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[
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esp
ec
ially
y
o
u
n
g
er
g
en
e
r
atio
n
s
.
Gam
if
icati
o
n
,
wh
ich
in
teg
r
ates
g
am
e
m
ec
h
a
n
ics
in
to
n
o
n
-
g
a
m
e
co
n
tex
ts
,
h
as
em
er
g
ed
as
a
p
r
o
m
is
in
g
a
p
p
r
o
ac
h
to
in
c
r
ea
s
e
en
g
ag
em
en
t
[
1
0
]
.
Ho
wev
er
,
s
tu
d
ies
ex
p
licit
ly
ex
am
in
in
g
u
s
er
p
e
r
ce
p
tio
n
s
o
f
g
am
if
ied
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
,
p
ar
ticu
lar
l
y
th
o
s
e
tar
g
etin
g
b
eh
a
v
io
r
ch
an
g
e
d
u
r
i
n
g
th
e
C
OVI
D
-
1
9
p
an
d
e
m
ic,
r
em
ain
lim
ited
.
T
h
is
g
ap
h
ig
h
lig
h
ts
th
e
n
ee
d
f
o
r
f
u
r
th
er
e
x
p
lo
r
atio
n
in
to
h
o
w
g
am
if
icatio
n
ca
n
b
e
o
p
tim
ized
to
d
r
i
v
e
b
eh
a
v
io
r
al
c
h
an
g
e
ef
f
ec
tiv
ely
.
2.
B
ACK
G
RO
UND
S
T
UD
Y
2
.
1
.
H
ea
lt
h a
wa
re
nes
s
ca
m
p
a
ig
n
A
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
aim
s
to
r
ea
ch
th
e
p
u
b
lic,
m
ea
s
u
r
es
th
at
o
u
tr
ea
ch
ac
c
u
r
ately
,
an
d
m
o
tiv
ate
th
em
to
ac
t f
o
r
a
b
ett
er
q
u
ality
o
f
life
.
I
n
o
th
e
r
wo
r
d
s
,
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
d
eliv
er
m
ess
ag
es
o
n
th
e
v
alu
e
o
f
h
ea
lth
an
d
it
s
im
p
ac
t
o
n
p
eo
p
le,
s
u
ch
as
th
o
s
e
r
elate
d
to
C
OVI
D
-
1
9
.
Gen
er
ally
,
p
eo
p
le
wo
r
ld
wid
e
ar
e
well
in
f
o
r
m
e
d
r
eg
ar
d
in
g
C
OVI
D
-
1
9
.
T
h
i
s
in
f
o
r
m
atio
n
was
d
eliv
er
ed
d
aily
v
ia
m
ed
ia,
n
ews
,
an
d
r
u
le
im
p
lem
en
tatio
n
s
[
1
1
]
.
Da
ily
u
p
d
ates
an
d
n
ews
r
eg
ar
d
in
g
C
OVI
D
-
1
9
an
d
th
e
v
ac
cin
at
io
n
p
r
o
g
r
am
s
h
av
e
b
ee
n
r
ep
o
r
ted
.
Ho
we
v
er
,
ar
e
p
eo
p
le
awa
r
e
o
f
all
th
e
p
r
ec
au
ti
o
n
s
an
d
p
r
ev
en
tio
n
s
?
A
s
tu
d
y
b
y
[
1
2
]
s
tated
th
at
em
p
lo
y
ed
p
eo
p
le
wer
e
m
o
r
e
awa
r
e
o
f
t
h
e
v
ir
u
s
th
an
n
o
n
-
wo
r
k
in
g
p
eo
p
le.
Hen
ce
,
p
r
o
v
i
d
in
g
p
eo
p
le
with
a
th
o
r
o
u
g
h
in
s
ig
h
t
i
n
to
th
e
C
OVI
D
-
1
9
p
a
n
d
em
ic
is
im
p
er
ativ
e
.
Ho
wev
er
,
p
e
o
p
le
m
u
s
t
b
e
v
ig
i
lan
t
an
d
co
n
s
cio
u
s
o
f
th
eir
p
r
esen
t
well
-
b
ein
g
a
n
d
th
e
co
n
tin
u
i
n
g
co
n
s
eq
u
en
ce
s
o
f
th
e
ep
i
d
em
ic
o
n
t
h
eir
p
er
s
o
n
al
an
d
p
r
o
f
ess
io
n
al
cir
cu
m
s
tan
ce
s
[
1
3
]
.
