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Article History

Received: 28 July 2025

Accepted: 24 December 2025

First Online: 2 January 2026

Declarations

:

: Ethical approval was granted by the Ethics Committee of Universidade Federal de São Paulo [CEP/UNIFESP 0424/2022 application number 5.452.965, date of approval 08.01.2021]. Written informed consent to participate was obtained from all participants. Participants provided informed consent in Portuguese, English, French, or Spanish. All procedures in the current study followed the institutional norms and ethical standards of the national research committee, and the 1964 Declaration of Helsinki and further amendments. All migrant participants completed Informed Consent Forms. To safeguard participant confidentiality across all research sites, all collected data (audio recordings, transcripts, and field notes) were immediately de-identified. Participants were assigned a unique code, and any identifying information was removed from the transcripts. In accordance with Brazilian centralized ethical regulations (Resolution No. 510/2016 of the National Health Council), the master list linking codes to identities is stored separately under the responsibility of the principal investigator at the lead institution. All digital research data (de-identified transcripts, recordings, and analysis files) were stored on a secure, password-protected cloud drive (Google Drive for Education). Access was strictly limited to the core research team members directly involved in data analysis, as authorized by the lead Principal Investigator.

: Not applicable, given that all data is de-identified and does not include individual participant data.

: The authors declare no competing interests.