sufficient
Instrument authorization should contain the following items:
The specific name of the instrument to be used
For what purpose the instrument will be used
If possible, statement that the person granting authorization owns the copyright (sometimes that is not the author of the instrument, it could be the journal in which the instrument was first published)
Authorization is granted to use the instrument
Authorization is granted to modify the instrument from the author and also the CDS associate dean (if applicable, typically this is not advised, as altering surveys can negate the validity)

Evidence you are qualified to administer, score and interpret the data obtained from the instrument.

Appendix F.
Codebook
There are many ways to construct a Codebook in qualitative research, and learners can draw from those approaches by citing the relevant research authorities. The most minimal approach, however, should still produce a table of all codes generated from the analysis regardless of their cycle, along with “definitions” for each code. A “definition” entails the interpretive meaning that made a particular code necessary in the mind of the learner and might offer clues on the situational context tied to that meaning. Because the focus is on the codes exclusively, it does not entail the listing of higher categories or themes, or the tracing of codes to those themes (which is really what should be discussed and illustrated in Ch. 4-Data Analysis Procedures and Ch. 4-Results).

Table F10.

Sample Codebook Comment by GCU: All tables (or figure) in Appendices must include the Appendix “Number” (Table F10.)

Code

Coding Cycle

Definition of Code

Name the code

Define sufficiently so someone else could follow directions and code your data

Etc.

Appendix G.
Transcripts
This appendix is added once data are analyzed to assist with the preparation of Chapters 4 and 5 and should include excerpts of interview transcripts. Transcripts showing codes (hand coded or codes within qualitative analysis software) are encouraged. Provide excerpts from coded transcripts or analyzed research materials.

Appendix H.
Feasibility and Benefits Checklist
As you develop your dissertation, please complete this table to help you consider the gatekeepers involved in your study, the possible risks, the benefits of the study, authorizations, and potential challenges. Research should have some benefits to be truly academic. Comment by GCU: Delete this information before you move into dissertation.

In addition, as you are designing your study, reading peer-reviewed journal articles and books, and talking to peers/colleagues, please consider the following:

Is your recruitment plan clear? (How will you access people that you want to talk to?)
How will you obtain the data you want to use?
Will you be able to collect data that you propose?
Are the data analyses well-developed?
Will you be able to accurately portray and understand what your participants/data had to say?

Gatekeepers:
Who are the possible gatekeepers? (i.e., If you are in a school district, have you checked with the principal and the superintendent’s office or their designee to see what the process is for research? Or, if you are at a company, talked with the management, etc.?

If you are planning on collecting data from a college, what is the process? It is preferred that you obtain Institutional Review Board (IRB) approval from that institution prior to applying for GCU’s IRB approval).

The possible gatekeepers in this research are the nurses and the medical doctors who will be operating the subjects who are involved in the research.

In the process of collecting the data from the institution, it is highly preferred and recommended that as the researcher it is important to obtain the approval of the IRB before applying for GCU’s IRB approval.

Gatekeeper Contact:
Who do you need to keep in contact with as you form your research project to ensure that the benefits outweigh the risk and you can conduct your research? How will you initiate and maintain contact with them?

The medical doctors and the nurses are the best people to use as gatekeepers as illustrated and named above. The medical doctors and the nurses are the ones who fully understand the full implication of any process and experiment that will be done on the subjects. this will help in making sure that the research’s risks do not outweigh the benefits, and this can only be identified by the medical staffs who have the professional knowledge in this area.

Outside IRB:
If you are planning on recruiting participants or getting data from a college (or other institutions with an IRB), have you talked to their IRB determine the process and what participants/data they will allow you access? Please note, IRB approval typically takes some time.

Currently, because the IRB approval is very long and usually taking time, the research has talked to the IRB board but the approval is still underway being processed.NOT USING A COLLEGE, NO OTHER IRB

Study Benefits:
What is the benefit of your research? Who do you need to keep in contact with as you form your research project to ensure that the benefits outweigh the risks?

