{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T04:31:09Z","timestamp":1780720269619,"version":"3.54.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Telehealth offers several advantages over traditional in-person clinic visits. Despite its potential benefits, some barriers affect the optimal use of telehealth. Understanding healthcare practitioners' (HCPs) acceptance of telehealth is essential to ensure the successful, high-quality, and safe implementation of telehealth programs. However, a comprehensive, theory-driven understanding of the factors influencing HCPs' acceptance of telehealth in the Kingdom of Saudi Arabia (KSA) is lacking, hindering the development of effective implementation strategies. Therefore, this study aimed to measure telehealth acceptance among HCPs in the KSA and to identify the key predictors of their intention to use it, with a specific focus on constructs derived from the Unified Theory of Acceptance and Use of Technology (UTAUT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted from June 2024 to January 2025. HCPs working in the KSA were included. The survey was grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT) and consisted of four constructs: performance expectancy (PE), effort expectancy (EE), social influence (SI), and facilitating conditions (FC). In addition to behavioral intention (BI) as the dependent variable. The data analysis included performing descriptive analysis for the sociodemographic variables and multivariate logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,051 HCPs completed the survey. The analysis indicated that 97.8% of respondents expressed a positive intention to use telehealth in the future. Performance expectancy (PE) emerged as a significant predictor of the intention to use telehealth [adjusted odds ratio (AOR)\u2009=\u20094.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05], as did social influence (SI) (AOR\u2009=\u200919.25.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01). Furthermore, employment in military or private hospitals was associated with a significantly lower likelihood of intending to use telehealth (AOR\u2009=\u20090.05,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05 and AOR\u2009=\u20090.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study represents the first large-scale, theory-driven investigation of telehealth acceptance among healthcare practitioners (HCPs) across all regions of the KSA. The findings underscore the critical role of performance expectancy (PE) and social influence (SI) as significant predictors of HCPs' intention to adopt telehealth services. These insights provide valuable direction for policymakers and healthcare leaders, emphasizing the importance of fostering supportive professional environments and highlighting perceived benefits to enhance telehealth adoption. To address concerns related to effort expectancy and the facilitating conditions, telehealth developers should prioritize user-friendly designs and provide accessible and responsive IT support for users.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2025.1659997","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T07:12:49Z","timestamp":1762240369000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Healthcare practitioners' acceptance of using telehealth in the Kingdom of Saudi Arabia: an application of the unified theory of acceptance and use of technology model"],"prefix":"10.3389","volume":"7","author":[{"given":"Abdullah A.","family":"AlMojaibel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulelah","family":"Aldhahir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Aldilaijan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayyan","family":"Almusally","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marah","family":"AlAtrash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Alkhofi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed M.","family":"Alghamdi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yousef","family":"Alqurashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Alsubaiei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"AlHarkan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jithin K.","family":"Sreedharan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoug","family":"Al Humoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"B1","article-title":"Telehealth in primary health care: a scoping review of the literature","volume":"19","author":"Beheshti","year":"2022","journal-title":"Perspect Health Inf Manag"},{"key":"B2","doi-asserted-by":"publisher","first-page":"101936","DOI":"10.1016\/j.eclinm.2023.101936","article-title":"Global burden of chronic respiratory diseases and risk factors, 1990\u20132019: an update from the global burden of disease study 2019","volume":"59","author":"Momtazmanesh","year":"2023","journal-title":"EClinicalMedicine"},{"key":"B3","volume-title":"Global Status Report on Noncommunicable Diseases 2010","year":"2011"},{"key":"B4","doi-asserted-by":"publisher","first-page":"E106","DOI":"10.5888\/pcd17.200130","article-title":"Prevalence of multiple chronic conditions among US adults, 2018","volume":"17","author":"Boersma","year":"2020","journal-title":"Prev Chronic Dis"},{"key":"B5","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1097\/01.NAJ.0000520244.60138.1c","article-title":"Telemedicine and telehealth: the potential to improve rural access