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Article History

Accepted: 18 July 2025

First Online: 4 August 2025

Declarations

:

: The authors declare that they have no competing interests.

: This study was approved by The University of Calgary Research Ethics Boards (REB22-1137).

: Verbal, informed consent to participate was obtained from participants in the interviews. Implied, informed consent was used for adult participants responding to surveys (i.e., by responding to the survey, participants are consenting to participate in research). Youth ages 14–18, with decision-making capacity were asked to read the study information and indicate informed consent by ticking a box. Decision-making capacity with youth ages 14–18 was assessed using 4 questions to evaluate that they understand the purpose of the study, that participation is voluntary, that they can stop participating at any time, and that their participation will not impact the care that they will receive. If all four questions were answered “yes” they were considered competent to consent to participate as a mature minor, according to Canadian ethical standards. PROMs data from youth 14–18 years old, who were competent to consent to participate, were given information about using their de-identified data for future research and were asked to consent to have their data used for research. Assent was sought for youth 14 years of age or under, or those not considered competent to participate, as well as guardians’ informed consent.

: This manuscript does not contain any individual person’s data in any form.