{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:49:31Z","timestamp":1782107371269,"version":"3.54.5"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"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. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite strong evidence for cognitive behavioral therapy for insomnia (CBT-I), uptake remains constrained by poorly understood cognitive, attitudinal, and practical barriers. This study examined determinants of willingness to enroll in sleep improvement programs among adults at risk of sleep disorders\u2014including insomnia, obstructive sleep apnea, and comorbid psychological distress\u2014attending a tertiary sleep clinic in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional knowledge-attitudes-practices survey was conducted among 2,661 adults attending the sleep and behavioral medicine outpatient clinic at Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, Jiangxi, China, between February 2022 and June 2025. Willingness to enroll in a structured sleep improvement program was assessed alongside sleep health knowledge, perceived need, CBT-I versus medication effectiveness beliefs, telehealth acceptability, clinical severity (Insomnia Severity Index, Epworth Sleepiness Scale, STOP-Bang), psychological symptoms (PHQ-2, GAD-2), perceived barriers, and sociodemographic characteristics. Multivariable logistic regression identified independent predictors of willingness to enrollment, with secondary analyses evaluating model discrimination and testing prespecified interactions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2,661 participants (median age 45 years, 56.5% female, median ISI\u00a0=\u00a013), 1,386 (52.1%) expressed willingness to enroll. Univariable comparisons showed no significant differences between willing and not-willing groups across demographics, clinical characteristics, or barriers (all p&amp;gt;0.05). However, multivariable modeling revealed that when considered simultaneously, cognitive-attitudinal factors emerged as significant independent predictors, suggesting complex interactions rather than simple bivariate associations. In multivariable models, perceived need (OR\u00a0=\u00a01.20, 95% CI: 1.16\u20131.25, p&amp;lt;0.001), beliefs that CBT-I is more effective and durable than sleep medication (OR\u00a0=\u00a01.12, 95% CI: 1.08\u20131.16, p&amp;lt;0.001), sleep health and treatment knowledge (assessed by a six-item knowledge score) (OR\u00a0=\u00a01.09, 95% CI: 1.05\u20131.13, p&amp;lt;0.001), and anxiety symptoms (OR\u00a0=\u00a01.07, p=0.005) positively predicted willingness. Paradoxically, depression symptoms (OR\u00a0=\u00a00.94, p&amp;lt;0.001) and insomnia severity (OR\u00a0=\u00a00.93, p&amp;lt;0.001) inversely predicted willingness. Model discrimination was modest (AUC\u00a0=\u00a00.543, 95% CI: 0.504\u20130.590). Time (mean 3.54) and cost (3.44) were most severe barriers but showed no independent association with willingness (p&amp;gt;0.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cognitive-attitudinal factors (perceived need, CBT-I beliefs, knowledge) independently predicted enrollment willingness, whereas demographics and practical barriers did not. Depression and insomnia severity paradoxically reduced willingness, creating an inverse care law. However, poor model discrimination and measurement of stated willingness rather than actual enrollment limit conclusions. Prospective validation and motivational enhancement strategies for patients with depression are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1804213","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:39:58Z","timestamp":1782106798000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive-attitudinal factors predict CBT-I enrollment willingness in Chinese sleep clinic patients: a knowledge-attitudes-practices survey"],"prefix":"10.3389","volume":"17","author":[{"given":"Chenglin","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Ganzhou Hospital-Nanfang Hospital, Southern Medical University (Ganzhou People\u2019s Hospital)","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanping","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Ganzhou Hospital-Nanfang Hospital, Southern Medical University (Ganzhou People\u2019s Hospital)","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Ganzhou Hospital-Nanfang Hospital, Southern Medical University (Ganzhou People\u2019s Hospital)","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingzhong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Ganzhou Hospital-Nanfang Hospital, Southern Medical University (Ganzhou People\u2019s Hospital)","place":["Ganzhou, Jiangxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9476","article-title":"Sleep is essential to health: an American Academy of Sleep Medicine position statement","volume":"17","author":"Ramar","year":"2021","journal-title":"J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7230","article-title":"Use of actigraphy for the evaluation of sleep disorders and circadian rhythm sleep-wake disorders: an American Academy of Sleep Medicine clinical practice