2
.
2
.
G
a
m
if
ic
a
t
io
n
Gam
es
cr
ea
te
en
g
ag
em
en
t,
wh
ich
is
n
ec
ess
ar
y
f
o
r
an
y
lear
n
in
g
ex
p
e
r
ien
ce
[
1
4
]
,
[
1
5
]
.
G
am
if
icatio
n
in
co
r
p
o
r
ates
g
am
e
-
lik
e
f
ea
tu
r
es
in
to
d
aily
ex
p
er
ien
ce
s
s
u
c
h
as
s
h
o
p
p
in
g
,
u
s
in
g
a
h
an
d
wr
itin
g
p
r
o
g
r
am
,
o
r
lear
n
in
g
s
cien
ce
.
A
r
ec
e
n
t
r
esear
ch
m
o
v
em
en
t
ca
lled
g
a
m
if
i
ca
tio
n
aim
s
to
ap
p
ly
elem
e
n
ts
o
f
g
am
e
d
esig
n
to
non
-
g
am
in
g
co
n
tex
ts
,
s
u
ch
as
ed
u
ca
tio
n
an
d
tr
ain
in
g
[
1
6
]
,
[
1
7
]
.
Gam
if
icatio
n
p
r
im
ar
ily
aim
s
to
b
o
o
s
t
u
s
er
en
g
ag
em
e
n
t
an
d
tr
an
s
f
o
r
m
n
o
n
-
g
am
i
n
g
en
v
ir
o
n
m
e
n
ts
in
to
v
is
u
ally
ap
p
ea
lin
g
an
d
en
jo
y
ab
le
en
v
ir
o
n
m
en
ts
.
Ad
d
itio
n
ally
,
g
am
i
f
icatio
n
im
p
lem
en
ts
g
am
e
d
esig
n
p
r
in
ci
p
les,
m
ec
h
an
ics,
an
d
g
am
e
t
h
in
k
in
g
t
o
in
cr
ea
s
e
m
o
tiv
atio
n
in
n
o
n
-
g
am
in
g
ac
ti
v
ities
[
1
8
]
.
R
ec
en
tly
,
s
ev
er
al
s
tu
d
ies
ha
ve
b
ee
n
d
o
n
e
o
n
th
e
g
am
if
ied
s
y
s
tem
.
Pre
v
io
u
s
s
tu
d
ies
h
a
v
e
s
h
o
wn
th
at
lear
n
in
g
b
eh
a
v
io
r
b
en
e
f
its
lea
r
n
in
g
p
er
f
o
r
m
a
n
ce
an
d
m
o
tiv
atio
n
[
1
1
]
.
Fu
r
th
e
r
m
o
r
e
,
g
am
i
f
icatio
n
tr
an
s
f
o
r
m
s
th
e
lear
n
in
g
p
r
o
ce
s
s
in
to
a
g
a
m
e
-
b
ased
wo
r
ld
[
1
9
]
.
As
p
eo
p
le
ten
d
to
lo
s
e
f
o
c
u
s
wh
en
r
ea
d
in
g
o
r
watc
h
in
g
s
o
m
eth
in
g
lo
n
g
tim
e
,
g
am
if
ic
atio
n
will
m
ak
e
lear
n
in
g
m
o
r
e
en
jo
y
a
b
le.
I
t
is
also
im
p
o
r
ta
n
t
to
r
em
e
m
b
er
th
at
u
s
in
g
a
g
am
e
in
a
n
o
n
-
g
am
in
g
en
v
ir
o
n
m
en
t
r
eq
u
ir
es
en
g
a
g
e
m
en
t
[
2
0
]
.
B
esid
es,
g
am
if
icatio
n
co
m
b
in
es
g
a
m
e
m
ec
h
an
ics
with
g
am
ep
lay
a
n
d
th
en
im
p
lem
en
ts
th
em
to
p
r
esen
t
lear
n
in
g
co
n
te
n
t
to
m
o
tiv
ate
p
lay
er
s
’
en
g
ag
em
e
n
t
[
1
5
]
.
