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Article History

Received: 21 April 2022

Accepted: 16 October 2022

First Online: 25 October 2022

Declarations

:

: This study has been reviewed and approved as an exempt study by the Boston University Medical Campus and Boston Medical Center Institutional Review Board (IRB#H-38776). The parent study was reviewed and approved by the University of Calgary Conjoint Health Research Ethics Board (REB18-0511). Participants in both the parent study and the current study were not restricted to individual institutions, but rather recruited from any institution across the five study countries, therefore it was determined to be impractical to get IRB approval from each potential institution in each study country. The parent study included an implied informed consent statement for survey completion attached to recruitment emails. As the current study was approved as exempt, an abbreviated informed consent process was permitted that included a study information sheet attached to all recruitment emails and included again on all scheduled interview calendar invitations. As the interviews were mostly done via Zoom or over the phone, verbal informed consent to participate at the start of each interview was permitted. Documentation of this consent was captured in the interview transcripts. The survey implied informed consent statement, interview study information sheet, and the verbal informed consent language for interviews were all reviewed and approved by the Boston University Medical Campus and Boston Medical Center IRB and the University of Calgary Conjoint Health Research Ethics Board.

: Individuals provided verbal informed consent prior to participating in interviews. The verbal informed consent process included reading the following statement: “Your participation in this study is purely voluntary and you may stop interviewing at any point, or refuse to respond to any questions you don’t feel comfortable answering. All information will be kept confidential and all results will be reported in the aggregate. Your participation in this interview will not be compensated. We will record this interview so that we can transcribe your words accurately. Do you agree to participate in the interview?” Individual quotes presented indicate only the interviewees’ profession and country in which they practice. The quotes do not include any information that could lead to identification of the individual.

: The authors declare that they have no competing interests.