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. 2026 Sep 7;14:1896650. doi: 10.3389/fpubh.2026.1896650

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Copyright © 2026 Bu, Zhu, Zhao, Xu and Song.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Scatter plot with error bars showing random intercepts for 2,591 class-year units, ranked along the x-axis. Blue dots represent intervals entirely below zero, red above zero, and gray include zero. Points are grouped and color-coded by interval type as detailed in the legend. — Caterpillar plot of class-year random intercepts (Model 2, empirical-Bayes estimates with approximate 95% intervals). Intervals entirely above zero (n = 529) and entirely below zero (n = 565) are distinguished from intervals that include zero (n = 1,497). These intervals are descriptive summaries of the estimated random effects and are not multiple-comparison-corrected significance tests.