to care","volume":"117","author":"Nelson","year":"2017","journal-title":"AJN Am J Nurs"},{"key":"B6","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/S0140-6736(12)60240-2","article-title":"Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study","volume":"380","author":"Barnett","year":"2012","journal-title":"Lancet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e065478","DOI":"10.1136\/bmjopen-2022-065478","article-title":"Telehealth use in Australian primary healthcare during COVID-19: a cross-sectional descriptive survey","volume":"13","author":"Halcomb","year":"2023","journal-title":"BMJ Open"},{"key":"B8","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1111\/ijpp.12340","article-title":"Telehealth: misconceptions and experiences of healthcare professionals in England","volume":"25","author":"Kayyali","year":"2017","journal-title":"Int J Pharm Pract"},{"key":"B9","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.ijmedinf.2016.03.002","article-title":"Analyzing older users\u2019 home telehealth services acceptance behavior\u2014applying an extended UTAUT model","volume":"90","author":"Cimperman","year":"2016","journal-title":"Int J Med Inform"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1186\/s12913-022-08837-y","article-title":"Specialized healthcare practitioners\u2019 challenges in performing video consultations to patients in Nordic countries\u2013a systematic review and narrative synthesis","volume":"22","author":"Baluszek","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"B11","first-page":"35","article-title":"Direct-to-patient telehealth: opportunities and challenges","volume":"103","author":"Diaz","year":"2020","journal-title":"R I Med J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1975","DOI":"10.1377\/hlthaff.2018.05132","article-title":"The current state of telehealth evidence: a rapid review","volume":"37","author":"Shigekawa","year":"2018","journal-title":"Health Aff"},{"key":"B13","doi-asserted-by":"publisher","first-page":"240","DOI":"10.4081\/monaldi.2020.1528","article-title":"Telemedicine during COVID-19: a survey of health care professionals\u00e2\u20ac\u2122 perceptions","volume":"90","author":"Elawady","year":"2020","journal-title":"Monaldi Arch Chest Dis"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e17298","DOI":"10.2196\/17298","article-title":"Determining if telehealth can reduce health system costs: scoping review","volume":"22","author":"Snoswell","year":"2020","journal-title":"J Med Internet Res"},{"key":"B15","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1111\/ajr.12869","article-title":"Benefits of and barriers to telehealth for the informal caregivers of elderly individuals in rural areas: a scoping review","volume":"30","author":"Lyu","year":"2022","journal-title":"Aust J Rural Health"},{"key":"B16","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1097\/CCM.0000000000002994","article-title":"Impact of telemedicine on mortality, length of stay, and cost among patients in progressive care units: experience from a large healthcare system","volume":"46","author":"Armaignac","year":"2018","journal-title":"Crit Care Med"},{"key":"B17","doi-asserted-by":"publisher","first-page":"43","DOI":"10.5195\/ijt.2020.6308","article-title":"Health care practitioners\u2019 determinants of telerehabilitation acceptance","volume":"12","author":"Almojaibel","year":"2020","journal-title":"Int J Telerehabil"},{"key":"B18","doi-asserted-by":"publisher","first-page":"102451","DOI":"10.1016\/j.ajp.2020.102451","article-title":"Acceptance of e-consult for substance use disorders during the COVID 19 pandemic: a study from India","volume":"54","author":"Sahu","year":"2020","journal-title":"Asian J Psychiatr"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.1186\/s12913-022-08802-9","article-title":"Digital technologies in routine palliative care delivery: an exploratory qualitative study with health care professionals in Germany","volume":"22","author":"May","year":"2022","journal-title":"BMC Health Serv Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"e42847","DOI":"10.2196\/42847","article-title":"Ten years of experience with a telemedicine platform dedicated to health care personnel: implementation report","volume":"12","author":"Azzolini","year":"2024","journal-title":"JMIR Med Inform"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e0250220","DOI":"10.1371\/journal.pone.0250220","article-title":"Healthcare providers\u2019 acceptance of telemedicine and preference of modalities during COVID-19 pandemics in a low-resource setting: an extended UTAUT model","volume":"16","author":"Shiferaw","year":"2021","journal-title":"PLoS One"},{"key":"B22","doi-asserted-by":"publisher","first-page":"16676","DOI":"10.3390\/ijerph192416676","article-title":"Perception of healthcare providers during the COVID-19 pandemic: a mixed method survey in an integrated healthcare delivery system in Saudi Arabia","volume":"19","author":"Alamri","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1866","DOI":"10.1177\/1460458219892162","article-title":"Predictive factors of physicians\u2019 satisfaction with telemedicine services acceptance","volume":"26","author":"Kissi","year":"2020","journal-title":"Health Informatics J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-023-10244-w","article-title":"Exploring healthcare providers\u2019 perspectives on virtual care delivery: insights into