Ethics approval and consent to participate
All interventions in this study were conducted under the approval of the Ethics Committee of Shiraz University of Medical Sciences (Approval Number: IR.SUMS.REC1399.1299). The study adhered to the fundamental principles outlined in the Helsinki Declaration (2013), and the investigator obtained the commitment of all participating students. Informed consent was diligently obtained from all students who participated in the study, and their parents were also required to consent. The investigator provided comprehensive and clear verbal and written information to the study subjects regarding the study’s nature, objectives, and potential risks and benefits. Informed consent was collected in written and dated form. Any modifications to the study protocol that may impact the study’s execution, student benefit, or student safety will require a formal protocol amendment. Such amendments will be subject to approval by the Vice-Chancellor of Research and the Ethics Committee of Shiraz University of Medical Sciences.