Evaluation of Design, Governance, and Implementation of Khelo-India University Games Policy: An Assessment through RIDIT

Authors
Merajuddin Faridi 1 iD
Md. Kamran Khan 1 iD
Iftikhar Ahmad Wani 2 iD
Saddam Hussain 1 iD
Affiliations
1Department of Physical Education, Aligarh Muslim University, Aligarh, India
2Directorate of Physical Education and Sports, University of Kashmir, Srinagar, India
Overview

Abstract

Objective:
This study aimed to assess stakeholders’ perceptions of the effectiveness of policy design, governance, and implementation of the Khelo India University Games (KIUG) scheme.

Methods:
A quantitative survey design was used. A structured questionnaire was personally administered to administrators, coaches, and players who participated in KIUG 2024. A total of 100 participants (25 administrators, 25 coaches, and 50 players) were selected using mixed-method sampling: coaches and players were recruited through random sampling, while administrators were selected purposively due to their limited numbers. Data were analyzed using RIDIT analysis and the Kruskal–Wallis test.

Results:
Overall, responses from players, coaches, and administrators were largely consistent, with no significant group differences across survey items. The only exception was item PDGI-05 (satisfaction with the central government’s initiative to organize KIUG in addition to Zonal/All-India Intervarsity competitions), which showed a significant difference among groups. Participants generally expressed support for the KIUG policy and its implementation, particularly regarding the development and upgrading of sports infrastructure, promotion of competition and talent development, inclusiveness, and fostering a balanced system integrating education and sport.

Conclusion:
Findings indicate broad stakeholder support for the KIUG policy and its implementation in KIUG 2024, with limited divergence across stakeholder groups. Further research is recommended to deepen the understanding of KIUG policy design, governance, and implementation, and to examine these dimensions across settings and time

Sports ManagementUniversity Sports in IndiaSports PolicyPolicy Evaluation

Introduction

India stands as the world's seventh-largest economy and one of the fastest-growing nations with a GDP of USD 2.30 trillion (1). The comprehensive country profile provides a look at India's extensive sporting ecosystem, exploring the policies, facilitators, and challenges associated with sports participation, elite athletics, and the role of sports in achieving broader goals. A crucial component in the process of national development is the growth of sports, especially when it comes to the caliber of human resources (2, 3). Development is the improvement of the community’s mental and physical well-being and building of a national character, personality, discipline, sportsmanship, and greater performance as well (4). India’s sports policy landscape has evolved from fragmented schemes to integrated national programs, with increasing emphasis on strategic design, governance, and implementation. The Khelo India policy was initiated by the Ministry of Youth Affairs and Sports (MYAS) in 2018 with different components targeting different age groups, for example, Khelo India school games (KISG), Khelo India university games (KIUG), including those who are not enrolled in either schools or colleges, such as Khelo India youth games (KIYG). A wide scope of research is available in terms of evaluating administrative policies, especially sports policies in India, as it is a young nation in terms of administration (5).

The Khelo India University Games (KIUG) - one of the primary components under the umbrella of the Khelo-India policy was launched in 2020 by the Indian government to build a sports culture at the university level. KIUG aims to find and develop athletic talent in universities nationwide and offers young athletes a disciplined pathway to success and a trip to competitions of international importance, like the Olympics. The significance of KIUG is not just limited to sports achievement. Rather, it is essential for fostering a healthy sense of competition, physical fitness, and a balanced attitude toward education and athletics among young people. Furthermore, KIUG strongly emphasizes finding talented university athletes with the potential to represent India in international competitions, supporting India’s goal of becoming a significant player in the world of sports (6).

The KIUG policy represents a pivotal shift toward institutionalizing talent identification and performance benchmarking at the university level, aligning its objectives with broader national sports development goals (7). Effective policy design in this context involves structured competition formats, targeted resource allocation, and athlete support mechanisms (8). However, governance challenges persist, including coordination gaps among stakeholders and limited transparency in administrative processes (9). Implementation efforts have introduced operational guidelines and monitoring frameworks, yet field evaluations reveal inconsistencies in execution, particularly in outreach to marginalized regions and clarity in benefit distribution (8). Evaluating the KIUG policy thus requires a multidimensional approach that critically examines its design architecture, governance structures, and implementation efficacy within India’s evolving sports ecosystem.