guideline","volume":"14","author":"Smith","year":"2018","journal-title":"J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.4758","article-title":"Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society","volume":"11","author":"Watson","year":"2015","journal-title":"J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10898","article-title":"Permanent standard time is the optimal choice for health and safety: an American Academy of Sleep Medicine position statement","volume":"20","author":"Rishi","year":"2024","journal-title":"J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101556","article-title":"Improving sleep quality leads to better mental health: a meta-analysis of randomised controlled trials","volume":"60","author":"Scott","year":"2021","journal-title":"Sleep Med Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.smrv.2018.10.006","article-title":"Insomnia as a predictor of mental disorders: a systematic review and meta-analysis","volume":"43","author":"Hertenstein","year":"2019","journal-title":"Sleep Med Rev"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/s41380-022-01638-z","article-title":"A systematic review and meta-analysis on prevalence of and risk factors associated with depression, anxiety and insomnia in infectious diseases, including COVID-19: a call to action","volume":"27","author":"Yuan","year":"2022","journal-title":"Mol Psychiatry"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/tbm\/ibae006","article-title":"Improve accessibility to evidence-based treatment for insomnia disorder","volume":"14","author":"Dietch","year":"2024","journal-title":"Trans Behav Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"101208","DOI":"10.1016\/j.smrv.2019.08.002","article-title":"Cognitive behavioral therapy for insomnia: a meta-analysis of long-term effects in controlled studies","volume":"48","author":"van der Zweerde","year":"2019","journal-title":"Sleep Med Rev"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.17759\/cpse.2022110208","article-title":"Cognitive behavioral therapy for insomnia (CBT-I): a primer","volume":"11","author":"Walker","year":"2022","journal-title":"Klinicheskaia i Spetsial'naia Psikhologiia = Clin Psychol Special Educ"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1395","DOI":"10.3390\/healthcare10081395","article-title":"Sleep disorders and mental stress of healthcare workers during the two first waves of COVID-19 pandemic: separate analysis for primary care","volume":"10","author":"Pataka","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1177\/1559827619867677","article-title":"Cognitive-behavioral therapy for insomnia: an effective and underutilized treatment for insomnia","volume":"13","author":"Rossman","year":"2019","journal-title":"Am J Lifestyle Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.4866","article-title":"Digital cognitive behavioral therapy for insomnia using a smartphone application in China: a pilot randomized clinical trial","volume":"6","author":"Zhang","year":"2023","journal-title":"JAMA Netw Open"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.13.04071","article-title":"Prevalence of sleep disturbances and associated factors among Chinese residents: a web-based empirical survey of 2019","volume":"13","author":"Wang","year":"2023","journal-title":"J Global Health"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-019-02371-x","article-title":"Sleep quality of Shanghai residents: population-based cross-sectional study","volume":"29","author":"Wu","year":"2020","journal-title":"Qual Life Res Int J Qual Life Aspects Treatment Care Rehabil"},{"key":"B16","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1001\/jamapsychiatry.2018.2745","article-title":"Effect of digital cognitive behavioral therapy for insomnia on health, psychological well-being, and sleep-related quality of life: a randomized clinical trial","volume":"76","author":"Espie","year":"2019","journal-title":"JAMA Psychiatry"},{"key":"B17","doi-asserted-by":"publisher","first-page":"11285","DOI":"10.3390\/ijerph182111285","article-title":"Age-related digital divide during the COVID-19 pandemic in China","volume":"18","author":"Song","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsac019","article-title":"Longitudinal associations between insomnia symptoms and all-cause mortality among middle-aged and older adults: a population-based cohort study","volume":"45","author":"Mahmood","year":"2022","journal-title":"Sleep"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab500","article-title":"Insomnia symptoms and incident heart failure: a population-based cohort study","volume":"42","author":"Mahmood","year":"2021","journal-title":"Eur Heart J"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2020.00442","article-title":"Barriers to professional mental health help-seeking among Chinese adults: a systematic review","volume":"11","author":"Shi","year":"2020","journal-title":"Front Psychiatry"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1177\/08404704221108314","article-title":"Progress towards enhanced access and use of technology during the COVID-19 pandemic: a need to be mindful of the continued digital divide for many rural and northern communities","volume":"35","author":"Freeman","year":"2022","journal-title":"Healthcare Manage Forum"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-083100","article-title":"Knowledge, attitude