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Article History

Received: 28 May 2025

Accepted: 27 January 2026

First Online: 5 February 2026

Declarations

:

: This study received ethical approval from the Institutional Ethics Committee of the School of Public Health, SRM Institute of Science and Technology, Tamil Nadu, India (Approval No: 71/76/79/90/96/99/100/IEC/2024). Written informed consent was obtained from all participants prior to data collection. For individuals with limited literacy, the consent form was read aloud in Tamil, and consent was recorded via thumb impression in the presence of a literate witness. Participants were informed that their participation was entirely voluntary and that they could withdraw at any point without any consequence. All identifying information was kept confidential, and responses were anonymized at the point of data entry. The study was conducted in accordance with the ethical standards outlined in the Declaration of Helsinki [73].

: Not applicable.

: Generative artificial intelligence tools (e.g., ChatGPT by OpenAI, 2024) were used solely to assist with language editing, grammar correction, formatting, and improvement of clarity and coherence. No AI tools were used for data analysis, data interpretation, or the generation of scientific content. All analytical, interpretive, and editorial decisions were made independently by the authors, who take full responsibility for the integrity, originality, and accuracy of the work.

: The authors declare no competing interests.