Fu
r
th
er
m
o
r
e,
b
u
s
in
ess
ar
ea
s
h
av
e
lar
g
ely
em
b
r
ac
ed
g
am
if
icatio
n
ele
m
en
ts
to
en
h
an
ce
em
p
lo
y
ee
s
’
e
x
p
er
ien
ce
th
r
o
u
g
h
r
ewa
r
d
s
,
lea
d
er
b
o
ar
d
s
,
an
d
b
ad
g
es
[
2
1
]
.
Gam
if
icatio
n
r
ec
eiv
ed
a
s
ig
n
if
ica
n
t
en
d
o
r
s
em
en
t
f
r
o
m
r
esear
ch
er
s
an
d
ed
u
ca
to
r
s
wh
o
ac
k
n
o
wled
g
ed
th
at
g
am
if
icatio
n
im
p
r
o
v
es
p
r
o
d
u
ctiv
ity
an
d
f
o
s
ter
s
cr
ea
tiv
e
ex
p
lo
r
atio
n
a
m
o
n
g
lear
n
er
s
[
2
2
]
,
[
2
3
]
.
2
.
3
.
G
a
m
if
ied hea
lt
h a
wa
re
n
ess
ca
m
pa
ig
n
Gam
e
-
b
ased
ac
tiv
ity
is
d
ef
i
n
ed
as
an
in
d
iv
id
u
al
e
n
g
ag
em
en
t
f
o
r
en
ter
tain
m
e
n
t
.
G
am
es
ar
e
f
u
n
d
am
e
n
tal
in
h
u
m
an
i
n
ter
ac
tio
n
an
d
lear
n
in
g
.
I
t
is
o
n
e
o
f
th
e
b
est
p
latf
o
r
m
s
to
ed
u
ca
te
p
eo
p
le.
Peo
p
le
wh
o
p
lay
g
am
es
h
av
e
an
e
x
ce
llen
t
o
p
p
o
r
tu
n
ity
to
lear
n
p
r
ac
tical
s
k
ills
.
No
wad
ay
s
,
g
am
es
ar
e
cr
ea
ted
f
o
r
ed
u
ca
tio
n
al
p
u
r
p
o
s
es,
wh
ich
h
av
e
cr
e
ated
awa
r
en
ess
f
o
r
p
eo
p
le
in
an
en
j
o
y
ab
le
ex
p
er
ie
n
ce
.
I
t
is
a
n
alte
r
n
ativ
e
th
at
m
ak
es
p
eo
p
le
p
a
y
atten
tio
n
to
s
p
ec
if
i
c
s
u
b
jects.
T
h
r
o
u
g
h
g
am
i
f
icatio
n
,
p
e
o
p
le
will
b
ec
o
m
e
m
o
r
e
a
ttra
cted
to
lear
n
in
g
as
it
s
tim
u
late
s
an
d
cr
ea
tes
en
g
ag
em
e
n
t
[
2
4
]
.
Hea
lth
awa
r
en
ess
ca
m
p
aig
n
s
th
r
o
u
g
h
g
a
m
if
icatio
n
in
cr
ea
s
e
s
o
ciety
’
s
u
n
d
er
s
tan
d
in
g
o
f
th
e
ca
m
p
aig
n
’
s
co
n
ten
t.
A
p
r
ev
io
u
s
s
tu
d
y
b
y
[
2
5
]
in
v
esti
g
ated
Gen
Z
’
s
in
s
ig
h
t in
to
g
am
if
ied
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
ag
ain
s
t th
e
C
OVI
D
-
1
9
p
an
d
em
ic.
I
d
en
tify
in
g
th
e
ch
allen
g
e
o
f
g
am
if
ied
h
ea
lth
awa
r
en
ess
also
s
er
v
es
as
a
b
lu
ep
r
in
t
f
o
r
c
r
ea
tin
g
a
n
ap
p
licatio
n
t
o
f
ig
h
t
t
h
e
C
OVI
D
-
1
9
p
a
n
d
em
ic.