Remember that research should have a benefit; what benefit does your research have to others beside yourself?

The benefit of the research is that all the participants of the research will benefit so much from the results that will be gotten from the research. The subjects and in this case are the mental patients will be understood more and better decisions will be taken in the process of treating them. At the same time, the medical practitioners will understand their patients more and therefore making the process of treating their patients easier.

The benefit is the ability to document and share the strategies mental health professionals use to encourage patients to begin and continue treatment. They will be shared with all the participants and published.

Medical professionals are the people that the researcher should make sure that are in contact with throughout the research processes since they are the ones who know the extent to which the risks are and if they are more or less than the benefits.

Research Activity:
Is your research part of normal every day activities? This is significant because this must be outlined in your site authorization. A preliminary site authorization letter could simply be an email from a school/college/organization that indicates they understand what you want to do and how that benefits the school/college/organization. In some cases this will determine the classification of the study (this is especially important for educational research studies).
***Please see below for information regarding preliminary site authorization

This research is a special one and therefore it is not put under the classification of normal day-to-day activities. This is because, the research in itself is covering a topic on mental health and dis s and therefore this makes it special due to the fact that it hands far more complicated clinical issues that are required by the researcher as a whole.

Recruitment:
Please describe your proposed recruitment strategy. How do you plan to involve your participants in the process? What would your flyer/email say?

The recruitment process will be strategic; this is because since the research aims on looking at mental issues and dis s, the participants will be chosen based on this. Participants who already have mental issues will be prioritized from those with extreme issue to the ones who are not seriously affected, and grouping will also be done based on this.
The participants will be involved in the process in a way that, the patients will be given the freedom to not answer or stop, but also to choose what to share.

handing the different problems that they are introduced or presented with and in the process understand their awareness, their health literacy and even how the financial factor come in in the process of making these decisions.
The research and the participants will be chosen on the basis of the severity of the mental issues that they do have, and every participant will be involved in a specific way depending on the kind of observation that is needed to be seen from them.

Data Collection
What are you asking of participants? Are you asking them personal information (like demographic information such as age, income, relationship status)? Is that personal information necessary? How much time are you asking of participants (for example, if you are asking them to be interviewed, be in a focus group, fill out a questionnaire, fill out a journal/survey, collect artifacts, etc.)? How much time will they have to spend to be in your study? Does each part of your data collection help answer your research question? Participants must be told how long it will take to participants to participate in each activity. Are you concerned that the activities will take too long and participants might not finish/drop out?
Can you collect your data in a reasonable amount of time considering the stakeholders and possible challenges of gaining access to participants?

Different questions will be asked and the kind or type of question that will be asked will depend on the kind of response that is needed from them. Personal information will be asked since in the process of The goal is to understand ing as to why people accept or reject mental health services.e reject mental health services, in many cases, this is usually caused by income, relationship status or even demographic information, which is to be identified.
The research will take a period of 16 1 HOUR
For each participant interview and 1 hour for the focus group.

months upon which the participants will be released and the data that is gotten is synthesized and analyzed by the researcher. Considering this therefore there are issues that have much to do with this since some participants might get bored in the process and fail to cooperate and therefore drop out of the research.
The process can be speeded up if all the stakeholders do cooperate and all the needed permits like the IEB approval is done fast, this will help in making sure that as the researcher, the researching process will take a significantly short time.

Child Assent. Studies with children often fall under the regulations for a full board review (full board reviews take significantly longer in IRB). Each child must fill out a child assent AFTER there is parental consent. (It can be very difficult to get parental consent, especially if this is something sent home to parents).

The research in this case is less considering children and therefore child assent can be avoided by avoiding using participants who are children.

NO children.

Informed Consent
Participants must be told how long it will take to participants to participate in each activity. Are you concerned that the activities will take too long and participants might not finish/drop out?

Considering all the factors and the timeline of the research, this is a possibility; however, this can be avoided if the central stakeholders play a significant role in making sure that this becomes a success.