telemedicine services","volume":"24","author":"Abdelghany","year":"2024","journal-title":"BMC Health Serv Res"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.12816\/0039678","article-title":"Telemedicine: between reality and challenges in Jeddah hospitals","volume":"68","author":"Althbiti","year":"2017","journal-title":"Egypt J Hosp Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"e19338","DOI":"10.2196\/19338","article-title":"Digital response during the COVID-19 pandemic in Saudi Arabia","volume":"22","author":"Hassounah","year":"2020","journal-title":"J Med Internet Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"10617","DOI":"10.3390\/ijerph182010617","article-title":"Perspectives on telemedicine during the era of COVID-19; what can Saudi Arabia do?","volume":"18","author":"Al-Hazmi","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B28","doi-asserted-by":"publisher","first-page":"208","DOI":"10.4103\/jfcm.JFCM_295_20","article-title":"Current status of telehealth in Saudi Arabia during COVID-19","volume":"27","author":"Alghamdi","year":"2020","journal-title":"J Family Community Med"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1128","DOI":"10.1186\/s12913-023-10032-6","article-title":"Examining supporting and constraining factors of physicians\u2019 acceptance of telemedical online consultations: a survey study","volume":"23","author":"Diel","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.3390\/healthcare12131267","article-title":"Exploring telemedicine usage intention using technology acceptance model and social capital theory","volume":"12","author":"Kung","year":"2024","journal-title":"Healthcare"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.47391\/JPMA.8263","article-title":"Awareness, practices, attitudes, and barriers of telehealth in Saudi Arabia","volume":"73","author":"Alharbi","year":"2023","journal-title":"J Pak Med Assoc"},{"key":"B32","doi-asserted-by":"publisher","first-page":"110","DOI":"10.15537\/smj.2021.1.25610","article-title":"Advantages and disadvantages of telemedicine during the COVID-19 pandemic era among physicians in Taif, Saudi Arabia","volume":"42","author":"Mubaraki","year":"2021","journal-title":"Saudi Med J"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e47065","DOI":"10.2196\/47065","article-title":"The perception of health care practitioners regarding telemedicine during COVID-19 in Saudi Arabia: mixed methods study","volume":"7","author":"Alqurashi","year":"2023","journal-title":"JMIR Form Res"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1426998","DOI":"10.3389\/fpsyt.2025.1426998","article-title":"Assessment of awareness, practices, perceptions, and satisfaction of telepsychiatry among mental healthcare providers in Saudi Arabia","volume":"16","author":"Alshaikhi","year":"2025","journal-title":"Front Psychiatry"},{"key":"B35","doi-asserted-by":"publisher","first-page":"S131","DOI":"10.1016\/j.annemergmed.2004.07.420","article-title":"Measuring the effect of a computerized nursing documentation system with objective measures and reported perceptions","volume":"44","author":"Asaro","year":"2004","journal-title":"Ann Emerg Med"},{"key":"B36","doi-asserted-by":"publisher","first-page":"682","DOI":"10.1177\/10497323145288","article-title":"Clinician acceptance is the key factor for sustainable telehealth services","volume":"24","author":"Wade","year":"2014","journal-title":"Qual Health Res"},{"key":"B37","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1111\/jan.12196","article-title":"Factors affecting front line staff acceptance of telehealth technologies: a mixed-method systematic review","volume":"70","author":"Brewster","year":"2014","journal-title":"J Adv Nurs"},{"key":"B38","volume-title":"Health Behavior and Health Education: Theory, Research, and Practice","author":"Glanz","year":"2008"},{"key":"B39","volume-title":"Introduction to Health Behavior Theory","author":"Hayden","year":"2009"},{"key":"B40","doi-asserted-by":"publisher","first-page":"319","DOI":"10.2307\/249008","article-title":"Perceived usefulness, perceived ease of use, and user acceptance of information technology","volume":"13","author":"Davis","year":"1989","journal-title":"MIS Q"},{"key":"B41","doi-asserted-by":"publisher","first-page":"425","DOI":"10.2307\/30036540","article-title":"User acceptance of information technology: toward a unified view","volume":"27","author":"Venkatesh","year":"2003","journal-title":"MIS Q"},{"key":"B42","doi-asserted-by":"publisher","first-page":"15643","DOI":"10.3390\/ijerph192315643","article-title":"What determines the acceptance and use of eHealth by older adults in Poland?","volume":"19","author":"R\u00f3j","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B43","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1002\/jclp.23289","article-title":"The development of a self-report scale to assess therapists\u2019 acceptance of telepsychotherapy","volume":"78","author":"B\u00e9k\u00e9s","year":"2022","journal-title":"J Clin Psychol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"15156","DOI":"10.3390\/ijerph192215156","article-title":"Social acceptance of mobile health among young adults in Japan: an extension of the UTAUT model","volume":"19","author":"Cao","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"B45","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1016\/j.jiph.2016.09.001","article-title":"Barriers and challenges in adopting Saudi