Ad
d
itio
n
ally
,
a
s
tu
d
y
b
y
[
2
2
]
d
is
cu
s
s
ed
im
p
r
o
v
i
n
g
k
n
o
wled
g
e
o
f
in
f
ec
tio
n
p
r
e
v
en
tio
n
an
d
co
n
tr
o
l
p
r
o
ce
d
u
r
es
(
I
PC
)
an
d
C
OVI
D
-
1
9
s
af
e
p
r
a
ctice
s
.
T
h
e
s
tu
d
y
also
d
eter
m
i
n
ed
a
s
er
io
u
s
g
a
m
e
ca
lled
‘
E
s
ca
p
e
C
OVI
D
-
1
9
’
to
im
p
r
o
v
e
co
m
p
lian
ce
with
t
h
e
C
OVI
D
-
1
9
s
af
e
r
u
l
es
a
n
d
m
o
d
if
y
th
e
in
ten
tio
n
to
f
o
llo
w
I
PC
g
u
id
elin
es
am
o
n
g
n
u
r
s
in
g
h
o
m
e
em
p
lo
y
ee
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
20
2
6
:
72
-
80
74
Fu
r
th
er
m
o
r
e
,
p
ast
r
esear
ch
h
a
s
ex
am
in
ed
th
e
ef
f
icac
y
o
f
h
ea
lth
g
am
es
as
a
tech
n
o
lo
g
ical
to
o
l
f
o
r
p
r
o
m
o
tin
g
h
ea
lth
th
r
o
u
g
h
a
n
ti
-
s
m
o
k
in
g
in
itiativ
es a
n
d
ad
v
er
tis
in
g
.
Fo
r
ex
a
m
p
le,
a
s
tu
d
y
b
y
[
2
6
]
e
x
am
in
ed
th
e
ef
f
ec
ts
o
f
v
o
ice
-
o
v
er
an
d
v
a
r
io
u
s
an
ti
-
s
m
o
k
in
g
a
d
v
er
tis
in
g
m
ess
ag
es
on
f
ir
s
t
-
p
er
s
o
n
s
h
o
o
ter
(
FP
S)
g
am
es.
T
h
e
s
tu
d
y
s
h
o
wed
h
o
w
v
i
d
eo
g
am
es
ca
n
b
e
u
s
ed
to
s
u
p
p
o
r
t
a
n
ti
-
s
m
o
k
in
g
ca
m
p
aig
n
s
.
I
n
t
h
e
v
i
d
eo
g
am
e
,
a
p
lay
er
ca
n
u
n
d
er
s
tan
d
th
e
h
ar
m
f
u
l
ef
f
ec
ts
o
f
s
m
o
k
in
g
cig
ar
ettes
an
d
h
o
w
it
af
f
ec
ts
th
eir
h
ea
lt
h
.
Mo
r
eo
v
er
,
g
am
if
icatio
n
is
b
en
ef
icial
f
o
r
an
awa
r
e
n
ess
ca
m
p
aig
n
as
it
h
elp
s
d
eliv
er
t
h
e
m
ess
ag
e
an
d
p
u
r
p
o
s
e
[
2
7
]
,
[
2
8
]
.
A
d
d
itio
n
ally
,
a
g
am
if
ied
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
tim
u
lates
in
ter
est
in
lear
n
in
g
an
d
im
p
r
o
v
es
p
e
o
p
le’
s
u
n
d
er
s
tan
d
in
g
an
d
atten
tio
n
to
th
e
ca
m
p
aig
n
’
s
co
n
ten
t
v
ia
u
s
er
en
g
a
g
em
en
t.
T
h
u
s
,
g
am
if
icatio
n
ca
n
b
e
im
p
le
m
en
ted
as
an
ex
citin
g
ap
p
r
o
ac
h
to
m
o
tiv
ate
p
eo
p
le
t
o
lear
n
.
2
.
4
.
K
ey
co
ntr
ibu
t
io
n
o
f
t
he
g
a
m
if
ied hea
lt
h a
wa
re
nes
s
ca
m
pa
ig
n
Sev
er
al
k
ey
co
n
tr
i
b
u
to
r
s
h
a
v
e
ad
v
an
ce
d
th
e
ir
u
n
d
er
s
tan
d
in
g
o
f
g
am
if
icatio
n
a
n
d
its
r
o
le
in
p
r
o
m
o
tin
g
en
g
ag
em
e
n
t
an
d
b
eh
a
v
io
r
al
c
h
an
g
e.