Site Authorization
Do you have a site authorization letter? How difficult will this be to get from the school/ school district/college/organization? Use the GCU template to ensure the correct information is included.

Currently the research does not have a site authorization letter. Getting this is a process that does need patience, this is because, the approval of different bodies like the IRB are needed in to get the GCU approval and therefore this will take some time to acquire.

Can you collect your data in a reasonable amount of time considering the stakeholders and possible challenges of gaining access to participants?

The time that will be taken to collect the data is fully determined by the time in which the IRB will give the approval that is needed in this process. Therefore, if the IRB gives the go ahead and gives the approval, then the data collection process can be reduced and collected in a reasonable time

Organizational Benefits:
Have you talked to your principal/supervisor/district/college/boss/ organization about your research? If so, have you asked them what you can do to help the district/organization/school?

As a researcher, I have talked to different bodies about the stipulated research and specifically the organization. The questions as to what that is to be done to help the institution has been asked and different recommendations have been given that have been incorporated in the dissertation that will help in ensuring that the institution does benefit from the research.

I will give a summary of the findings to the participants and to the site administrators.

What is the overall benefit of your research to participants?

The research does help the participants of the study generally in the identification and knowing the strategies that do influence the individual’s decision in utilizing or reject mental services.
This will therefore help in identifying the strategies that the health providers can use to make informed decisions. These will be shared in a summary of the fiindings.

What are the risks of your research? Please note that there are usually some risks (like revealing participant identity) in all research.

Some of the risks of the research are, the confidential information that the participants do provide is always at a risk of being exposed, which is an ethical risk. There are other legal and social risks that are there, e.g., some methods can end up having negative impacts on the participants.

Now that you have contemplated the above questions, how long do you imagine it will take you prior to access your participants/data? AND, how much are you asking of your participants?

I have site authorization. Once I have approval and IRB approval, then it may take 3-4 weeks to get all participants to schedule interviews. I will send one email, and three reminders.

Prior to accessing the participant’s data, it will take a maximum of 10 months and that is if all the stakeholders do play a significant role in making sure that the all the required data is gotten by the researcher.
The most important thing that the participants are asked of is their time, patience, and honesty in the whole process.

Based on the information that you have learned, is your study feasible? Why or why not? If not, how can you modify your ideas to make your study manageable?

I already have site authorization. There are a significant number of people 125 working at each facility and a total of four facilities so I believe I will be able to get 10-20 participants.

The study is purely feasible, the feasibility of this study is approved made possible by many factors. Some of the things that the research has and that does make it feasible is because the research has extensively used the required data and it has used the required subjects in the process of establishing and making sure that the research is a success.

·
Formal Site Authorization: Comment by GCU: Delete this information before moving into the dissertation.

Written on organizational letterhead
Dated within the last 12 months
Signed by an authorized representative of the site
Clearly indicate activities for which researcher has obtained authorization – This is very important. The authorization should clearly indicate EXACTLY what authorization is being granted. For example: recruiting by email during work hours, interviewing primary teachers during their planning hours, distributing an electronic survey to staff members, granting access to email, etc.
This information must align with recruitment, informed consent and the IRB application
· Instrument Authorization

Should be from an author or administrator of the organization
A written letter, e-mail, or a screenshot of the email correspondence is sufficient
Instrument authorization should contain the following items:
The specific name of the instrument to be used
For what purpose the instrument will be used
If possible, statement that the person granting authorization owns the copyright (sometimes that is not the author of the instrument, it could be the journal in which the instrument was first published)
Authorization is granted to use the instrument
Authorization is granted to modify the instrument from the author and also the CDS associate dean (if applicable, typically this is not advised, as altering surveys can negate the validity)
Evidence you are qualified to administer, score and interpret the data obtained from the instrument.
· Please see the DC network (
https://dc.gcu.edu/irb)
for help with the difference between anonymity and confidentiality, informed consent, site authorization, data use agreements and many other helpful videos and job-aids.
· Something to consider: If you are doing a quantitative study you should consider having a company collect data for you; this is a VERY quick way to collect your data. Each company has their own requirements and capabilities. Please research to see how they can help you; it will depend on the eligibility criteria you have for your study and if they have access to that participant pool. Please see Qualtric, SurveyMonkey, Mturk, Prolific
·

