{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T03:42:06Z","timestamp":1794454926474,"version":"4.9.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001839","name":"University Grants Committee","doi-asserted-by":"publisher","award":["24608019"],"award-info":[{"award-number":["24608019"]}],"id":[{"id":"10.13039\/501100001839","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001839","name":"University Grants Committee","doi-asserted-by":"publisher","award":["24608019"],"award-info":[{"award-number":["24608019"]}],"id":[{"id":"10.13039\/501100001839","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001839","name":"University Grants Committee","doi-asserted-by":"publisher","award":["24608019"],"award-info":[{"award-number":["24608019"]}],"id":[{"id":"10.13039\/501100001839","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Community reintegration is a key goal for younger survivors of stroke due to participation demands such as returning to work and caring for dependents. However, current post-stroke rehabilitation services largely cater to older survivors and lack targeted support to promote reengagement in life activities. This study aimed to explore the community participation experiences of young stroke survivors to better understand their recovery needs and provide insight into strategies to enhance community reintegration and post-stroke care services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A qualitative descriptive study was carried out. Twenty-one stroke survivors aged between 18 and 64 years were recruited from a community-based rehabilitation centre and stroke support group in Hong Kong. Individual semi-structured interviews were conducted to explore participants\u2019 experiences of post-stroke community participation, associated facilitators and barriers, unmet health needs, and required support. Interview data were thematically analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants were aged 55.5 (SD: 7.0) years on average, and had stroke for a mean of 8.1 years (SD: 6.5). Four main themes were identified: (1) self-expectations and personal drive to recover; (2) physical, psychosocial, and environmental obstacles; (3) personal strategies to overcome barriers; and (4) external facilitators and recovery needs. Overall, while survivors were motivated and expressed a keen desire to resume life engagement by taking up former responsibilities and activities, factors such as limited functional mobility, lack of age-appropriate rehabilitation services, and insufficient social and vocational support were notable barriers to participation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated that the resumption of community participation was a significant concern for younger stroke survivors, indicating that diversified stroke rehabilitation and support services are required to meet their age-based recovery demands. Return to work may be supported by timely vocational rehabilitation and promoting disability-friendly workplace policies, while volunteering opportunities could be provided as an alternative vocational activity. Furthermore, educational and psychosocial interventions to promote positive interpersonal relationships and strengthen survivors\u2019 mental health would be helpful in facilitating participation outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12889-025-25918-9","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:24:42Z","timestamp":1765974282000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Young stroke survivors\u2019 experiences and approaches to community reintegration: a descriptive qualitative study"],"prefix":"10.1186","volume":"26","author":[{"given":"Suzanne Hoi Shan","family":"Lo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janita Pak Chun","family":"Chau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laveeza","family":"Butt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Demers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"25918_CR1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","volume":"20","author":"VL Feigin","year":"2021","unstructured":"Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and National burden of stroke and its risk factors, 1990\u20132019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021;20:795\u2013820.","journal-title":"Lancet Neurol"},{"key":"25918_CR2","doi-asserted-by":"publisher","first-page":"e2444","DOI":"10.1212\/WNL.0000000000007533","volume":"92","author":"MS Ekker","year":"2019","unstructured":"Ekker MS, Verhoeven JI, Vaartjes I, van Nieuwenhuizen KM, Klijn CJM, de Leeuw F. Stroke incidence in young adults according to age, subtype, sex, and time trends. Neurology. 