telemedicine network: the perceptions of decision makers of healthcare facilities in Saudi Arabia","volume":"9","author":"Alaboudi","year":"2016","journal-title":"J Infect Public Health"},{"key":"B46","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1186\/s12877-024-05361-y","article-title":"Effect of older adults willingness on telemedicine usage: an integrated approach based on technology acceptance and decomposed theory of planned behavior model","volume":"24","author":"Li","year":"2024","journal-title":"BMC Geriatr"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.55533\/2996-6833.1100","article-title":"Advancing telemedicine adoption: insights from health behavior models with a focus on the multi-theory model","volume":"5","author":"Islam","year":"2025","journal-title":"J Public Health Deep South"},{"key":"B48","doi-asserted-by":"publisher","first-page":"103346","DOI":"10.1016\/j.jretconser.2023.103346","article-title":"The determinants of users\u2019 intention to adopt telehealth: health belief, perceived value and self-determination perspectives","volume":"73","author":"Yuen","year":"2023","journal-title":"J Retail Consum Serv"},{"key":"B49","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1166\/jmihi.2014.1278","article-title":"The adoption of a telehealth system: the integration of extended technology acceptance model and health belief model","volume":"4","author":"Tsai","year":"2014","journal-title":"J Med Imaging Health Inform"},{"key":"B50","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1080\/10371656.2023.2270852","article-title":"Applying diffusion of innovation theory to examine providers\u2019 perceptions of rural telehealth application and competencies","volume":"32","author":"Yarbrough","year":"2023","journal-title":"Rural Soc"},{"key":"B51","doi-asserted-by":"publisher","first-page":"1325031","DOI":"10.3389\/fpubh.2023.1325031","article-title":"The determinants of public acceptance of telemedicine apps: an innovation diffusion perspective","volume":"11","author":"Liu","year":"2023","journal-title":"Front Public Health"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1177\/20552076241257050","article-title":"Factors influencing telemedicine adoption among physicians in the Malaysian healthcare system: a revisit","volume":"10","author":"Tan","year":"2024","journal-title":"Digit Health"},{"key":"B53","doi-asserted-by":"publisher","first-page":"e25435","DOI":"10.2196\/25435","article-title":"Using an extended technology acceptance model to understand the factors influencing telehealth utilization after flattening the COVID-19 curve in South Korea: cross-sectional survey study","volume":"9","author":"An","year":"2021","journal-title":"JMIR Med Inform"},{"key":"B54","doi-asserted-by":"publisher","first-page":"230","DOI":"10.4103\/sjmms.sjmms_10_21","article-title":"Determinants of telerehabilitation acceptance among patients attending pulmonary rehabilitation programs in the United States","volume":"9","author":"Almojaibel","year":"2021","journal-title":"Saudi J Med Med Sci"},{"key":"B55","doi-asserted-by":"publisher","first-page":"236","DOI":"10.4103\/sjmms.sjmms_358_23","article-title":"Development and validation of the Saudi telehealth acceptance scale based on the unified theory of acceptance and use of technology","volume":"12","author":"Almojaibel","year":"2024","journal-title":"Saudi J Med Med Sci"},{"key":"B56","first-page":"952","volume-title":"Discovering Statistics Using IBM SPSS Statistics","author":"Field","year":"2013"},{"key":"B57","doi-asserted-by":"publisher","first-page":"1527","DOI":"10.3390\/healthcare10081527","article-title":"Healthcare providers\u2019 perception and barriers concerning the use of telehealth applications in Saudi Arabia: a cross-sectional study","volume":"10","author":"Alghamdi","year":"2022","journal-title":"Healthcare"},{"key":"B58","doi-asserted-by":"publisher","first-page":"e27020","DOI":"10.1016\/j.heliyon.2024.e27067","article-title":"Social influence, performance expectancy, and price value as determinants of telemedicine services acceptance in Chile","volume":"10","author":"Vidal-Silva","year":"2024","journal-title":"Heliyon"},{"key":"B59","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1472-6947-13-129","article-title":"Healthcare professionals\u2019 acceptance of BelRAI, a web-based system enabling person-centred recording and data sharing across care settings with interRAI instruments: a UTAUT analysis","volume":"13","author":"Vanneste","year":"2013","journal-title":"BMC Med Inform Decis Mak"},{"key":"B60","doi-asserted-by":"publisher","first-page":"2949","DOI":"10.2147\/JMDH.S467172","article-title":"Healthcare providers\u2019 experience with Saudi Arabia\u2019s 937 virtual medical call centers and telehealth","volume":"17","author":"Al-Wathinani","year":"2024","journal-title":"J Multidiscip Healthc"}],"container-title":["Frontiers in Digital Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2025.1659997\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T07:12:52Z","timestamp":1762240372000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fdgth.2025.1659997\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":60,"alternative-id":["10.3389\/fdgth.2025.1659997"],"URL":"https:\/\/doi.org\/10.3389\/fdgth.2025.1659997","relation":{},"ISSN":["2673-253X"],"issn-type":[{"value":"2673-253X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"article-number":"1659997"}}