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Article History

Received: 19 June 2024

Accepted: 18 March 2026

First Online: 2 April 2026

Competing interests

: The authors declare no competing interests.

: Ethical approval for this study was granted by the Ethics Committee of the Institute of Health Data Science, Lanzhou University (Ethics Review Approval No. HDS-202505-01).

: For the quantitative phase, participants were informed about the purpose of the study, the voluntary nature of participation, and the confidential handling of their personal information and responses on the Wenjuanxing questionnaire landing page. Questionnaire completion and submission were taken to indicate consent to participate in the quantitative phase and to the use of de-identified questionnaire data for research and publication purposes. For the follow-up qualitative phase, interview participants were informed about the interview procedures, the voluntary nature of participation, the confidential handling of interview materials, the use of de-identified dialog logs for analysis and publication, and the temporary use of call audio solely for immediate post-call accuracy checking, and they agreed to participate before the WeChat interview. For the Phase-0 cognitive interviews conducted for instrument refinement, participants were informed about the purpose of the interviews, the voluntary nature of participation, and the handling of the interview materials, and they agreed to participate before the interview.