Analysis was concurrent with data collection, and proceeded until no further unique themes emerged from successive interviews (thematic saturation). Data were organized using Microsoft Office software. The principal investigator identified unique themes using constant comparative technique . First, interview transcripts were read to identify, define and organize themes in participant responses relevant to the main interview questions (first-level coding). Second, a codebook was developed to organize codes reflecting emerging themes, their definition and sample quotes illustrating application of that code. Third, transcripts were reviewed to assess whether and how to expand or merge themes (second-level coding). Saturation was determined through discussion of emerging themes among all members of the research team on three occasions during the iterative data analysis process until it was deemed by consensus that the most recent interviews produced consistent information.