A
s
tu
d
y
b
y
[
2
9
]
in
tr
o
d
u
ce
d
th
e
co
n
ce
p
t
o
f
g
am
if
icati
o
n
,
em
p
h
asizin
g
its
p
o
ten
tial
to
in
cr
ea
s
e
m
o
tiv
atio
n
b
y
in
teg
r
atin
g
g
am
e
m
ec
h
an
ics
in
to
n
o
n
-
g
a
m
e
co
n
tex
ts
.
B
esid
es,
a
s
tu
d
y
b
y
[
1
7
]
co
n
d
u
cted
a
co
m
p
r
eh
e
n
s
iv
e
r
ev
iew,
h
ig
h
lig
h
tin
g
g
am
if
icatio
n
’
s
ef
f
ec
tiv
en
ess
in
en
h
an
cin
g
lear
n
in
g
an
d
b
eh
av
io
u
r
wh
en
d
esig
n
ed
th
o
u
g
h
tf
u
lly
.
I
n
h
ea
lth
ca
m
p
aig
n
s
,
Al
-
Aza
wi
et
a
l
.
[
1
9
]
d
em
o
n
s
tr
ated
h
o
w
g
am
if
icatio
n
im
p
r
o
v
es
u
s
er
en
g
ag
em
en
t
co
m
p
ar
ed
to
tr
ad
itio
n
al
ed
u
ca
tio
n
al
m
eth
o
d
s
.
L
u
an
d
Ho
[
24
]
ex
te
n
d
ed
th
is
u
n
d
er
s
tan
d
in
g
b
y
s
h
o
win
g
th
e
r
o
l
e
o
f
g
a
m
if
icatio
n
in
en
h
an
cin
g
u
s
er
e
n
g
ag
e
m
en
t,
m
ai
n
ly
f
o
cu
s
in
g
o
n
h
o
w
g
am
if
ied
elem
e
n
ts
ca
n
in
f
lu
e
n
ce
s
u
s
tain
ab
le
b
e
h
av
io
u
r
i
n
d
ig
ital
ap
p
licatio
n
s
.
I
n
th
e
c
o
n
tex
t
o
f
C
OVI
D
-
1
9
,
[
11
]
d
ev
el
o
p
ed
th
e
GAM
E
B
C
m
o
d
el,
s
h
o
wca
s
in
g
its
a
b
ilit
y
to
e
n
g
ag
e
Gen
Z
au
d
ien
ce
s
i
n
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
.
Yo
o
a
n
d
E
asti
n
[
26
]
f
u
r
th
er
em
p
h
asized
g
am
if
icatio
n
’
s
p
o
ten
tial
in
h
e
alth
p
r
o
m
o
tio
n
b
y
d
em
o
n
s
tr
atin
g
h
o
w
s
to
r
y
tellin
g
an
d
in
ter
ac
tiv
e
g
am
e
elem
e
n
ts
ef
f
ec
tiv
ely
en
h
an
ce
h
ea
lth
-
r
elate
d
m
ess
ag
es,
s
u
ch
as
an
ti
-
s
m
o
k
i
n
g
ca
m
p
aig
n
s
.
T
o
g
eth
e
r
,
t
h
ese
s
tu
d
ies
u
n
d
er
s
co
r
e
th
e
im
p
o
r
tan
ce
o
f
g
a
m
if
icatio
n
as
a
t
o
o
l
f
o
r
f
o
s
ter
in
g
en
g
ag
em
en
t a
n
d
b
eh
av
io
r
al
c
h
an
g
e
in
d
iv
e
r
s
e
co
n
tex
ts
.
3.
M
E
T
H
O
D
3
.
1
.
Crit
er
ia
f
o
r
pa
r
t
icipa
t
io
n
T
h
is
s
tu
d
y
in
v
o
lv
ed
1
8
0
u
n
d
er
g
r
ad
u
ate
s
tu
d
en
ts
f
r
o
m
th
e
C
o
lleg
e
o
f
C
o
m
p
u
tin
g
,
I
n
f
o
r
m
atics
an
d
Ma
th
em
atics
(
KPPIM
)
,
UiT
MCM,
J
a
s
in
C
am
p
u
s
,
wh
o
f
u
lf
illed
th
e
in
clu
s
io
n
cr
iter
ia.