The success of KIUG depends upon its policy design, governance, and implementation (10, 11). Therefore, understanding how well these components function together can provide information about KIUG's strengths and areas for improvement. Policy Design- The policy framework governing KIUG is central to its success. Designing a policy involves the formulation of guidelines, the establishment of objectives that should be aligned with the broader national sports development goals, and proper allocation of resources (7). The outcome of the policy depends upon the enthusiasm and capacity of individuals accountable for its execution, even though policies can aid in coordinating activities and fostering cooperation (12). Assessing the policy design is necessary to determine whether the foundational strategies are strong and helpful to achieve the foreseen outcomes. Governance- Effective governance ensures that the designed policy is implemented efficiently and transparently (13). The governance framework of the KIUG policy encompasses multiple stakeholders such as the Ministry of Youth Affairs and Sports (MYAS), the sports authority of India (SAI), national and state sport federations, and university sports boards. Evaluating the governance mechanisms can display the efficacy of coordination and accountability among these bodies (9). Implementation- The implementation process involves the selection of host universities, provision of facilities, organization of events, and engagement with athletes and coaches. The implementation of the policy guidelines is no doubt a primary component that affects the success of any program in any setting (14). In their study, 15) concluded that Nigeria’s below-par performance in the Olympics and FIFA World Cup since 2009 was a result of failure in the implementation of the Sports Policy of Nigeria 2009. Evaluating the implementation process delves into a realistic picture of the financial, logistical, and administrative hurdles that affect the program's success.

The KIUG represents a strategic effort to identify university athletes with the potential to contribute significantly to the nation's sporting landscape. However, the success of KIUG depends on a well-designed policy framework, effective governance, and efficient implementation. Assessing these components is crucial to understanding the program's impact, pointing out the areas for improvement, and ensuring that the initiative achieves its anticipated outcomes. The present study focuses on providing a comprehensive evaluation of KIUG, shedding some light on its successes and challenges, and offering suggestions for future enhancements.

Material and Methods

Research Design

The present study aimed at assessing the success rate of the policy design, governance, and implementation of Khelo India University Games, a major component of the Khelo India initiative targeting Indian university sports. A cross-sectional quantitative research design was employed by the researchers. A structured questionnaire was used for data collection. Researcher personally administered the questionnaire to the administrators, coaches, and players during the Khelo India University Games 2024. These games were hosted by the North-East states of India- Assam, Meghalaya, Sikkim, Tripura, Arunachal Pradesh, Mizoram, and Nagaland. A total of 20 games were included of which a major proportions of the games were held at Assam. Population of the study included administrators, coaches, and players. To get the unbiased data researcher felt it necessary to include not only the players but the coaches and the administrators too.

Participants

Participants from universities across the country took part in these games. A total of hundred participants voluntarily participated in this study in which 25 were administrators, 25 were coaches and 50 were players. The unequal representation across stakeholder categories (particularly the higher proportion of players) reflected the actual structural distribution within university sports systems, where athletes significantly outnumbered coaches and administrators. The modest sample size (n=100) was determined based on feasibility constraints associated with data collection during a multi-sport event of national repute and was consistent with sample sizes commonly used in applied sport governance and policy perception studies (16). A mixed-method sampling was employed to ensure representation across heterogeneous stakeholder groups. Specifically, simple random sampling was used for the selection of players and coaches to minimize selection bias within these relatively accessible populations compared to administrators. In contrast, purposive sampling was adopted for the selection of administrators due to their limited availability, smaller population size, and their direct involvement in policy implementation and governance processes. Prior to administering the questionnaire, the informed consent was taken from the participants, ensuring their confidentiality.

Instrument Used

A structured survey questionnaire was used for the collection of data. This questionnaire consisted of 15 questions which were focused on Policy design, governance, and implementation. All the items of the questionnaire were based on a five point likert scale with 5 indicating strongly agree, 4 – agree, 3 – partially agree, 2 - disagree and 1 indicating strongly disagree. The reliability coefficient of the questionnaire was assessed by employing Cronbach’s alpha and was found (α = 0.87) which is highly reliable than the acceptable 0.7 value. For validity, Content Validity Ratio (CVR) was calculated based on the responses of concerned ten experts.

CVR = (ne – N/2)/(N/2) = (9 – 10/2)/(10/2) = 0.8

Where, ne represents the number of experts marked the item as essential and N represents the total number of experts.

