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Article History

Received: 4 September 2024

Accepted: 4 July 2025

First Online: 19 July 2025

Competing interests

: The authors declare no competing interests.

: This study was approved by the Institutional Ethics Board (IEB) of Shaanxi Normal University under ethics approval number SNNU-ETH-2023-Ed0316, on September 10, 2023. The approval covered all stages of the research process, including participant recruitment, data collection, and data analysis. Ethical approval was obtained prior to data collection. All procedures involving human participants were conducted in accordance with the ethical standards of the committee and the Declaration of Helsinki.

: The participants were seventh-grade students from rural middle schools in Hainan Province, most of whom were left-behind children. Informed consent was obtained in September 2023 by the researchers and classroom teachers. Given the rural setting and the difficulty of obtaining signed written consent from all legal guardians, the purpose, procedures, voluntary nature, and confidentiality of the study were verbally explained to the students during class meetings, using a standardized script approved by the ethics board. Some guardians participated remotely through phone or video conferencing. Participation was entirely voluntary, and students were informed that they could withdraw at any time without any consequences. This consent process was reviewed and approved by the IEB of Shaanxi Normal University as appropriate for the study context. While some basic demographic information (e.g., family background and parents’ occupations) was collected for research purposes, no personally identifiable information was obtained, and participants’ anonymity was strictly protected throughout the study.