2019;92:e2444\u201354.","journal-title":"Neurology"},{"key":"25918_CR3","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1080\/10749357.2024.2312640","volume":"79","author":"CA Scott","year":"2022","unstructured":"Scott CA, Li L, Rothwell PM. Diverging temporal trends in stroke incidence in younger vs older people: a systematic review and meta-analysis. JAMA Neurol. 2022;79:1036\u201348. https:\/\/doi.org\/10.1080\/10749357.2024.2312640.","journal-title":"JAMA Neurol"},{"key":"25918_CR4","doi-asserted-by":"publisher","unstructured":"Toglia J, Askin G, Gerber LM, Jaywant A, O\u2019Dell MW. Participation in younger and older adults post-stroke: frequency, importance, and desirability of engagement in activities. Front Neurol. 2019;10:1108. https:\/\/doi.org\/10.3389\/fneur.2019.01108.","DOI":"10.3389\/fneur.2019.01108."},{"key":"25918_CR5","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1080\/07370016.2022.2077074","volume":"39","author":"Y Zhang","year":"2022","unstructured":"Zhang Y, Mou Y, Zhang Y, Wang J, Kong F. Psychological experience and social reintegration needs of young stroke patients: a systematic review and meta-aggregation of qualitative studies. J Community Health Nurs. 2022;39:150\u201369.","journal-title":"J Community Health Nurs"},{"key":"25918_CR6","doi-asserted-by":"publisher","first-page":"e0213447","DOI":"10.1371\/journal.pone.0213447","volume":"14","author":"K T\u00f6rnbom","year":"2019","unstructured":"T\u00f6rnbom K, Lund\u00e4lv J, Sunnerhagen KS. Long-term participation 7\u20138 years after stroke: experiences of people in working-age. PLoS One. 2019;14:e0213447.","journal-title":"PLoS One"},{"key":"25918_CR7","doi-asserted-by":"publisher","first-page":"2500","DOI":"10.1080\/09638288.2020.1836522","volume":"44","author":"I Lindgren","year":"2022","unstructured":"Lindgren I, Brog\u00e5rdh C, Pessah-Rasmussen H, Jonasson SB, Gard G. Work conditions, support, and changing personal priorities are perceived important for return to work and for stay at work after stroke \u2013 a qualitative study. Disabil Rehabil. 2022;44:2500\u20136.","journal-title":"Disabil Rehabil"},{"key":"25918_CR8","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1080\/09638288.2019.1645889","volume":"43","author":"MM Martin-Saez","year":"2021","unstructured":"Martin-Saez MM, James N. The experience of occupational identity disruption post stroke: a systematic review and meta-ethnography. Disabil Rehabil. 2021;43:1044\u201355.","journal-title":"Disabil Rehabil"},{"key":"25918_CR9","doi-asserted-by":"publisher","unstructured":"Lo SHS, Chau JPC, Chang AM. Strategies adopted to manage physical and psychosocial challenges after returning home among people with stroke: a qualitative study. Med (Baltim). 2021;100:e25026.\u00a0https:\/\/doi.org\/10.1097\/MD.0000000000025026.","DOI":"10.1097\/MD.0000000000025026"},{"key":"25918_CR10","unstructured":"Meyerson DE, Zuckerman D. Identity theft: rediscovering ourselves after stroke. Andrews McMeel Publishing; 2019."},{"key":"25918_CR11","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1080\/09638288.2018.1534278","volume":"42","author":"J Shipley","year":"2020","unstructured":"Shipley J, Luker J, Thijs V, Bernhardt J. How can stroke care be improved for younger service users? A qualitative study on the unmet needs of younger adults in inpatient and outpatient stroke care in Australia. Disabil Rehabil. 2020;42:1697\u2013704.","journal-title":"Disabil Rehabil"},{"issue":"5","key":"25918_CR12","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1177\/1744987119880234","volume":"25","author":"L Doyle","year":"2020","unstructured":"Doyle L, McCabe C, Keogh B, Brady A, McCann M. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443\u201355. https:\/\/doi.org\/10.1177\/1744987119880234.","journal-title":"J Res Nurs"},{"key":"25918_CR13","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","volume":"19","author":"A Tong","year":"2007","unstructured":"Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349\u201357.","journal-title":"Int J Qual Health Care"},{"key":"25918_CR14","doi-asserted-by":"publisher","first-page":"3547","DOI":"10.1161\/STROKEAHA.115.011226","volume":"46","author":"A Wong","year":"2015","unstructured":"Wong A, Law LSN, Liu W, Wang Z, Lo ESK, Lau A, et al. Montreal cognitive assessment. Stroke. 2015;46:3547\u201350.","journal-title":"Stroke"},{"key":"25918_CR15","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1111\/jocn.15529","volume":"30","author":"G Harris Walker","year":"2021","unstructured":"Harris Walker G, Oyesanya TO, Hurley A, Sandhu S, Liu C, Mulla M, et al. Recovery experiences of younger stroke survivors who are parents: a qualitative content analysis. J Clin Nurs. 2021;30:126\u201335.","journal-title":"J Clin Nurs"},{"key":"25918_CR16","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1080\/09602011.2017.1292922","volume":"29","author":"L Hutton","year":"2019","unstructured":"Hutton L, Ownsworth T. A qualitative investigation of sense of self and continuity in younger adults with stroke. Neuropsychol Rehabil. 2019;29:273\u201388.","journal-title":"Neuropsychol Rehabil"},{"key":"25918_CR17","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1177\/1747493019897847","volume":"15","author":"A Mountain","year":"2020","unstructured":"Mountain A, Patrice Lindsay M, Teasell R, Salbach NM, de Jong A, Foley N, et al. Canadian stroke best practice recommendations: rehabilitation, recovery, and community participation following stroke. Part two: transitions and community participation following stroke. Int J Stroke. 2020;15:789\u2013806.","journal-title":"Int J Stroke"},{"key":"25918_CR18","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1080\/09602011.2022.2049827","volume":"33","author":"SHS Lo","year":"2023","unstructured":"Lo SHS, Chau JPC, Lam SKY, Saran R. Understanding the priorities in life beyond the first year after stroke: qualitative findings and non-participant observations of stroke survivors and service providers. Neuropsychol Rehabil. 2023;33:794\u2013820.","journal-title":"Neuropsychol Rehabil"},{"key":"25918_CR19","doi-asserted-by":"publisher","first-page":"1082","DOI":"10.1111\/1460-6984.12845","volume":"58","author":"SHS Lo","year":"2023","unstructured":"Lo SHS, Chau JPC. Experiences of participating in group-based rehabilitation programmes: a qualitative study of community-dwelling adults with post-stroke aphasia. Int J Lang Commun Disord. 2023;58:1082\u201397.","journal-title":"Int J Lang Commun Disord"},{"key":"25918_CR20","doi-asserted-by":"publisher","unstructured":"Johnson JL, Adkins D, Chauvin S. A review of the quality indicators of rigor in qualitative research. Am J Pharm Educ. 2020;84:7120. https:\/\/doi.org\/10.5688\/ajpe7120.","DOI":"10.5688\/ajpe7120"},{"key":"25918_CR21","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77\u2013101.","journal-title":"Qual Res Psychol"},{"key":"25918_CR22","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1007\/s11135-017-0574-8","volume":"52","author":"B Saunders","year":"2018","unstructured":"Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52:1893\u2013907.","journal-title":"Qual Quant"},{"key":"25918_CR23","unstructured":"Hospital Authority. (2022). Hospital Authority strategic plan 2022\u20132027. https:\/\/www.ha.org.hk\/haho\/ho\/ap\/HA_StrategicPlan2022-2027_Eng_211216_1.pdf"},{"key":"25918_CR24","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1080\/09638288.2020.1817157","volume":"44","author":"FH Chang","year":"2022","unstructured":"Chang FH, Lin YN, Liou TH. Recovery after stroke: perspectives of young stroke survivors in Taiwan. Disabil Rehabil. 2022;44:1976\u201383.","journal-title":"Disabil Rehabil"},{"key":"25918_CR25","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1111\/ane.13180","volume":"141","author":"E Westerlind","year":"2020","unstructured":"Westerlind E, Persson HC, Eriksson M, Norrving B, Sunnerhagen KS. Return to work after stroke: a Swedish nationwide registry-based study. Acta Neurol Scand. 