and practice towards insomnia and sleep hygiene among patients with chronic insomnia in Northwest China in 2023: a cross-sectional survey","volume":"14","author":"Zhu","year":"2024","journal-title":"BMJ Open"},{"key":"B23","doi-asserted-by":"publisher","first-page":"11663","DOI":"10.1038\/s41598-024-62502-4","article-title":"Knowledge, attitude, and practice toward sleep disorders and sleep hygiene among perimenopausal women","volume":"14","author":"Shi","year":"2024","journal-title":"Sci Rep"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.4088\/pcc.v09n0502","article-title":"Morbidity associated with sleep disorders in primary care: a longitudinal cohort study","volume":"9","author":"Wallander","year":"2007","journal-title":"Primary Care Companion to J Clin Psychiatry"},{"key":"B25","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1186\/s12888-021-03435-4","article-title":"Predictors of help-seeking behaviour in people with mental health problems: a 3-year prospective community study","volume":"21","author":"Doll","year":"2021","journal-title":"BMC Psychiatry"},{"key":"B26","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1186\/s12889-022-14937-5","article-title":"The Seeking Mental Health Care model: prediction of help-seeking for depressive symptoms by stigma and mental illness representations","volume":"23","author":"McLaren","year":"2023","journal-title":"BMC Public Health"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1186\/s12875-019-1070-0","article-title":"Clinician and patient barriers to the recognition of insomnia in family practice: a narrative summary of reported literature analysed using the theoretical domains framework","volume":"21","author":"Ogeil","year":"2020","journal-title":"BMC Family Pract"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4390-1","article-title":"Increasing access to and utilization of cognitive behavioral therapy for insomnia (CBT-I): a narrative review","volume":"33","author":"Koffel","year":"2018","journal-title":"J Gen Internal Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2020.110406","article-title":"Environmental exposures and sleep outcomes: a review of evidence, potential mechanisms, and implications","volume":"196","author":"Liu","year":"2021","journal-title":"Environ Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00332747.2021.1940470","article-title":"Perceived need for mental health treatment and the mental health response to the COVID-19 pandemic in the United States","volume":"85","author":"Breslau","year":"2022","journal-title":"Psychiatry"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-018-0863-0","article-title":"Perceived need for treatment and engagement in mental health services among community-referred racial\/ethnic minority adolescents","volume":"45","author":"Fisher","year":"2018","journal-title":"Administration Policy Ment Health"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2022.801231","article-title":"Predictors of professional help-seeking intention toward depression among community-dwelling populations: a structural equation modeling analysis","volume":"13","author":"Li","year":"2022","journal-title":"Front Psychiatry"},{"key":"B33","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1038\/s41746-023-00800-3","article-title":"Digital cognitive behavioral therapy for insomnia on depression and anxiety: a systematic review and meta-analysis","volume":"6","author":"Lee","year":"2023","journal-title":"NPJ Digital Med"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2020.08.020","article-title":"Efficacy of digital cognitive behavioural therapy for insomnia: a meta-analysis of randomised controlled trials","volume":"75","author":"Soh","year":"2020","journal-title":"Sleep Med"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2019.101230","article-title":"Changes in dysfunctional beliefs about sleep after cognitive behavioral therapy for insomnia: a systematic literature review and meta-analysis","volume":"49","author":"Thakral","year":"2020","journal-title":"Sleep Med Rev"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.4088\/PCC.08r00743bro","article-title":"Why treat insomnia","volume":"12","author":"Matteson-Rusby","year":"2010","journal-title":"Primary Care Companion to J Clin Psychiatry"},{"key":"B37","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1186\/s12875-024-02615-x","article-title":"Knowledge, attitude, and practice of chronic insomnia management among general practitioners in China: a cross-sectional survey","volume":"25","author":"An","year":"2024","journal-title":"BMC Primary Care"},{"key":"B38","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1007\/s11414-022-09796-2","article-title":"Predictors of mental health help-seeking during COVID-19: social support, emotion regulation, and mental health symptoms","volume":"50","author":"Tambling","year":"2023","journal-title":"J Behav Health Serv Res"},{"key":"B39","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1186\/s12888-022-03806-5","article-title":"Barriers and facilitators for treatment-seeking in adults with a depressive or anxiety disorder in a Western-European health care setting: a qualitative study","volume":"22","author":"Waumans","year":"2022","journal-title":"BMC