{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:56:03Z","timestamp":1791482163323,"version":"4.3.4"},"reference-count":61,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Older adults experiencing anxiety disorders, particularly those from minority ethnic backgrounds, are less likely to use formal mental health services than younger adults. This UK-based multicultural qualitative study explored beliefs underpinning coping strategies for anxiety among White British, South Asian, African and Caribbean older adults who self-reported anxiety, informed by Leventhal\u2019s Common-Sense Model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individual semi-structured interviews were conducted with 52 older adults aged \u226565 who self-reported current or past anxiety. Professional interpreters supported interviews with non-English-speaking participants (n\u2009=\u200910). Eight public contributors collaborated on different aspects of the study. Data were managed and analysed using the Framework Method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>The study drew on the perspectives of 27 participants with distressing anxiety and 25 with non-distressing anxiety. Across all cultural groups, participants adopted a range of coping strategies, with self-help strategies being the most prominent. Our findings suggest that coping strategy selection was shaped by factors extending beyond cultural background. Participants tended to adopt strategies that were congruent with their salient identities, perceived need for support, candidacy for healthcare, social relationships, and beliefs about the appropriateness and effectiveness of different responses. This complexity helps explain variation in perceptions both across and within cultural groups. Inductive analysis identified new dimensions not recognised in Leventhal\u2019s Model: factors underlying the motivation to take action, beliefs about treatment providers and new treatment-related beliefs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Interventions that support older adults to apply self-help strategies more effectively may represent acceptable adjuncts to formal therapy. Nevertheless, addressing barriers to formal help-seeking remains essential, particularly among those with perceived need for professional support. No one model can depict the complexity of coping behaviours. While applying Leventhal\u2019s Model offered novel insights, it could not fully capture the motivational factors underlying engagement with specific coping behaviours. Cross-cultural research should attend to within-group heterogeneity rather than impose assumptions of cultural homogeneity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0346995","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:28:56Z","timestamp":1791480536000},"page":"e0346995","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Older adults\u2019 beliefs about coping strategies for anxiety: A UK-based multicultural qualitative study informed by Leventhal\u2019s Common-Sense Model of Self-Regulation"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0283-9569","authenticated-orcid":true,"given":"Rasha","family":"Alkholy","sequence":"first","affiliation":[{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health"]},{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Manchester Academic Health Science Centre"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penny","family":"Bee","sequence":"additional","affiliation":[{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health"]},{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Manchester Academic Health Science Centre"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Pedley","sequence":"additional","affiliation":[{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health"]},{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Manchester Academic Health Science Centre"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Lovell","sequence":"additional","affiliation":[{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Division of Nursing, Midwifery and Social Work, School of Health Sciences, Faculty of Biology, Medicine and Health"]},{"name":"The University of Manchester","place":["Manchester, United Kingdom"],"department":["Manchester Academic Health Science Centre"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"issue":"2","key":"pone.0346995.ref001","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/da.20653","article-title":"Anxiety disorders in older adults: A comprehensive review","volume":"27","author":"KB Wolitzky-Taylor","year":"2010","journal-title":"Depress Anxiety"},{"key":"pone.0346995.ref002","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.jad.2018.02.011","article-title":"A systematic review of the association of anxiety with health care utilization and costs in people aged 65 years and older","volume":"232","author":"JK Hohls","year":"2018","journal-title":"J Affect Disord"},{"issue":"3","key":"pone.0346995.ref003","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/da.20911","article-title":"Disorder-specific mental health service use for mood and anxiety disorders: associations with age, sex, and psychiatric comorbidity","volume":"29","author":"CS Mackenzie","year":"2012","journal-title":"Depress Anxiety"},{"key":"pone.0346995.ref004","first-page":"100440","article-title":"Barriers and enablers to help-seeking behaviour for mental health reasons among community dwelling older adults with anxiety: Mixed-methods systematic review","volume":"10","author":"R Alkholy","year":"2022","journal-title":"J Affect Disord