What triggers environmental sustainability in the organization? Empirical evidence from the cause-and-effect relationship

The application of environmental sustainability within organizations relies on leadership style (Bass & Avolio, 1990; Li, Xue, Li, Chen, & Wang, 2020; Peng, Chen, Zou, & Nie, 2021). However, leadership styles vary (Lundqvist, Wallo, Coetzer, & Kock, 2023), and it is largely unexplored in the literature whether, and if so, how environmental transformational leadership is effective in triggering environmental sustainability in organizations. Under the theoretical background of transformational leadership (Bass & Avolio, 1990), environmental transformational leadership (ETL) has gained widespread recognition in the literature (e.g. Robertson & Barling, 2013, 2017; Khan & Khan, 2021; Elshaer, Abdelrahman, Azazz, Alrawad, & Fayyad, 2022; Karuppiah, Sankaranarayanan, & Ali, 2022; Zhu, Tang, Zhang, & Wang, 2022; López-Cabarcos, Vázquez-Rodríguez, & Quiñoá-Piñeiro, 2022; Huang, Guo, Deng, & Wang, 2023). Environmental transformational leadership is defined as “a manifestation of transformational leadership in which the content of the leadership is all focused on encouraging pro-environmental and green initiatives” (Robertson & Barling, 2013; Elshaer et al., 2022; Karuppiah et al., 2022).

Over the past few years, most organizations have realized the significance of employees’ pro-environmental behaviors to improve their environmental performance (Hadi & Rasool, 2017; Saleem, Mahmood, & Ahmed, 2019; Farukh et al., 2022; Darvishmotevali &Altinay, 2022; Yadav & Mathew, 2023; Mi et al., 2024; Lisboa, Gómez-Román, Guntín, & Monteiro, 2024; Brick et al., 2024). According to Peng et al. (2021), Zheng, Gao, Li, & Dang (2023), Zacher, Kühner, Katz, & Rudolph (2024) and Piao & Managi (2024), organizational environmental performance can be improved through employees’ pro-environmental behaviors. Pro-environmental behaviors are unremunerated, environmentally friendly behaviors exhibited by employees that influence organizational environmental performance (Hadi & Rasool, 2017; Saleem et al., 2019; Omarova & Jo, 2022).

Drawing on social psychology literature, we argue that environmental transformational leadership may trigger employees’ pro-environmental behaviors because employees learn such behaviors by observing their environmental leaders and then try to exhibit green behaviors (Farrukh, Ansari, Raza, Wu, & Wang, 2022). For example, environmentally specific transformational leaders emphasize the importance of environmental protection, and followers are more attentive due to leaders’ idealized influence. Therefore, environmental transformational leadership can be a valuable strategy for triggering environmental sustainability in the organization. However, far too little attention has been paid to how transformational leadership triggers environmental sustainability (López-Cabarcos et al., 2022; Perez, Ejaz, & Ejaz, 2023; Katou, Kafetzopoulos, & Vayona, 2023). To fill this gap, we posit that there exists a causal mechanism between environmental transformational leadership and employees’ pro-environmental behaviors that has remained elusive in the context of Pakistan, where environment-related issues are salient to organizational performance (Farrukh et al., 2022, p. 2).

For example, Saleem et al. (2019) investigated the mediating role of intrinsic motivation in the relationship between transformational leadership and employees’ pro-environmental behavior. However, they found inconclusive results regarding the causal mechanism. Ahmad, Islam, Sadiq, & Kaleem (2021) found a partial mediation of Green Human Resource Management (GHRM) between ethical leadership and green behavior. Similarly, Farrukh et al. (2022) found a complementary mediation of GHRM between green transformational leadership and employees’ pro-environmental behaviors. Perez et al. (2023) investigated the mediating role of pro-environmental behavior between green transformational leadership, GHRM and environmental performance.

Interestingly, all these studies overlooked the proximate effect of environmental transformational leadership on autonomous environmental motivation, which can be understood through the lens of transformational leadership and self-determination theories (Bass & Avolio, 1990; Ryan & Deci, 2000; Deci, Olafsen, & Ryan, 2017). Thus, under the rubric of transformational leadership and self-determination theories, we propose that autonomous environmental motivation is the explanatory mechanism linking environmental transformational leadership with employees’ pro-environmental behaviors (PEBs). For instance, an environmental transformational leader satisfies employees’ psychological needs (e.g. need for autonomy, need for relatedness and need for competence) in the workplace. The satisfaction of these needs creates a set of environmental energetic forces within employees (i.e. autonomous environmental motivation) that positively affect pro-environmental behaviors.