Appendix I.
Strategies to Establish Trustworthiness

Used with Permission:
Chess, P.S. (2017). Chapter 3, Validity and reliability in qualitative research. In Grand Canyon
University (Ed). (2017). GCU doctoral research: Advanced qualitative research methods.

http://lc.gcumedia.com/res855/gcu-doctoral-research-advanced-qualitative-research-methods/v1.1/

Appendix J.

Today we will begin with questions about how you encourage regular patients to begin and to continue using mental health services. In the second section, we will talk specifically about patients who are trying to reject mental health services, and how you encourage them.

Accepting Mental Health Support

· RQ 1: What strategies do mental health providers use to encourage patients to begin using mental health services?
How do you access and address patient’s perceptions of mental health treatment when they begin using mental health services (theoretical framework Beck)?
1. What strategies do YOU use to encourage patients to begin using mental health services?
2. Can you tell me about any other strategies?

3. Can you give me an example of how you have used that strategy?
4. How well has that strategy worked for you?

· RQ 2: What strategies do mental health providers use to encourage patients to continue
using mental health services?
5. How do you access and address patient’s perceptions of mental health treatment when they are wanting to continue using mental health services (theoretical framework Beck)?
6. What strategies do YOU use to encourage patients to continue using mental health services?
7. Can you tell me about any other strategies?
8. Can you give me an example of how you have used that strategy?
9. How well has that strategy worked for you?

Reject Mental Health

· RQ 3: What strategies do mental health providers use to address when patients reject beginning to use mental health services?
How do you access and address patient’s perceptions of mental health treatment when they ARE REJECTING to begin using mental health services (theoretical framework Beck)?
What strategies do YOU use to encourage patients when they ARE REJECTING to begin using mental health services? (Stickley et al., 2018)
· Can you tell me about any other strategies?
· Can you give me an example of how you have used that strategy?
· How well has that strategy worked for you?
RQ 4: What strategies do mental health providers use to address patients who reject to continue using mental health services?
· How do you access and address patient’s perceptions of mental health treatment when they ARE REJECTING to continue using mental health services (theoretical framework Beck)? (Gondek et al., 2017)
What strategies do YOU use to encourage patients when they ARE REJECTING to continue using mental health services?
· Can you tell me about any other strategies?
· Can you give me an example of how you have used that strategy?
· How well has that strategy worked for you?

Appendix F

Interview Questions

1. What do mental health providers identify as reasons patients reject mental health services?
2. What strategies do mental health providers have to address when patients reject beginning to use mental health services?
3. Are there instances where behavior has influenced the seeking of mental health services?
4. What strategies do mental health providers have to encourage patients to continue using mental health services?
1. What strategies do mental health providers have to address patients who reject to continue using mental health services?
2. What drives those seeking mental health services to accept or reject the service?

Appendix G

Focus Group questions

1. What are your experiences with patients who don’t want to begin mental health treatment? How did you encourage them to begin?
2. What are the issues commonly faced when trying to encourage patients to begin mental health treatment?
3. What are your experiences with patients who want to reject mental health treatment? How did you encourage them to continue?
4. What are the issues commonly faced when trying to encourage patients who want to reject to continue mental health treatment?

