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Article History

Received: 1 August 2025

Accepted: 3 November 2025

First Online: 10 December 2025

Declarations

:

: This study adhered to ethical principles as outlined in the Helsinki Declaration. Researchers obtained IRB approval from the Virginia Department of Health and George Mason University prior to conducting analyses for this study. Both IRB boards waived the need for consent to participate and determined that this secondary research study of deidentified survey data does not meet the federal regulation definition of research with human subjects according to 45 CFR 46.102(e) [ ].

: Not applicable.

: The authors declare no competing interests.