The study extends the body of knowledge in the following ways: first, by empirically examining the proximate effect of environmental transformational leadership on autonomous environmental motivation in an environmental nonprofit organization, this study contributes to a more coherent understanding of the ETL–AEM relationship in environmental sustainability literature. Second, as suggested by Perez et al. (2023), the role of green motivation could be an important consideration in future research on employees’ PEBs. Our study thus introduces the mediating role of autonomous environmental motivation in the relationship between environmental transformational leadership and employees’ pro-environmental behaviors. Third, the study further advances the existing literature by empirically examining the cause-and-effect relationship between environmental transformational leadership and employees’ pro-environmental behaviors via autonomous environmental motivation. This pathway has lacked empirical validation and requires further exploration. Fourth, our study integrates two different theoretical perspectives (i.e. transformational leadership and self-determination) into a single, novel structure and confirms the applicability of both frameworks in achieving organizational environmental sustainability. The study also makes a significant contribution to national and global environmental sustainability goals.

The theoretical background of this study is grounded in transformational leadership and self-determination theories (Bass, 1985; Bass & Avolio, 1990; Deci & Ryan, 2000; Deci et al., 2017). Self-determination and transformational leadership are distinct perspectives but offer complementary insights into fostering employees’ intrinsic motivation. For example, transformational leaders use four attributes to inspire and motivate their followers: they provide inspirational motivation, offer intellectual stimulation, show individualized consideration and exert idealized influence (Bass, 1985; Bass & Avolio, 1990). Meanwhile, the self-determination theory suggests that employees are most effectively motivated when their psychological needs are met (Deci & Ryan, 2000; Deci et al., 2017). The following explanation illustrates the alignment between transformational leadership and self-determination theories: for instance, transformational leaders build trust and foster connections (idealized influence), thereby fulfilling employees’ needs for relatedness. They also inspire and motivate (inspirational motivation) their followers with empowerment, thereby fulfilling employees’ needs for autonomy. By nurturing creativity, innovation, personal mentorship and growth opportunities (intellectual stimulation and individualized consideration), transformational leaders meet employees’ needs for competence.

Thus, we can argue that the self-determination theory provides a valuable framework for understanding the psychological mechanisms that make transformational leadership behaviors more effective. In the context of the current study, we posit that environmental transformational leadership and self-determination jointly foster a sense of self-environmental motivation in employees, which, in turn, leads to their pro-environmental behaviors (see Figure 1).

From a social psychology perspective, employees learn by observing and imitating the behaviors of transformational leaders (Graves, Sarkis, & Zhu, 2013; Hadi & Rasool, 2017; Farrukh et al., 2022; Zheng et al., 2023; Song, Deng, Zhang, Peng, & Jin, 2024; Zacher et al., 2024; Lundqvist et al., 2023). For this reason, transformational leadership has gained widespread recognition in the leadership literature. With their four attributes (i.e. inspirational motivation, idealized influence, intellectual stimulation and individualized consideration), transformational leaders understand how to trigger employees’ pro-environmental behaviors (Omarova & Jo, 2022). Previous studies have shown that employees’ pro-environmental behaviors are influenced by environmental transformational leadership (Graves et al., 2013; Hadi & Rasool, 2017; Farrukh et al., 2022; Zheng et al., 2023; Song et al., 2024; Zacher et al., 2024). These studies argue that environmental-specific transformational leaders emphasize the importance of environmental protection, and followers are more attentive due to leaders’ idealized, individualized, intellectual and inspirational influence. Consequently, followers voluntarily participate in environmentally friendly behavior.

Other studies (e.g. Saleem et al., 2019; Jo et al., 2022; Althnayan, Alarifi, Bajaba, & Alsabban, 2022; Elshaer et al., 2022) found a significant effect of environmental transformational leadership on employees’ pro-environmental behaviors, which, in turn, leads to environmental sustainability (Wang, Zhang, Wang, Zhu, & Morabbi Heravi, 2023). Omarova & Jo (2022) cited Wangari Maathai: “You cannot protect the environment unless you empower people, inform them, and you help them.” Together, these findings suggest that environmental transformational leadership can be a valuable strategy for triggering environmental sustainability in the organization. Therefore, this study hypothesizes that:

The relationship between transformational leadership and employees’ motivation is positive and significant (Graves et al., 2013; Xu, Zeng, Wang, Qian, & Gu, 2022; Tjahjadi et al., 2023). However, the proximate effect of environmental transformational leadership specifically on autonomous environmental motivation in the environmental sustainability literature is missing and requires scholarly attention (Hadi & Rasool, 2017; Xu et al., 2022; Perez et al., 2023). The relationship between environmental transformational leadership and employees’ autonomous environmental motivation can be understood through the lens of two frameworks (i.e. transformational leadership theory and self-determination theory). Drawing on these complementary theoretical perspectives, we argue that the proximate cause of environmental transformational leadership is autonomous environmental motivation.

For example, environmental transformational leaders fulfill employees’ competence needs by providing training and coaching on environmental issues (intellectual stimulation attribute). Furthermore, they encourage employees to challenge assumptions and express themselves (inspirational motivation attribute). Transformational leaders also imbue their environmental values (Xu et al., 2022; Su & Zhang, 2023; Khan, Gan, Khan, & Saif, 2023) in the minds of their employees by paying attention to each group member; in turn, followers will adopt these values and feel a sense of pride (idealized influence). Consequently, employees will be intrinsically motivated. Therefore, it is hypothesized that:

Pro-environmental behaviors of employees are driven by their intrinsic motivation (Graves et al., 2013; Hadi & Rasool, 2017; Saleem et al., 2019; Budzanowska-Drzewiecka & Tutko, 2021; Zheng et al., 2023). In their conceptual study, Hadi & Rasool (2017) conceptualized the relationship between autonomous motivation and pro-environmental behaviors. They maintain that autonomously motivated employees spontaneously engage in green behaviors. Graves et al. (2013) and Saleem et al. (2019) suggested that autonomous motivation is critical in shaping pro-environmental behaviors. From a self-determination perspective, pro-environmental behaviors are likely to occur because employees find them personally interesting and satisfying (Ryan & Deci, 2020).

These arguments suggest that autonomously motivated employees are more likely to pursue pro-environmental behaviors because people behave according to their intrinsic values and goals. To put it another way, intrinsic motivation originates internally and is driven by personal interests and values (Bandhu et al., 2024); therefore, employees will pursue pro-environmental behaviors. Therefore, this study proposes that:

Because the literature on the mediating mechanism between environmental transformational leadership and employees’ pro-environmental behavior is limited, especially in the context of environmental nonprofit organizations, further exploration is needed. Regarding the strength of mediation, Saleem et al. (2019) found that intrinsic motivation did not explain the relationship between transformational leadership and employees’ pro-environmental behavior, which contradicts the well-known literature. According to their findings, the variance accounted for (VAF) is 16%, which falls below the minimum recommended value of 20% (Hair, Hult, Ringle, & Sarstedt, 2014; Hadi, Abdullah, & Sentosa, 2016b). The instrument used by the researchers may have influenced the strength of the mediation result, as they measured transformational leadership with only five items (two for idealized influence and one each for inspirational motivation, intellectual stimulation and individualized consideration). According to Edwards & Bagozzi (2000), Petter et al. (2007) and Hadi (2022), the lack of theoretical clarity on the nature of constructs and their measurement, as defined under measurement theory, has prevented researchers from meaningfully assessing the theory.

In addition, Hadi & Rasool (2017) and Perez et al. (2023) suggested that the role of green values and autonomous environmental motivation should be considered in future studies on PEBs. In the current study, the role of autonomous environmental motivation will be examined to explain the relationship between environmental transformational leadership and employees’ pro-environmental behaviors. This study argues that environmental transformational leaders serve as catalysts for employees’ autonomous environmental motivation (referencing transformational leadership and self-determination theories), which, in turn, triggers employees’ pro-environmental behavior. Specifically, a set of energetic forces generated by environmental transformational leaders within employees (i.e. autonomous environmental motivation) is responsible for driving responsible environmental behaviors. These findings form the basis for the fourth hypothesis of this study:

The study was conducted in the Local Government and Community Development Department (LG&CD Department) in Lahore, Pakistan, for the following reasons: the LG&CD Department is actively engaged in environmental sustainability efforts. According to Salman & Wang (2025), Pakistan is currently facing several environmental challenges, and specifically, Lahore is one of the major cities confronting severe pollution and environmental hazards. To maintain the health of residents, the timely removal of waste in an environmentally acceptable manner is required. Following Krejcie & Morgan (1970) recommendation for determining an appropriate sample size, data were randomly collected from employees via self-administered questionnaires. The initial sample consisted of managerial and supervisory employees, with 62% of the respondents having more than three years of experience. A total of 216 valid responses were analyzed using PROCESS Macro Model 4 (Hayes, Montoya, & Rockwood, 2017; Hayes, 2018). This method was chosen due to its free accessibility, ease of use and ability to probe direct and indirect effects in mediation analysis.

