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Article History

Received: 12 June 2025

Accepted: 29 January 2026

First Online: 4 March 2026

Declarations

:

: This study was reviewed by the Jefferson Institutional Review Board (IRB), which determined that formal oversight was not required as the study did not involve the collection of sensitive or personally identifiable information. All procedures adhered to institutional and national ethical standards, and the study was conducted in accordance with the ethical principles outlined in the Declaration of Helsinki. All participants provided informed consent prior to participation. The interview questions focused exclusively on clinic-level processes and did not include any personal or identifying information. Participant identities remain confidential and are known only to the research team.

: Not applicable

: The authors declare no competing interests.