Psychiatry"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1007\/s40614-021-00308-9","article-title":"A behavioral economic model of help-seeking for depression","volume":"44","author":"Trusty","year":"2021","journal-title":"Perspect Behav Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/s2213-2600(15)00141-1","article-title":"Identifying and managing sleep disorders in primary care","volume":"3","author":"Chai-Coetzer","year":"2015","journal-title":"Lancet Respir Med"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/34.5.601","article-title":"The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response","volume":"34","author":"Morin","year":"2011","journal-title":"Sleep"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2013.06.130064","article-title":"Validation of the Insomnia Severity Index in primary care","volume":"26","author":"Gagnon","year":"2013","journal-title":"J Am Board Family Med JABFM"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.6004\/jadpro.2018.9.7.4","article-title":"Cognitive behavioral therapy for sleep in cancer patients: research, techniques, and individual considerations","volume":"9","author":"Melton","year":"2018","journal-title":"J Advanced Practitioner Oncol"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/j.invent.2024.100781","article-title":"Internet-based cognitive behavioural therapy for insomnia comorbid with chronic benign pain - a randomized controlled trial","volume":"38","author":"Bothelius","year":"2024","journal-title":"Internet Interventions"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.18502\/ijph.v52i7.13236","article-title":"Application and use of Andersen's behavioral model as theoretical framework: a systematic literature review from 2012-2021","volume":"52","author":"Alkhawaldeh","year":"2023","journal-title":"Iranian J Public Health"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1354","DOI":"10.3390\/healthcare9101354","article-title":"Determinants of healthcare use based on the Andersen model: a systematic review of longitudinal studies","volume":"9","author":"Hajek","year":"2021","journal-title":"Healthcare (Basel)"},{"key":"B48","first-page":"68","article-title":"Sleep medicine: insomnia and sleep","volume":"116","author":"Bollu","year":"2019","journal-title":"Missouri Med"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2024.1413694","article-title":"The efficacy of cognitive behavioral therapy for insomnia in adolescents: a systematic review and meta-analysis of randomized controlled trials","volume":"12","author":"Mei","year":"2024","journal-title":"Front Public Health"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.798453","article-title":"Efficacy of face-to-face delivered cognitive behavioral therapy in improving health status of patients with insomnia: a meta-analysis","volume":"12","author":"Xu","year":"2021","journal-title":"Front Psychiatry"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10784","article-title":"Sleep medicine in China: current clinical practice","volume":"19","author":"Xu","year":"2023","journal-title":"J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1080\/15402002.2019.1591958","article-title":"You're missing out on something great\": Patient and provider perspectives on increasing the use of cognitive behavioral therapy for insomnia","volume":"18","author":"Koffel","year":"2020","journal-title":"Behav Sleep Med"},{"key":"B53","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s12888-016-0790-0","article-title":"Determinants of help-seeking behavior in depression: a cross-sectional study","volume":"16","author":"Boerema","year":"2016","journal-title":"BMC Psychiatry"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.3205\/psm000089","article-title":"Re-revisiting Andersen's behavioral model of health services use: a systematic review of studies from 1998-2011","volume":"9","author":"Babitsch","year":"2012","journal-title":"Psycho-Social Med"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.568531","article-title":"Demographic and clinicopathologic factors associated with colorectal adenoma recurrence","volume":"9","author":"Awan","year":"2026","journal-title":"JAMA Netw Open"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1257401","article-title":"An exploratory study of knowledge, attitudes, and practices toward HPV associated anal cancer among Pakistani population","volume":"13","author":"Awan","year":"2023","journal-title":"Front Oncol"},{"key":"B57","doi-asserted-by":"publisher","DOI":"10.1016\/j.dib.2020.106234","article-title":"Dataset of knowledge, attitude, practices and psychological implications of healthcare workers in Pakistan during COVID-19 pandemic","volume":"32","author":"Qasim","year":"2020","journal-title":"Data Brief"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1804213\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T05:39:59Z","timestamp":1782106799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1804213\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,22]]},"references-count":57,"alternative-id":["10.3389\/fpsyt.2026.1804213"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1804213","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,22]]},"article-number":"1804213"}}