All variables were measured through multi-item, five-point Likert scales. To ensure validity and consistency, we adapted established scales from prior literature. For instance, the environmental transformational leadership scale was adapted from previous studies (Bass & Avolio, 1990; Çekmecelioğlu & Özbağ, 2019). We asked employees to indicate the extent to which their leader “provides teaching and coaching on environmental issues,” “provides appealing images about the clean environment,” “lets others know how he thinks he is doing about the environment” and “talks enthusiastically about what he needs to do to protect the environment.”

Autonomous environmental motivation was measured using the scale developed by Graves et al. (2013). Respondents were asked to share how much they agree with the following statements: “I engage in green behaviors because it is personally important to me,” “I engage in green behaviors because I enjoy it” and “I engage in green behaviors because it fits my own values.” Employees’ pro-environmental behavior items were adapted from Afshar Jahanshahi, Maghsoudi, & Shafighi (2021). They were asked to express their views on statements such as: “I recycle and reuse materials which are reusable,” “I perform environmental tasks that my company does not require” and “I help others solve environmental problems.” (see  Appendix 1 for full items). To achieve contextual fit, minor modifications were made to the items’ wording, primarily because prior studies were conducted in manufacturing organizations. Exploratory factor analysis and Cronbach’s alpha coefficients were used to ensure construct validity and reliability. Furthermore, Braman & Azzam (2023) found that the results of unmodified and contextually modified surveys are generally comparable, supporting the appropriateness of adapted scales.

The underlying structure of the items was examined via exploratory factor analysis. The results regarding the Kaiser–Meyer–Olkin (KMO) measure and Bartlett’s Test of Sphericity were satisfactory (KMO > 0.50; BTSp = 0.001), indicating that the sample size was reasonable to proceed with the analysis (Hadi, Abdullah, & Sentosa, 2016a). The results further revealed that all items converged on their respective constructs, except for one item of environmental transformational leadership. Five items of autonomous environmental motivation and ten items of employees’ pro-environmental behaviors loaded cleanly on their respective constructs. Factor loadings exceeding 0.50 confirmed the convergent and discriminant validity of the three constructs. The maximum variance explained by a single factor was below 50%, thereby addressing the issue of common method variance. In addition, the Cronbach’s alpha coefficients for all three constructs ranged between 0.70 and 0.92, indicating strong internal consistency of the scales (see Table 1).

Analysis of PROCESS Macro Model 4 revealed that the direct relationship between ETL and employees’ PEBs was positive and statistically significant (β = 0.384, p = 0.001), thereby supporting H1 (total effect). The result also reveals a positive and significant relationship between ETL and AEM (β = 0.256, p = 0.001), supporting H2. In the second phase, the effect of both ETL and AEM on employees’ PEBs was tested. The results indicated that the path from perceived ETL to employees’ PEBs (direct effect) was positive and significant (β = 0.337, p = 0.001), as well as the path from AEM to employees’ PEBs (β = 0.192, p = 0.001). These findings lend empirical support to H3.

Interestingly, the inclusion of the mediator slightly reduced the total effect of ETL on employees’ PEBs (the beta value decreased from 0.384 to 0.337). However, the mediational hypothesis or the indirect effect of ETL on employees’ PEBs via AEM was still supported (β = 0.0493, BootSE = 0.024, BootLLCI = 0.010, BootULCI = 0.016), as indicated in Table 2. Surprisingly, when examining the strength of mediation using the VAF, as proposed by Hair et al. (2014) and Hadi et al. (2016b), no significant mediating effects were observed. The result of the VAF analysis is consistent with the inconclusive findings of Saleem et al. (2019, p. 129) and therefore warrants further scholarly investigation. To explore this inconclusive outcome regarding VAF, the study considered the Inspirational Environmental Motivation (IEM) aspect of ETL. Inspirational environmental motivation is defined as “the ability of leaders to passionately motivate their subordinates to go beyond their self-interests and to strive for a shared pro-environmental vision” (Robertson & Barling, 2013). The results of this analysis are presented in Table 2.

