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Article History

Received: 15 September 2025

Accepted: 16 March 2026

First Online: 20 March 2026

Declarations

:

: Ethical approval for this study was obtained from the Research Ethics Committee at King Salman bin Abdulaziz Medical City (IRB Log No: 047-24). The study was conducted in accordance with the ethical principles of the Declaration of Helsinki and its later amendments. Informed consent was obtained from all participants prior to data collection. Participants were provided with clear information regarding the study’s objectives, potential benefits, and assurance of risk-free participation. Confidentiality and anonymity were strictly maintained, and all data were used exclusively for research purposes. Participants were informed of their right to withdraw from the study at any point without any consequences.For illiterate participants, informed consent was obtained through a standardized procedure whereby the informed consent document was read aloud to participants by trained researchteam members, and participants were given ample opportunity to ask questions and seek clarification before verbal consent was obtained and documented. This approach is in line with Article (13.5) of the “Implementing Regulations of the Law of Ethics of Research on Living Creatures” in Saudi Arabia. No legal guardians were involved in the consent process, as all participants were competent adults capable of providing their own informed consent despite literacy limitations.

: Not applicable.

: AHZ is a member of the Editorial Board of MBC Public Health. This manuscript has been submitted in accordance with the journal’s policies, and AHZ has not been involved in the editorial handling or peer review process of this submission. All other authors declare no conflicts of interest.