Statistical Analysis

Post Shapiro-Wilk normality check, non-parametric RIDIT analysis was used. RIDIT an abbreviation used for ‘Relative to an Identified Distribution’ analysis followed by Kruskal Wallis test was employed to test the degree of agreement of the coaches, players, and administrators on all the 15 questions of Policy design, governance, and implementation success of KIUG. While performing RIDIT analysis, identification of the reference data set becomes necessary to calculate ridit values of scale items. RIDIT scores (Rj) were computed to evaluate the relative positioning of ordinal response categories across 15 items assessing Policy Design Governance and Evaluation (PDGI). The RIDIT methodology assigns scores based on cumulative proportions derived from a reference distribution, allowing for non-parametric comparison of ordinal data. The data received from coaches, administrators, and players as a whole was taken as reference data set of the study. The general rules to interpret the values of ρi are shown below (17, 18, 19, 20, 21, 22, 23).

Response patterns of respondents for each scale item with mean RIDIT deviating from the threshold (0.5) shows a significant difference between the comparison data set and reference data set. If the confidence interval of mean RIDIT contains 0.5, it is accepted that the value does not significantly deviate from 0.5.

Among the high and low values of mean RIDIT for each scale item, low value is preferred as the lower value depicts the low probability of being in a negative inclination.

Among the respondents, the confidence intervals of mean RIDIT overlapping the threshold value of scale items are considered to be statistically different from each other.

Results

The survey data collected from the administrators, coaches, and players participated in Khelo India University Games 2024 is highlighted in this section. The present survey study was conducted to assess the success rate of policy design, governance, and implementation of Khelo India University Games. The response frequencies of participants on scale items are given in table 1 along with the RIDIT values (in the last row) for each ordered category of the reference data set. The items selected for the survey are given as follows:

PDGI-01. Do you think that the Central Government consults the university sports board Administrator, Coaches, Experts, and Players at the time of framing the plan and policy for Khelo India University Games?

PDGI-02. Do you think that the Khelo India University Games policy is regularly evaluated by the experts to improve the shortcomings?

PGDI-03. Do you think that the Central Government's strategic plans related to Khelo India University Games include the viability of how the plans and policy can be resourced (Financially, technologically, Human resourcely)?

PDGI-04. Do you think that the Khelo India University Game policy and plan have a vision for the future development of university sports in India?

PDGI-05. Extend your level of satisfaction with the initiative taken by the Central Government to organize Khelo India University Games in addition to Zonal/All-India Intervarsity competitions.

PDGI-06. Do you think that the Khelo India University Games strategic plans include a clear understanding of actions?

PDGI-07. Do you think that the Khelo India University Games strategic plan includes clear, attainable objectives?

PDGI-08. Extend your level of satisfaction to achieve sports competition and talent development through the organization of Khelo India University Games

PDGI-09. Extend your level of satisfaction with the objective to achieve the promotion of inclusiveness through sports by the organization of Khelo India University Games

PDGI-10. Extend your level of satisfaction with the objective to achieve Khelo India Centre and Sports academies through the organization of Khelo India University Games.

PDGI-11. Extend your level of satisfaction with the objective to achieve the creation and upgradation of sports infrastructure through the organization of Khelo India University Games.

PDGI-12. Extend your level of satisfaction with the objectives to achieve Success in Fit India Movement through the organization of Khelo India University Games.

PDGI-13. Extend your level of satisfaction with the objective to achieve a Strong Interlinked System of Education and Sports through the organization of Khelo India University Games.

PDGI-14. Extend your level of satisfaction with the objective to achieve the Promotion of University levels of Sports and make it a Breeding Ground for the champions through the organization of Khelo India University Games.

PDGI-15. Extend your level of satisfaction with the objectives to achieve the Boost to Sports Infrastructure and Strengthen the Sports Ecosystem in the University through the organization of Khelo India University Games.

Ha: Significant difference will be there in the responses of coaches, players, and administrators regarding all the items of policy design, governance, and implementation of Khelo India University Games.

