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Article History

Received: 1 August 2024

Accepted: 2 December 2025

First Online: 4 February 2026

Declarations

:

: Ethical approval for this study was granted by the Institutional Review Board at San Francisco State University, San Francisco, California 94132, U.S. (X21-018R1) and the Faculty of Health and Medicine Research Ethics Committee at Lancaster University, Lancaster, Lancashire, England, United Kingdom according to the United Kingdom Data Protection Act (2018), General Data Protection Regulation principles, and the Code of Federal Regulations (CFR) – Title 45 CFR Part 46 (2018), and Title 21 CFR Parts 50 and 56. All research participants underwent a consent process, and written or recorded verbal consent was obtained before participation in the research study. All research participants were informed they were free to withdraw from the study at any time. Before starting the interview, the researcher asked all participants whether they consented to be part of the study and if they were willing to have the interview recorded using a digital recorder or audio or video recorded using secure video conference software. The informed consent form template is available upon request. Pseudonyms were given to all research participants to protect their anonymity. All data was anonymised, and personal data was collected, managed, and stored according to the United Kingdom Data Protection Act (2018), General Data Protection Regulation principles, the Code of Federal Regulations – Title 45 CFR Part 46 (2018), and Title 21 CFR Parts 50 and 56.

: Not applicable.

: AG was a doctoral candidate at the Division of Health Research, Faculty of Health and Medicine, Lancaster University at the time this research was conducted, and is an Assistant Professor at the College of Health and Social Services, San Francisco State University, California, U.S. PH is a Senior Lecturer and FA is a Lecturer at the Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, United Kingdom.

: The authors declare that they have no competing interests.