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Article History

Received: 15 November 2024

Accepted: 13 August 2025

First Online: 26 August 2025

Competing interests

: The authors declare no competing interests.

: This research has received ethical approval from the Research Ethics Committee under the Institute for Research and Community Service (Lembaga Penelitian dan Pengabdian kepada Masyarakat/LPPM), State University of Malang, with approval number No.16.2.2/UN32.14.2.8/LT/2024. Declared to be ethically appropriate in accordance with 7 (seven) WHO 2011 Standards, 1) Social Values, 2) Scientific Values, 3) Equitable Assessment and Benefits, 4) Risks, 5) Persuasion/Exploitation, 6) Confidentiality and Privacy, and 7) Informed Consent, referring to the 2016 CIOMS Guidelines. The fulfillment of the indicators of each standard indicates this. This declaration of ethics applies during the period February 16, 2024 until February 16, 2025.

: Informed consent was obtained verbally from all participants involved in the study. Each participant was given a detailed explanation of the purpose, scope, and potential impacts of the study. Informed consent was obtained by the lead researcher over the course of February to April 2024, from informants residing in the study site aged 25-65. Informants agreed to participate voluntarily, to allow the use of their data for research, analysis, and reporting purposes, and to provide permission for publication of the combined findings, with assurance of confidentiality and protection of individual identities in all published materials.