Table 1. Shows RIDITs calculation of the data set

Questions

HS/A (5)

S/F (4)

PS/S (3)

DS/S (2)

HD/N (1)

πi

PDGI-01

20

51

27

2

0

100

PDGI-02

20

63

16

0

1

100

PDGI-03

29

47

23

1

0

100

PDGI-04

30

50

18

1

1

100

PDGI-05

34

51

13

1

1

100

PDGI-06

27

53

19

1

0

100

PDGI-07

23

50

27

0

0

100

PDGI-08

17

63

19

1

0

100

PDGI-09

20

58

19

3

0

100

PDGI-10

12

72

16

0

0

100

PDGI-11

17

59

22

1

1

100

PDGI-12

20

54

24

1

1

100

PDGI-13

28

55

15

2

0

100

PDGI-14

24

51

25

0

0

100

PDGI-15

18

53

28

1

0

100

Fi

339

830

311

15

5

1500

(1/2) * fi

169.5

415

155.5

7.5

2.5

Fj

169.5

754

1324.5

1487.5

1497.5

Rj

0.113

0.502667

0.883

0.991667

0.998333

PDGI = Policy Design, Governance and Implementation, HS/A (5) = Highly Satisfied/Always, S/F (4) = Satisfied/Frequently, PS/S (3) = Partially Satisfied/Sometimes, DS/S (2) = Dissatisfied/Seldom, HD/N (1) = Highly Dissatisfied/Never, * = multiplied by.

As shown in Table 1, the highest RIDIT score was observed for the category "HD/N (1)" (Rj = 0.998), indicating it was least favored relative to the reference distribution, while "HS/A (5)" yielded the lowest relative score (Rj = 0.113), reflecting its highest endorsement. Intermediate categories such as "S/F (4)" and "PS/S (3)" demonstrated RIDIT scores of 0.502 and 0.883, respectively, suggesting a gradation in perceived agreement. These results imply a strong skew toward positive evaluations, with the majority of responses concentrated in higher ordinal categories, thereby supporting the directional consistency of the PDGI items.

Table 2. RIDITs for data set comparison

Item

5

4

3

2

1

Pi

Rank

LB

UB

W-calculated

Item significance

PDGI-01

0.02

0.25

0.23

0.02

0

0.53

14

0.47

0.59

0.13

No significant difference

PDGI-02

0.02

0.31

0.14

0

0.01

0.49

6

0.43

0.54

0.01

No significant difference

PDGI-03

0.03

0.23

0.20

0.01

0

0.48

5

0.42

0.53

0.03

No significant difference

PDGI-04

0.03

0.25

0.15

0.01

0.01

0.46

3

0.40

0.52

0.12

No significant difference

PDGI-05

0.04

0.25

0.11

0.01

0.01

0.42

1

0.37

0.48

0.50

There is significant difference

PDGI-06

0.03

0.26

0.16

0.01

0

0.47

4

0.41

0.53

0.06

No significant difference

PDGI-07

0.02

0.25

0.23

0

0

0.51

10

0.45

0.57

0.02

No significant difference

PDGI-08

0.02

0.31

0.16

0.01

0

0.51

9

0.45

0.57

0.01

No significant difference

PDGI-09

0.02

0.29

0.16

0.03

0

0.51

8

0.45

0.56

0.01

No significant difference

PDGI-10

0.01

0.36

0.14

0

0

0.51

11

0.45

0.57

0.02

No significant difference

PDGI-11

0.02

0.29

0.19

0.01

0.01

0.52

13

0.47

0.58

0.08

No significant difference

PDGI-12

0.02

0.27

0.21

0.01

0.01

0.52

12

0.46

0.58

0.06

No significant difference

PDGI-13

0.03

0.27

0.13

0.02

0

0.46

2

0.40

0.51

0.15

No significant difference

PDGI-14

0.02

0.25

0.22

0

0

0.50

7

0.44

0.56

0.00

No significant difference

PDGI-15

0.02

0.26

0.24

0.01

0

0.54

15

0.48

0.60

0.20

No significant difference

1.40

KS W

17.56

Chi square

23.68

DF

14

P value

0.05

= Highly Satisfied/Always, 4 = Satisfied/Frequently, 3 = Partially Satisfied/Sometimes, 2 = Dissatisfied/Seldom, 1 = Highly Dissatisfied/Never

Ha: Rejected for all items except PDGI-05

Table 2 depicts different RIDITs, Pi represents the mean RIDIT, LB and UB represent the lower bound and the upper bound of the confidence interval of Pi/Mean RIDIT (95%). The calculated value of Kruskal-Wallis (W) is also shown for each item in the table. Since the Kruskal-Wallis (17.56) is found significantly lower than chi-square (23.68) with 14 degree of freedom, it can be said that the obtained responses of the players, administrators, and coaches on the scale items are insignificantly different except item no. 5 (PGDI-05).