Rep"},{"issue":"12","key":"pone.0346995.ref005","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1097\/JGP.0b013e31818cd3be","article-title":"Older adults\u2019 help-seeking attitudes and treatment beliefs concerning mental health problems","volume":"16","author":"CS Mackenzie","year":"2008","journal-title":"Am J Geriatr Psychiatry"},{"key":"pone.0346995.ref006","volume-title":"Mental health and wellbeing in England: Adult Psychiatric Morbidity Survey 2014","author":"S McManus","year":"2016"},{"issue":"4","key":"pone.0346995.ref007","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1080\/08870449808407425","article-title":"Self-regulation, health, and behavior: A perceptual-cognitive approach","volume":"13","author":"H Leventhal","year":"1998","journal-title":"Psychol Health"},{"key":"pone.0346995.ref008","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1007\/978-1-4419-1005-9_1220","article-title":"Common-sense model of self-regulation.","volume-title":"Encyclopedia of Behavioral Medicine","author":"PA Mora","year":"2013"},{"issue":"3","key":"pone.0346995.ref009","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1080\/17437199.2021.1878050","article-title":"The common sense model of illness self-regulation: A conceptual review and proposed extended model","volume":"16","author":"MS Hagger","year":"2022","journal-title":"Health Psychol Rev"},{"key":"pone.0346995.ref010","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/978-0-387-09488-5_11","article-title":"Lay representations of illness and treatment: A framework for action.","volume-title":"Handbook of behavioral medicine: Methods and applications","author":"H Leventhal","year":"2010"},{"issue":"3","key":"pone.0346995.ref011","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1378\/chest.129.3.573","article-title":"No symptoms, no asthma: the acute episodic disease belief is associated with poor self-management among inner-city adults with persistent asthma","volume":"129","author":"EA Halm","year":"2006","journal-title":"Chest"},{"issue":"4","key":"pone.0346995.ref012","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1080\/17437199.2019.1644189","article-title":"Introduction to the special issue on the common sense model of self-regulation","volume":"13","author":"Y Benyamini","year":"2019","journal-title":"Health Psychol Rev"},{"key":"pone.0346995.ref013","article-title":"Older adults\u2019 beliefs about anxiety: A multicultural qualitative study informed by Leventhal\u2019s Common-Sense Model of Self-Regulation","author":"R Alkholy","year":"2026","journal-title":"medRxiv"},{"key":"pone.0346995.ref014","first-page":"22","article-title":"Cultural variations in the clinical presentation of depression and anxiety: Implications for diagnosis and treatment","author":"LJ Kirmayer","year":"2001","journal-title":"J Clin Psychiatry"},{"issue":"2","key":"pone.0346995.ref015","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/088704403100081321","article-title":"A meta-analytic review of the common-sense model of illness representations","volume":"18","author":"MS Hagger","year":"2003","journal-title":"Psychol Health"},{"issue":"11","key":"pone.0346995.ref016","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1037\/bul0000118","article-title":"The common sense model of self-regulation: Meta-analysis and test of a process model","volume":"143","author":"MS Hagger","year":"2017","journal-title":"Psychol Bull"},{"issue":"6","key":"pone.0346995.ref017","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.jpsychores.2015.10.006","article-title":"Illness perceptions and coping in physical health conditions: A meta-analysis","volume":"79","author":"M Dempster","year":"2015","journal-title":"J Psychosom Res"},{"key":"pone.0346995.ref018","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.3389\/fpsyg.2020.01167","article-title":"Relationship between illness representations, psychosocial adjustment, and treatment outcomes in mental disorders: A mini review","volume":"11","author":"P Averous","year":"2020","journal-title":"Front Psychol"},{"issue":"4","key":"pone.0346995.ref019","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1002\/cpp.2721","article-title":"The common-sense model and mental illness outcomes: A meta-analysis","volume":"29","author":"M Cannon","year":"2022","journal-title":"Clin Psychol Psychother"},{"issue":"3","key":"pone.0346995.ref020","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s10880-012-9337-9","article-title":"A systematic review of the literature exploring illness perceptions in mental health utilising the self-regulation model","volume":"20","author":"T Baines","year":"2013","journal-title":"J Clin Psychol Med Settings"},{"key":"pone.0346995.ref021","first-page":"100099","article-title":"Illness representations in depression and their association with clinical and treatment outcomes: A systematic review of the literature","volume":"4","author":"G Mavroeides","year":"2021","journal-title":"J Affect Disord Rep"},{"issue":"1","key":"pone.0346995.ref022","first-page":"123","article-title":"Characteristics and correlates of caregivers\u2019 perceptions of their family members\u2019 memory loss","volume":"22","author":"H Yu","year":"2023","journal-title":"Alzheimers Dement"},{"issue":"4","key":"pone.0346995.ref023","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1111\/papt.12345","article-title":"Understanding the illness representations of young people with anxiety and depression: A qualitative study","volume":"94","author":"HA Bear","year":"2021","journal-title":"Psychol Psychother"},{"issue":"2","key":"pone.0346995.ref024","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0263232","article-title":"Children and young people\u2019s beliefs about