An inductive, qualitative content analysis approach was used to identify emerging themes . This is a bottom-up approach that inductively builds upon the data as opposed to establishing a deductive coding scheme in advance of the analysis. Two researchers performed coding consensus using a line-by-line open coding technique . Key concepts, ideas, beliefs, and/or events were coded with one or more codes. Codes were added or modified as necessary as new meanings emerged . To assess coding consistency, codes and their assignment to text were checked and rechecked. If any discrepancies arose, researchers discussed the codes until consensus was reached. Using a constant comparison method , codes were compared and queried to identify themes that emerged from the groups.