2020;141:56\u201364.","journal-title":"Acta Neurol Scand"},{"key":"25918_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2021.101565","volume":"65","author":"S Cain","year":"2022","unstructured":"Cain S, Churilov L, Collier JM, Carvalho LB, Borschmann K, Moodie M, et al. Factors associated with paid employment 12 months after stroke in A Very Early Rehabilitation Trial (AVERT). Ann Phys Rehabil Med. 2022;65:101565.","journal-title":"Ann Phys Rehabil Med"},{"key":"25918_CR27","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1007\/s10926-021-09978-3","volume":"31","author":"J Jansen","year":"2021","unstructured":"Jansen J, van Ooijen R, Koning PWC, Boot CRL, Brouwer S. The role of the employer in supporting work participation of workers with disabilities: a systematic literature review using an interdisciplinary approach. J Occup Rehabil. 2021;31:916\u201349.","journal-title":"J Occup Rehabil"},{"key":"25918_CR28","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2019.105458","volume":"185","author":"R Brouns","year":"2019","unstructured":"Brouns R, Valenzuela Espinoza A, Goudman L, Moens M, Verlooy J. Interventions to promote work participation after ischaemic stroke: a systematic review. Clin Neurol Neurosurg. 2019;185:105458.","journal-title":"Clin Neurol Neurosurg"},{"key":"25918_CR29","doi-asserted-by":"publisher","first-page":"7641","DOI":"10.1080\/09638288.2021.1980622","volume":"44","author":"A Murray","year":"2022","unstructured":"Murray A, Watter K, McLennan V, Vogler J, Nielsen M, Jeffery S, et al. Identifying models, processes, and components of vocational rehabilitation following acquired brain injury: a systematic scoping review. Disabil Rehabil. 2022;44:7641\u201354.","journal-title":"Disabil Rehabil"},{"issue":"1","key":"25918_CR30","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1017\/S0047279421000490","volume":"52","author":"CH-K Chui","year":"2023","unstructured":"Chui CH-K, Chan CH, Chandra Y. The role of social enterprises in facilitating labour market integration for people with disabilities: a convenient deflection from policy mainstreaming? J Soc Policy. 2023;52(1):176\u201396.","journal-title":"J Soc Policy"},{"key":"25918_CR31","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1016\/j.hrtlng.2021.07.002","volume":"50","author":"JPC Chau","year":"2021","unstructured":"Chau JPC, Lo SHS, Choi KC, Butt L, Zhao J, Thompson DR. Participation self-efficacy plays a mediation role in the association between mobility and social participation among stroke survivors. Heart Lung. 2021;50:857\u201362.","journal-title":"Heart Lung"},{"key":"25918_CR32","doi-asserted-by":"publisher","first-page":"1711","DOI":"10.1177\/1049732319833366","volume":"29","author":"G Kitzm\u00fcller","year":"2019","unstructured":"Kitzm\u00fcller G, Mangset M, Evju AS, Angel S, Aadal L, Martinsen R, et al. Finding the way forward: the lived experience of people with stroke after participation in a complex psychosocial intervention. Qual Health Res. 2019;29:1711\u201324.","journal-title":"Qual Health Res"},{"key":"25918_CR33","doi-asserted-by":"publisher","unstructured":"Erler KS, Sullivan V, Mckinnon S, Inzana R. Social support as a predictor of community participation after stroke. Front Neurol. 2019;10 :1013. https:\/\/doi.org\/10.3389\/fneur.2019.01013.","DOI":"10.3389\/fneur.2019.01013"},{"key":"25918_CR34","doi-asserted-by":"publisher","DOI":"10.1016\/j.rehab.2022.101686","volume":"66","author":"C Della Vecchia","year":"2023","unstructured":"Della Vecchia C, Pr\u00e9au M, Haesebaert J, Viprey M, Rode G, Termoz A, et al. Factors associated with post-stroke social participation: a quantitative study based on the ICF framework. Ann Phys Rehabil Med. 2023;66:101686.","journal-title":"Ann Phys Rehabil Med"},{"key":"25918_CR35","unstructured":"Demers M, Kwah KL, Thilarajah S, Charalambous M, Bazadona D, Chapman S et al. Identification of knowledge and information needs of young people with stroke from eight different countries. Neurorehabil Neural Repair. 2023;37(SS);35S."