mental health and illness in Indonesia: A qualitative study informed by the Common Sense Model of Self-Regulation","volume":"17","author":"H Brooks","year":"2022","journal-title":"PLoS One"},{"key":"pone.0346995.ref025","volume-title":"The influence of illness representations on help-seeking and coping for anxiety among older adults: A multicultural qualitative study","author":"R Alkholy","year":"2025"},{"key":"pone.0346995.ref026","doi-asserted-by":"crossref","first-page":"173","DOI":"10.4324\/9780203413081_chapter_9","article-title":"Qualitative data analysis for applied policy research.","volume-title":"Analyzing qualitative data","author":"J Ritchie","year":"1994"},{"issue":"7","key":"pone.0346995.ref027","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1016\/j.janxdis.2010.05.002","article-title":"Development and initial validation of a self-report assessment tool for anxiety among older adults: The Geriatric Anxiety Scale","volume":"24","author":"DL Segal","year":"2010","journal-title":"J Anxiety Disord"},{"key":"pone.0346995.ref028","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1300\/J018v05n01_09","article-title":"Geriatric depression scale (GDS): Recent evidence and development of a shorter version","volume":"5","author":"JA Yesavage","year":"1986","journal-title":"Clin Gerontol"},{"key":"pone.0346995.ref029","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1471-244X-7-57","article-title":"Depression in the elderly: Does family system play a role? A cross-sectional study","volume":"7","author":"AM Taqui","year":"2007","journal-title":"BMC Psychiatry"},{"issue":"2","key":"pone.0346995.ref030","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.ajp.2009.04.005","article-title":"Applicability of 15-item Geriatric Depression Scale to detect depression in elderly medical outpatients","volume":"2","author":"O Prakash","year":"2009","journal-title":"Asian J Psychiatr"},{"issue":"2","key":"pone.0346995.ref031","doi-asserted-by":"crossref","first-page":"109","DOI":"10.4103\/ijph.IJPH_162_19","article-title":"Psychometric validation of geriatric depression scale - Short form among bengali-speaking elderly from a rural area of West Bengal: Application of item response theory","volume":"64","author":"A Lahiri","year":"2020","journal-title":"Indian J Public Health"},{"key":"pone.0346995.ref032","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"NK Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"issue":"8","key":"pone.0346995.ref033","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1016\/j.janxdis.2014.08.001","article-title":"Measuring anxiety in late life: A psychometric examination of the geriatric anxiety inventory and geriatric anxiety scale","volume":"28","author":"CE Gould","year":"2014","journal-title":"J Anxiety Disord"},{"issue":"1","key":"pone.0346995.ref034","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.socscimed.2004.11.063","article-title":"Resisting medicines: A synthesis of qualitative studies of medicine taking","volume":"61","author":"P Pound","year":"2005","journal-title":"Soc Sci Med"},{"issue":"6","key":"pone.0346995.ref035","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1080\/01634372.2013.811144","article-title":"Depression in older adults: A meta-synthesis","volume":"56","author":"J Corcoran","year":"2013","journal-title":"J Gerontol Soc Work"},{"issue":"1","key":"pone.0346995.ref036","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/nhs.12071","article-title":"Surviving depressive ill-health: A qualitative systematic review of older persons\u2019 narratives","volume":"16","author":"AL Holm","year":"2014","journal-title":"Nurs Health Sci"},{"issue":"12","key":"pone.0346995.ref037","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0264603","article-title":"Self-management of depression and anxiety amongst frail older adults in the United Kingdom: A qualitative study","volume":"17","author":"P Nair","year":"2022","journal-title":"PLoS One"},{"issue":"5","key":"pone.0346995.ref038","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1080\/01612840.2021.1998263","article-title":"Self-identity and meaning in life as enablers for older adults to self-manage depression","volume":"43","author":"M Polacsek","year":"2022","journal-title":"Issues Ment Health Nurs"},{"issue":"1","key":"pone.0346995.ref039","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1186\/s12888-020-02559-3","article-title":"An exploration of the conditions for deploying self-management strategies: A qualitative study of experiential knowledge in depression","volume":"20","author":"D Smit","year":"2020","journal-title":"BMC Psychiatry"},{"issue":"7","key":"pone.0346995.ref040","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1080\/13607863.2020.1729337","article-title":"Managing loneliness: A qualitative study of older people\u2019s views","volume":"25","author":"K Kharicha","year":"2021","journal-title":"Aging Ment Health"},{"key":"pone.0346995.ref041","first-page":"261","article-title":"The psychology of self-affirmation: Sustaining the integrity of the self.","volume-title":"Advances in experimental social psychology","author":"CM Steele","year":"1988"},{"issue":"4","key":"pone.0346995.ref042","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1606\/1044-3894.3921","article-title":"Power, pathological worldviews, and the strengths perspective in social work","volume":"90","author":"JG Grant","year":"2009","journal-title":"Fam Soc"},{"key":"pone.0346995.ref043","volume-title":"Social prescribing and community-based support","author":"NHS England","year":"2020"},{"key":"pone.0346995.ref044","first-page":"103","article-title":"Self-identity benefits of