Document is current

Article History

Received: 9 January 2025

Accepted: 4 June 2026

First Online: 11 June 2026

Competing interests

: The authors declare no competing interests.

: The questionnaire and methodology for this study were approved by the Institutional Review Board of Huazhong University of Science and Technology, Wuhan, China (Approval No. SEIRB/0623/2023; June 23, 2023), which reviewed the entire multi-country protocol. The study employed a non-experimental, survey-based research design involving minimal risk, with no anticipated physical, psychological, or social harm to participants. All research procedures were conducted in accordance with institutional guidelines and international ethical standards, including the principles outlined in the Declaration of Helsinki (2013 revision). In Finland, ethical review was not required under the Finnish National Board on Research Integrity (TENK) guidelines (Section 4.2); in Pakistan, an exemption was granted under the Higher Education Commission (HEC) framework.

: All participants were adults (18 years or older) and participated voluntarily. Informed consent was obtained electronically prior to data collection. Before accessing the questionnaire, participants were presented with an online informed consent form describing the study purpose, procedures, duration, voluntary nature of participation, confidentiality measures, and the right to withdraw at any time without penalty. Participants were required to explicitly indicate their consent by selecting an “I agree to participate” option before proceeding to the survey. Data were collected between April 6 and June 5, 2024. No personally identifiable information was collected, and all responses were anonymized prior to analysis.