The results revealed that the relationship between IEM and AEM was positive and significant (β = 0.167, p = 0.001). The effects of IEM on employees’ PEBs (β = 0.121, p = 0.007) and AEM on employees’ PEBs (β = 0.262, p = 0.001) are noteworthy and statistically significant. Regarding the indirect effect of IEM on employees’ PEBs, the study supports the mediation hypothesis (β = 0.0456, BootSE = 0.019, BootLLCI = 0.013, BootULCI = 0.089). The strength of mediation under IEM is also statistically meaningful, accounting for 27% of the variance, which is above the recommended 20% threshold (Hair et al., 2014). This analysis further confirms that transformational leadership is a multidimensional reflective–formative construct (Hadi, 2022; see  Appendix 2). According to Sarstedt, Hair, Cheah, Becker, & Ringle (2019), “a higher order construct could be reflective–formative; formative–reflective; formative–formative; or reflective–reflective”(p. 198).

Table 3 presents the results of all four hypotheses. Based on the reported t-statistics and probability values, each hypothesis was supported. However, the strength of mediation between ETL and employees’ PEBs was found to be weaker, as the value of VAF was less than 20%, indicating no mediation (Hair et al., 2014, p. 225). Given the nature of causal relationships, we further explored the strength of mediation. Because transformational leadership is caused by four measures, namely “intellectual stimulation,” “inspirational motivation,” “individualized consideration” and “idealized influence”, an increase in intellectual stimulation may not necessarily increase autonomous environmental motivation, whereas an increase in inspirational environmental motivation may influence AEM. As such, the IEM aspect of ETL was investigated independently. The generated model is presented in Figure 2.

Grounded in transformational leadership and self-determination theories, this study aims to determine the cause-and-effect relationship between ETL and employees’ PEBs. The study identifies a critical path from the inspirational aspect of ETL to employees’ PEBs through AEM. The inspirational environmental aspect of ETL plays a key role in facilitating employees’ AEM, which subsequently leads to their pro-environmental behaviors. However, when considering the strength of mediation (as measured by the variance accounted for – VAF value) in the overall effect of ETL on employees’ PEBs through the mediating role of AEM, the results of the study were not statistically significant, in line with those reported by Saleem et al. (2019). One possible explanation for this outcome lies in the complexity of environmental sustainability within organizational contexts. As Hadi (2024) noted, the concept is still in its early stages of development. Therefore, it is crucial to have authentic and knowledgeable environmental leaders who possess a deep understanding of environmental sustainability (Cezarino, Liboni, Hunter, Pacheco, & Martins, 2022; Katou et al., 2023). A lack of environmental knowledge may negatively impact an environmental transformational leader’s ability to provide intellectual stimulation, which may, in turn, diminish their individualized consideration and idealized influence.

To further investigate the strength of mediation, this study specifically focused on the IEM aspect of ETL in the aforementioned relationship. Upon examining the link between IEM and AEM, this study found a positive and significant relationship, thereby supporting H4. This finding highlights that transformational leadership’s concentration on environmental issues helps build an understanding of self-environmental motivation, which is critical to fostering pro-environmental behaviors. These results are consistent with the findings of Graves et al. (2013). However, this study makes a more specific contribution by demonstrating that the IEM aspect of ETL is especially critical for promoting organizational sustainable performance.

Similarly, the findings of this study align with the transformational leadership theory (Bass, 1985), which proposes that when employees perceive high levels of ETL behaviors, they become intrinsically motivated, as ETL is closely tied to employees’ subjective perceptions. Furthermore, when ETL leaders instill environmental values in the minds of employees, the employees tend to align their values with those of their leaders. This alignment, in turn, cultivates a sense of self-environmental motivation, as ETL influences employees’ self-determination (Chua & Ayolo, 2021). Finally, the findings of this study confirm that transformational leadership is a multidimensional reflective–formative construct, and testing it as a composite variable may yield inconclusive results (Hadi, 2022). In addition, the absence of relevant mediators, such as employees’ psychological needs satisfaction, may introduce omitted variable bias, further complicating the interpretation of causal pathways.