Developing Qualitative Interview Questions Systematically
Luis E. Zayas, PhD
Associate Professor & Peer Reviewer
College of Doctoral Studies
Grand Canyon University
Used with Permission

Qualitative Interviewing

· What is a qualitative interview?
· A conversation with a purpose – data gathering
· Open-ended format using probes
· Ideally with the least interviewer interjection as possible
· Interviewer is an extension of the instrument
· Requires many technical skills to elicit quality data
· Face-to-face vs telephone vs survey interviews
· Individual, in-depth vs. group interviews (small focus groups vs. large town hall meetings)

Dramaturgy and Interviewing

· Symbolic interactionism
· People perceive and interact in reality through the use of symbols
· The meaning of these symbols comes about as a result of a process of social interaction
· Interviewing as social performance
· Drama – a mode of symbolic action in which actors perform symbolically for an audience.
· Involves social actors and audience
· Active interviewing – meaning-making
· Interviewer’s role – actor, director, choreographer
· Interviewee’s role – leading actor in life drama

Types of Qualitative Interviews

· Major difference is degree of rigidity with regards to presentational structure
· Standardized (structured)
· Semi-standardized (semi-structured)

· Unstandardized (unstructured)

Standardized Interviews

· Similar in format to survey, but open-ended
· Use when you have a pretty good idea about the things you want to uncover
· Assumes the meaning of each Q is the same for every subject (positivist / objectivist framework)
· Operate from perspective that one’s thoughts are intricately related to one’s actions
Examples:
· Tell me what you eat for breakfast? (laundry list)? _______
· How many times a week do you eat fruits? _____________
· What kinds of physical activities do you engage in? _______
· Major limitations: short responses; lack of probing; manifest (literal) meaning, lack of context

Semi-Standardized Interviews

· Use when you have a general idea of what you want to elicit but do not want to restrict how it is presented
· Predetermined questions, special topics
· More flexibility in wording of questions and probing
· Assumes that not all subjects will necessarily find equal meaning in like-worded questions (phenomenological / relativistic framework)
· Reflects awareness that individuals understand the world in varying ways
See template and example

Unstandardized Interviews

· Use when you don’t know in advance what questions to ask (e.g. participant observation)
· Completely unstructured, no set to Qs.
· Total flexibility in wording of questions and probing
· Same epistemological assumptions as semi-standardized (phenomenological / relativistic)
· Reflects awareness that individuals understand the world in varying ways
· Questions and probes appropriate to each given situation & to the purpose of the study

Instrument Development (Brainstorming)

· Determine the nature of the investigation and research objectives (how structured?)
· Develop an outline listing broad categories relevant to the study that are based on the literature or theory.
· Develop set of questions relevant to each of the categories in the outline
· Exercise: develop semi-structured schedule
· Topic: learning to cope with asthma

Template for Instrument Development

· Main Study Question
Topic I:
Q.1:
Q.2:
Q.3:
Topic II:
Q.4:
Q.5:
Q.6:
Topic III:
Q.7:
Q.8:
Q.9:
What else that we’ve not discussed can you tell me…?

Example of Questions Within a Template

· RQ: How do adults w/ asthma living in communities w/ high asthma prevalence can learn to cope w/ the illness?
Theme I: Perceptions of asthma.
Q.1: What do you think asthma is?
Q.2: What do you think gives people asthma?
Q.3: What things worry you more about asthma?
Theme II: Coping with asthma.
Q.4: How can people take care of their asthma?
Q.5: How does your doctor help you with your asthma?
Q.6: What lifestyle changes can help people with asthma?
Theme III: Learning about asthma.
Q.7: How do you get information about asthma?
Q.8: How do you learn to take care of your asthma?
Q.9: How else could people get information about asthma?
Q.10. What could be done to improve asthma education in your community?

Q.11. What else that we’ve not discussed thus far can you tell me about…?

Schedule Development (Sequencing)

· Question (sequencing)
1. Start with easy, nonthreatening questions
2. Next, more important questions (not sensitive)
3. Then, more sensitive questions
4. Validating questions (pertaining to important or sensitive questions)
5. Next important topic or conceptual area of Qs.
6. Repeat steps 3 and 4, and so on
· Content – level of language, wording
· Styles of Qs – essential, extra, throw-away (general Qs to develop rapport), probing
· Number of Qs based also on interview length and depth (e.g., 8-12 Qs for 60 min interview)
· Problems in question formulation

1. Affectively worded questions
· Try to neutralize the sense of the questions
· “How come?” vs. “why did you do that wrong”?
2. Double-barrel questions
· “How many times have you smoked marijuana, or have you only tried cocaine”?
3. Complex questions
· Keep questions brief and concise
4. Too many questions (long interviews)
· Keep interview between 60-90 mins.
· Telephone interviews 20-30 mins.