leisure activities.","volume-title":"Benefits of leisure","author":"L Haggard","year":"1991"},{"key":"pone.0346995.ref045","doi-asserted-by":"crossref","DOI":"10.4324\/9781315648569","volume-title":"The new psychology of health: Unlocking the social cure","author":"C Haslam","year":"2018"},{"key":"pone.0346995.ref046","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s10464-007-9100-9","article-title":"The relationship between self-reported received and perceived social support: A meta-analytic review","volume":"39","author":"MG Haber","year":"2007","journal-title":"Am J Community Psychol"},{"issue":"7","key":"pone.0346995.ref047","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.socscimed.2011.11.023","article-title":"Psychological pathways linking social support to health outcomes: a visit with the \u201cghosts\u201d of research past, present, and future","volume":"74","author":"BN Uchino","year":"2012","journal-title":"Soc Sci Med"},{"key":"pone.0346995.ref048","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1017\/CBO9780511984945.014","article-title":"Social support and mental health.","volume-title":"A handbook for the study of mental health: Social contexts, theories, and systems","author":"RJ Turner","year":"2009","edition":"2"},{"issue":"9","key":"pone.0346995.ref049","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1017\/S003329171200284X","article-title":"Common mental disorder diagnosis and need for treatment are not the same: Findings from a population-based longitudinal survey","volume":"43","author":"J Sareen","year":"2013","journal-title":"Psychol Med"},{"key":"pone.0346995.ref050","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1186\/1471-2288-6-35","article-title":"Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups","volume":"6","author":"M Dixon-Woods","year":"2006","journal-title":"BMC Med Res Methodol"},{"key":"pone.0346995.ref051","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.socscimed.2016.08.022","article-title":"Illness identity as an important component of candidacy: Contrasting experiences of help-seeking and access to care in cancer and heart disease","volume":"168","author":"S Macdonald","year":"2016","journal-title":"Soc Sci Med"},{"issue":"5","key":"pone.0346995.ref052","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1177\/07334648211067710","article-title":"Help-seeking behaviors among older adults: A scoping review","volume":"41","author":"K Teo","year":"2022","journal-title":"J Appl Gerontol"},{"issue":"1","key":"pone.0346995.ref053","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1027\/1016-9040\/a000353","article-title":"Supporting adherence to medicines for long-term conditions: A perceptions and practicalities approach based on an extended common-sense model","volume":"24","author":"R Horne","year":"2019","journal-title":"Eur Psychol"},{"issue":"12","key":"pone.0346995.ref054","doi-asserted-by":"crossref","first-page":"1977","DOI":"10.1080\/13607863.2019.1647132","article-title":"Supporting frail older people with depression and anxiety: A qualitative study","volume":"24","author":"R Frost","year":"2020","journal-title":"Aging Ment Health"},{"issue":"1","key":"pone.0346995.ref055","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12910-017-0179-8","article-title":"Implicit bias in healthcare professionals: A systematic review","volume":"18","author":"C FitzGerald","year":"2017","journal-title":"BMC Med Ethics"},{"issue":"11","key":"pone.0346995.ref056","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1007\/s11606-013-2441-1","article-title":"Physicians and implicit bias: How doctors may unwittingly perpetuate health care disparities","volume":"28","author":"EN Chapman","year":"2013","journal-title":"J Gen Intern Med"},{"issue":"2","key":"pone.0346995.ref057","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1353\/hpu.2010.0233","article-title":"Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education","volume":"9","author":"M Tervalon","year":"1998","journal-title":"J Health Care Poor Underserved"},{"key":"pone.0346995.ref058","first-page":"42","article-title":"The Common-Sense Model of Self-Regulation of health and illness.","volume-title":"The self-regulation of health and illness behaviour","author":"H Leventhal","year":"2003"},{"issue":"1","key":"pone.0346995.ref059","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1037\/0033-2909.92.1.111","article-title":"Control theory: A useful conceptual framework for personality\u2013social, clinical, and health psychology","volume":"92","author":"CS Carver","year":"1982","journal-title":"Psychol Bull"},{"key":"pone.0346995.ref060","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/B978-012109890-2\/50040-8","article-title":"Self-regulation and health behavior: The Health Behavior Goal Model.","volume-title":"Handbook of self-regulation","author":"S Maes","year":"2000"},{"key":"pone.0346995.ref061","first-page":"335","article-title":"Toward a conception of culture suitable for a social psychology of culture.","volume-title":"The psychological foundations of culture","author":"G Adams","year":"2004"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346995","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:29:07Z","timestamp":1791480547000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346995"}},"subtitle":[],"editor":[{"given":"Wejdan","family":"Shahin","sequence":"first","affiliation":[{"name":"RMIT University","place":["AUSTRALIA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,8]]},"references-count":61,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0346995","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,8]]}}}