Organizations are increasingly focusing on building effective environmental strategies to address global environmental problems and avoid catastrophic consequences. In response to this need, the present study empirically investigated the impact of ETL on employees’ PEBs through autonomous environmental motivation. The hypothesized relationships were generally supported, except for the strength of mediation, which proposed that AEM would mediate the relationship between ETL and employees’ PEBs. However, this unexpected result was further examined through post-hoc analysis. The results revealed that AEM significantly mediates the relationship between the IEM aspect of ETL and employees’ PEBs. Taken together, these findings suggest that the IEM aspect of ETL fosters a sense of self-environmental motivation in employees, which, in turn, leads to their pro-environmental behaviors.

The present study contributes to the environmental sustainability literature by empirically examining the proximate effect of ETL on AEM in nonprofit, environmentally sustainable organizations. By empirically testing the cause-and-effect relationship, this study advances the literature, which has so far lacked empirical validation in this context. Furthermore, the study integrates two distinct theoretical perspectives (transformational leadership and self-determination) into a unified framework, confirming its applicability in the field of environmental sustainability. Our findings also confirm that ETL is a higher-order reflective–formative construct, thus addressing a gap in the conceptualization of leadership constructs in sustainability studies. At large, this paper also contributes to the United Nations Sustainable Development Goals (SDGs) 12–15, which emphasize responsible consumption and production, climate action, life below water, and life on land (Souza Piao, Scalco, Vazquez-Brust, Plaza-Ubeda, & Tavera Cortés, 2022).

To address escalating environmental problems and mitigate potential catastrophic consequences, organizations should prioritize the hiring of environmental transformational leaders. Second, to develop a strong pool of such leaders, organizations are encouraged to adopt several key strategies: offer comprehensive environmental training programs; create opportunities for hands-on learning; foster a workplace culture that prioritizes sustainability; and recognize and reward individuals who demonstrate leadership in environmental matters. Third, this study underscores the importance of the inspirational aspect of environmental transformational leadership in enhancing employees’ self-environmental motivation. Therefore, HR departments should revise managerial selection criteria to prioritize candidates who highly demonstrate inspirational environmental motivation attributes.

In addition, transformational leaders should strive to maintain a balanced display of all four dimensions of transformational leadership. Any imbalance may result in reduced effectiveness, as “anything multiplied by zero equals zero.” Finally, to manage environmental challenges and safeguard public health, this study offers a comprehensive leadership-based solution specifically tailored to the Pakistani context, particularly for the city of Lahore.

This study is not without limitations, which provide several avenues for future research.

First, we acknowledge that the findings of this study are subject to geographic limitations, as the data were collected exclusively from the LG&CD Department in Lahore. Future research may benefit from replicating this study in other regions to explore potential geographical variations in results. Second, the strength of mediation might have been affected due to an omitted variable bias effect. For instance, the relationship between ETL and autonomous environmental motivation may be partially explained by employees’ psychological needs fulfillment, a mechanism that has not been thoroughly addressed in existing literature. We strongly recommend that future research explicitly examine how each attribute of transformational leadership satisfies the three basic psychological needs (autonomy, competence and relatedness), and how these, in turn, influence autonomous environmental motivation.

Third, due to political sensitivity, public sector employees were reluctant to provide detailed insights into their environmental tasks. Therefore, future studies should consider eco-friendly organizations in the private sector, where employees may be more open to sharing environmentally relevant behaviors. Fourth, future investigations may explore the effects of alternative leadership styles (e.g. ethical leadership, servant leadership or distributed leadership) on employees’ pro-environmental behaviors in environmentally sustainable organizations. Finally, for greater precision in understanding leadership impact, future studies could limit the sample to highly experienced managerial-level employees, as the effect of ETL on employees’ PEBs may take time to manifest and is more likely to be evident among experienced professionals in the long term.

The authors gratefully acknowledge the constructive suggestions of anonymous reviewers, the thematic associate editor and the editor-in-chief. Their suggestions make a significant contribution to the value of the current study.

L.C. Author’s contributions: Noor Ul Hadi: corresponding author, conceptualization (lead), formal analysis (lead), investigation (lead), supervision (lead), writing – original draft (lead); Furqan Rasool: data curation (lead), resources (equal), validation (equal), writing – review and editing (equal); John O. Kuforiji: Writing – review and editing (equal).

The authors declare no competing interests.

The study received institutional review and approval in terms of ethics and permissions.

The survey was provided with a cover letter that briefly explained its purpose and content. All participants voluntarily agreed to take part in the research.

Correspondence and requests for materials should be addressed to NH.