},{"key":"25918_CR36","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1177\/1474515120926069","volume":"20","author":"G Pucciarelli","year":"2021","unstructured":"Pucciarelli G, Lommi M, Magwood GS, Simeone S, Colaceci S, Vellone E, et al. Effectiveness of dyadic interventions to improve stroke patient\u2013caregiver dyads\u2019 outcomes after discharge: a systematic review and meta-analysis study. Eur J Cardiovasc Nurs. 2021;20:14\u201333.","journal-title":"Eur J Cardiovasc Nurs"},{"key":"25918_CR37","doi-asserted-by":"publisher","first-page":"2336","DOI":"10.1080\/09638288.2022.2089919","volume":"45","author":"K Ushizawa","year":"2023","unstructured":"Ushizawa K, Otaka Y, Kitamura S, Inoue S, Sakata S, Kondo K, et al. Development of an assessment form for the performance of public transportation use in individuals with stroke. Disabil Rehabil. 2023;45:2336\u201345.","journal-title":"Disabil Rehabil"},{"key":"25918_CR38","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.1016\/j.apmr.2019.04.023","volume":"100","author":"M Gunnes","year":"2019","unstructured":"Gunnes M, Indredavik B, Langhammer B, Lydersen S, Ihle-Hansen H, Dahl AE, et al. Associations between adherence to the physical activity and exercise program applied in the LAST study and functional recovery after stroke. Arch Phys Med Rehabil. 2019;100:2251\u20139.","journal-title":"Arch Phys Med Rehabil"},{"key":"25918_CR39","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1111\/jan.15076","volume":"78","author":"A Holloway","year":"2022","unstructured":"Holloway A, Chandler C, Aviles Reinso L, Clarissa C, Putri A, Choi H, et al. Young Adults Rehabilitation Needs and Experiences following Stroke (YARNS): a review of digital accounts to inform the development of age-appropriate support and rehabilitation. J Adv Nurs. 2022;78:869\u201382.","journal-title":"J Adv Nurs"},{"key":"25918_CR40","unstructured":"Hospital Authority. (2013). Hospital Authority strategic service framework for rehabilitation services. https:\/\/www.ha.org.hk\/haho\/ho\/ap\/HA-RehabSSF-01.pdf"},{"key":"25918_CR41","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1080\/02699052.2020.1762002","volume":"34","author":"R Hughes","year":"2020","unstructured":"Hughes R, Fleming P, Henshall L. Peer support groups after acquired brain injury: a systematic review. Brain Inj. 2020;34:847\u201356.","journal-title":"Brain Inj"},{"key":"25918_CR42","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1080\/09638288.2018.1524521","volume":"42","author":"P Masterson-Algar","year":"2020","unstructured":"Masterson-Algar P, Williams S, Burton CR, Arthur CA, Hoare Z, Morrison V, et al. Getting back to life after stroke: co-designing a peer-led coaching intervention to enable stroke survivors to rebuild a meaningful life after stroke. Disabil Rehabil. 2020;42:1359\u201372.","journal-title":"Disabil Rehabil"},{"key":"25918_CR43","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104001","volume":"121","author":"X Wan","year":"2021","unstructured":"Wan X, Chau JPC, Mou H, Liu X. Effects of peer support interventions on physical and psychosocial outcomes among stroke survivors: a systematic review and meta-analysis. Int J Nurs Stud. 2021;121:104001.","journal-title":"Int J Nurs Stud"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-25918-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12889-025-25918-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12889-025-25918-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:19:33Z","timestamp":1781623173000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12889-025-25918-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,17]]},"references-count":43,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["25918"],"URL":"https:\/\/doi.org\/10.1186\/s12889-025-25918-9","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,17]]},"assertion":[{"value":"4 May 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Joint Chinese University of Hong Kong-New Territories East Cluster Clinical Research Ethics Committee (Reference No.: 2019.010). Written informed consent was obtained from all participants before interviews.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"269"}}