Fig. 1 shows a visual representation of the participant’s item-wise satisfaction level based on the mean RIDIT score.Article figure

Table 3. Depicts the ranks of scale items based on the agreement and satisfying propensity of respondents.

Item

Rank

PDGI-05: Extend your level of satisfaction with the initiative taken by the Central Government to organize Khelo India University Games in addition to Zonal/All-India Intervarsity competitions.

1

PDGI-13: Extend your level of satisfaction with the objective to achieve a Strong Interlinked System of Education and Sports through the organization of Khelo India University Games.

2

PDGI-04: Do you think that Khelo India University Game policy and plan have a vision for the future development of university sports in India?

3

PDGI-06: Do you think that the Khelo India University Games strategic plans include a clear understanding of actions?

4

PDGI-03: Do you think that the Central Government strategic plans related to Khelo India University Games includes the viability of how the plans and policy can be resourced (Financially, Technologically, Human resourcely)?

5

PDGI-02: Do you think that the Khelo India University Games policy is regularly evaluated by the experts to improve the shortcomings?

6

PDGI-14: Extend your level of satisfaction with the objective to achieve the Promotion of University levels of Sports and make it a Breeding Ground for champions through the organization of Khelo India University Games.

7

PDGI-09: Extend your level of satisfaction with the objective to achieve the promotion of inclusiveness through sports by the organization of Khelo India University Games.

8

PDGI-08: Extend your level of satisfaction with the objective to achieve sports competition and talent development through the organization of Khelo India University Games.

9

PDGI-07: Do you think that the Khelo India University Games strategic plan includes clear attainable objectives?

10

PDGI-10: Extend your level of satisfaction with the objective to achieve Khelo India Centre and Sports academies through the organization of Khelo India University Games.

11

PDGI-12: Extend your level of satisfaction with the objectives to achieve Success in Fit India Movement through the organization of Khelo India University Games.

12

PDGI-11: Extend your level of satisfaction with the objective to achieve the creation and upgradation of sports infrastructure through the organization of Khelo India University Games.

13

PDGI-01: Do you think that the Central Government consults the university sports board Administrator, Coaches, Experts, and Players at the time of framing the plan and policy for Khelo India University Games?

14

PDGI-15: Do you think that Khelo India University Game policy and plan have a vision for the future development of university sports in India?

15

Based on the RIDIT Analysis (refer to table 1), table 3 shows the position of scale items in accordance with agreeing and satisfying propensity of the respondents with the different dimensions of the Khelo India University Games (KIUG) policy and implementation of the same. The ranking was done based on the level of satisfaction or agreement by the respondents to the statements. The findings showed that the respondents had the best level of satisfaction with PDGI-05, which evaluated their satisfaction with the step that the Central Government took to host Khelo India University Games alongside the already available Zonal and All-India Intervarsity Games (Rank = 1). This is an indication that participants were able to value KIUG as an auxiliary competition platform.

This was then followed by PDGI-13 (Rank = 2), which was based on the satisfaction with the goal of having a strong interlocking system of education and sports through KIUG, and PDGI-04 (Rank = 3), which measured the perceptions regarding the future vision incorporated in KIUG policy and planning. The Rank of both the above-mentioned items, PDGI-06 (Rank = 4) and PDGI-03 (Rank = 5) is relatively high, meaning that there is a positive attitude toward the strategic clarity and resource planning of KIUG.

On the other hand, PDGI-01 (Rank = 14) and PDGI-15 (Rank = 15) scored the lowest implying that the respondents were least satisfied with the degree of consultation of stakeholders in the policy formulation process, as well as, the perceived long-term vision of the KIUG policy and plan. In general, these findings indicate that the respondents are generally satisfied with the introduction and goals of KIUG, but they are less satisfied with the aspects of consultative processes and the long-term vision of the policy.

Discussion

Our research purpose was to assess the policy design, governance, and implementation success of the Khelo India University Games (KIUG). RIDIT analysis unveiled that respondents generally perceive the central government as consultative with university sports board administrators, coaches, and experts during the formation process of policy. The findings indicate a predominantly positive perception of consultative policy formulation, periodic expert evaluation, and strategic resource planning. These results align closely with contemporary models of collaborative sports governance, which emphasize multi-stakeholder participation, transparency, and shared accountability in policy design and execution (24, 25, 26).

