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Article History

Received: 4 March 2025

Accepted: 20 October 2025

First Online: 21 November 2025

Declarations

:

: This study is a secondary analysis of de-identified survey data collected through the American College Health Association-National College Health Assessment (ACHA-NCHA). As part of the original data collection process, participating students provided informed consent in accordance with ACHA’s institutional protocols. No personally identifiable information was available to the authors. This secondary analysis was approved by the Institutional Review Board at Texas A&M University (reference number 156863) and complied with the Declaration of Helsinki.

: All study participants provided informed consent before data collection. They were informed about the study’s aims, procedures, potential risks, and benefits. Participation was entirely voluntary, and participants had the right to withdraw from the study at any point without penalty.

: The authors declare no competing interests.