Pretesting

· Expert review
· Mock interview
· Assess for:
· Inclusion of all the necessary questions
· Do questions elicit the types of response anticipated?
· Is the language of the research instrument meaningful to the respondents?
· Are there other problems with the questions? (e.g., multiple issues addressed in single Q.)
· Does it motivate and engage respondents?

Interview Training

· Learning to build rapport
· Learn the questions, practice
· Develop listening skills
· Probing skills without leading
· Silence, echoing, follow leads
Probes: repeat question, what, when, where, how, give me an example, tell me a story that illustrates that point, please elaborate on that.
· Issues of power
· Self-reflection
· Professionalism

Focus Groups

· Moderator’s guide similar to individual interview schedule, but must consider group dynamic
· Collective brainstorming, synergistic group effect
· Greater interviewing skill level required in to moderate effectively
· Guide should be shorter (6-8 Qs) in to engage as many participants as much as possible.
· Qs should NOT be same as individual interview Qs in studies using multiple sources of data collection
· FG Qs should explore a specific aspect of research problem or of findings from individual interviews.

References

Padgett, Deborah K. (2008). Qualitative methods in social work research. Sage Publications.
Zayas L.E., McLean D. Asthma patient education opportunities in predominantly minority urban communities. Health Education Research, 2007;22(6):757-769.

Appendix K.
Sample Frames, Interview Duration, Transcript Expectations

Qualitative Research Design

Reasonable Sample Frame

Minimum Projected

Sample Size

Minimum Achieved Sample Size

Case Study

60+ individuals

20 individuals

10 individuals

Qualitative Descriptive

60+ individuals

20 individuals

10 individuals

Phenomenology

35+ individuals

12 individuals

8 individuals

Narrative Study

35+ individuals

12 individuals

8 individuals

Grounded Theory

60+ individuals

20 individuals (*iterative sampling)

10 individuals

Qualitative Research Design

Minimum

Interview Length
Per Person

Corresponding *

Minimum Transcript Length
Per Person

Corresponding *

Minimum Transcript Range
Per Person

Case Study

45+ minutes

8+ pages single-space typed

8-12 pages single-space typed

Qualitative Descriptive

45+ minutes

8+ pages single-space typed

8-12 pages single-space typed

Phenomenology

60+ minutes

15+ pages single-space typed

15-20 pages single-space typed per person

Narrative Study

60+ minutes

15+ pages single-space typed

15-20 pages single-space typed

Grounded Theory

45+ minutes

8+ pages single-space typed

8-12 pages single-space typed

* “Corresponding” projections above are based on the minimum interview length shown for each core design. Learners can pursue longer interviews, which would increase the corresponding range of transcript pages.

Appendix L.
Additional Appendices Comment by GCU: The learner will delete this this appendix if it is not used.
Additional appendices may include descriptive statistical results, raw data (as appropriate), or other critical information pertinent to the dissertation. For the proposal, consider including all recruitment scripts (flyers, email text) and other documents planned for use in the study. Consult with the chair on additional appendices appropriate for the dissertation.

Example:

Copy of the Invitation to Participate (Study Advertisement)

Learners should provide a template of the recruitment materials that will advertise the study to candidates from the target population. For example, this might entail a preview of the email outreach or other forms of communication, such as a traditional letter, a posted flier, a web-forum post, or a full web-page advertisement. Recruitment materials are important in qualitative research because they advertise the inclusion criteria for the study and help enforce the sampling strategy.

Important Note: for learners who plan to use a web-forum or webpage to advertise their study, please be aware that you cannot publish a live post or webpage pertaining to your study until GCU-IRB has completed its review and assigned IRB approval. You can only preview its design in this Appendix as part of the proposal.

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