The observed perception that the central government actively consults university sports boards, coaches, and technical experts during KIUG policy formulation supports the principles of participatory governance, which are considered essential for sustainable sport development (27). Similarly, the regular evaluation of policy by experts, as reported by the respondents, corresponds with the concept of evidence-informed sport policy, where continuous feedback and assessment are regarded as key drivers of effective program implementation (28).

Strategic planning that incorporates financial, technological, and human resource sustainability also reflects the sport development pyramid model, which highlights the need for stable institutional support at the base to achieve elite performance outcomes (29). The sight for future development of the university sports within KIUG policies is well-received, aligning with broader sports development goals. However, this finding of our research counteracts with (30) in which they stated that the decline of sports in Indian universities resulted due to lack of infrastructure, strategic planning, future opportunities and no support from government.

Regarding PDGI-05; which addresses satisfaction with the central government's initiative to organize KIUG in addition to Zonal/All-India Intervarsity competitions, the respondents’ level of satisfactions were noted significantly different from each other indicates that while the policy intent is widely accepted, its operational integration with existing competition structures may still require refinement. This finding resonates with policy implementation research suggesting that even well-designed sports policies often face coordination challenges at the execution level (31). No significant difference were recorded among administrators, coaches, and players over other PDGI items, in fact high similarities regarding the items focused on creating and upgrading sports infrastructure, promoting sports competition and talent development, inclusiveness, and fostering a balanced system of education and sports were recorded which confirms KIUG’s alignment with international best practices in university sport systems, particularly those observed in the NCAA (USA) and FISU-supported models (32, 33).

Overall, this study contributes to the growing body of Indian sport governance literature by providing empirical evidence that KIUG has initiated a positive shift in university sports policy design, governance accountability, and development orientation. By situating these findings within both national and global sport policy frameworks, the study highlights KIUG as an emerging model of structured university sport governance in India.

Conclusion

The present study demonstrates that the Khelo India University Games (KIUG) has emerged as a structurally sound policy intervention for strengthening governance and development mechanisms within India’s university sports ecosystem. KIUG policy has succeeded in establishing a credible and participatory governance framework, marked by consultative policy design, periodic expert evaluation, and strategic resource planning. This reflects a meaningful shift toward the principles of good governance in sport, particularly transparency, stakeholder inclusion, and accountability. The findings hold direct relevance for policymakers responsible for university sports governance in India. The strong alignment observed between KIUG objectives and infrastructure development, talent identification, inclusivity, and the education; sport balance underscores KIUG’s role as a central coordinating mechanism within the fragmented Indian university sport landscape.

Despite these positive outcomes, our study is not free from limitations. Administering a questionnaire to the players in the presence of their coaches during the KIUG event may have introduced social desirability bias, potentially inflating favorable responses (34). Additionally, the relatively modest sample size limits the generalizability of the findings, a constraint commonly noted in applied sport policy research conducted within event-based environments (16). Future studies should employ larger, multi-event samples and independent data collection settings to strengthen external validity.

In conclusion, KIUG represents a significant policy advancement in the governance of university sports in India. Its continued effectiveness, however, will depend on sustained political commitment, institutional coordination, and evidence-driven policy refinement. By positioning KIUG within a governance-centered development framework, this study contributes a policy-relevant empirical foundation for strengthening India’s university sport ecosystem.

Acknowledgement

The authors are highly grateful to the Aligarh Muslim University, Aligarh (India), and the Directorate of Sports and Youth Welfare, Assam (India)

Author’s Contribution

Author1: Conceptualization, Supervision, Validation, Funding acquisition; Author2: Project administration, Investigation, Data curation, Funding acquisition; Author3: Methodology,Writing – original draft, Writing – review and editing, Funding acquisition; Author4: Formal analysis, Funding acquisition; Author5: Visualization, Funding acquisition.

Conflict of Interest

No conflicts of interest are to be declared by the authors.

Funding

The authors received no monetary support from any organization for publishing this paper.

Ethics Statement

Before administering the questionnaire, participants were informed about the purpose of the study and the voluntary nature of their participation, and a written informed consent was also obtained from all participants ensuring them all the confidentiality of their responses and personal data.

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