T
h
e
p
ar
ticip
an
ts
m
u
s
t
h
av
e
ex
p
e
r
ien
ce
p
lay
i
n
g
co
m
p
u
ter
g
am
es
as
b
eg
in
n
e
r
s
,
m
o
d
er
ates
,
o
r
h
ar
d
c
o
r
e
g
am
e
r
s
.
T
h
e
p
ar
ticip
an
ts
wer
e
also
r
eq
u
ested
to
c
o
m
p
lete
a
c
o
n
s
en
t
s
u
r
v
e
y
f
o
r
th
is
r
esear
c
h
p
r
o
ce
d
u
r
e
.
C
o
n
f
id
e
n
tiality
a
n
d
an
o
n
y
m
ity
wer
e
s
tr
ictly
m
ain
tain
ed
th
r
o
u
g
h
o
u
t
th
e
s
tu
d
y
.
3
.
2
.
I
ns
t
rum
ent
T
ab
le
1
s
h
o
ws
a
s
elf
-
ad
m
i
n
is
ter
ed
in
s
tr
u
m
en
t
ad
a
p
ted
b
a
s
ed
o
n
th
e
GAM
E
B
C
Mo
d
el
[
1
7
]
.
T
h
e
GAM
E
B
C
Mo
d
el
is
a
q
u
esti
o
n
n
air
e
c
o
n
ce
r
n
in
g
th
e
p
r
o
p
o
s
ed
d
esig
n
cr
iter
ia
f
o
r
b
eh
a
v
io
r
ch
a
n
g
e
,
wh
ic
h
in
v
o
lv
es
Au
to
n
o
m
y
,
C
o
m
p
eten
ce
,
R
elate
d
n
ess
,
an
d
E
n
g
a
g
e
m
en
t
elem
en
ts
.
T
h
e
r
esp
o
n
d
en
ts
wer
e
ex
p
ec
ted
to
s
p
ec
if
y
th
eir
a
g
r
e
em
en
t
with
th
e
item
s
r
elate
d
to
th
e
p
er
c
ep
tio
n
o
f
d
esig
n
f
o
r
b
e
h
av
io
r
ch
an
g
e
th
r
o
u
g
h
a
g
am
if
ied
h
ea
lth
awa
r
e
n
ess
ca
m
p
aig
n
.
E
ac
h
co
m
p
o
n
e
n
t
was
m
ea
s
u
r
ed
th
r
o
u
g
h
a
s
et
o
f
s
tr
u
ctu
r
ed
item
s
u
s
in
g
a
f
iv
e
-
p
o
i
n
t
L
ik
e
r
t
s
ca
le
r
a
n
g
in
g
f
r
o
m
s
tr
o
n
g
ly
d
is
ag
r
ee
to
s
tr
o
n
g
ly
a
g
r
ee
.
T
h
e
in
s
tr
u
m
e
n
t
u
n
d
er
wen
t
a
v
alid
ity
ass
es
s
m
en
t
an
d
was
ad
ap
ted
f
r
o
m
p
r
io
r
s
tu
d
ies
to
en
s
u
r
e
its
r
eliab
ilit
y
an
d
r
elev
an
ce
to
th
e
co
n
tex
t
o
f
g
a
m
if
ied
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
.
3
.
3
.
P
r
o
ce
du
re
T
h
e
p
r
o
ce
s
s
o
f
d
is
tr
ib
u
tin
g
to
r
esp
o
n
d
e
n
ts
th
r
o
u
g
h
an
o
n
lin
e
p
latf
o
r
m
in
v
o
lv
es
s
ev
er
al
k
ey
s
tep
s
to
en
s
u
r
e
ef
f
ec
ti
v
e
d
ata
co
llectio
n
.
First,
th
e
ta
r
g
et
a
u
d
ien
ce
is
id
en
tifie
d
,
en
s
u
r
in
g
th
e
y
alig
n
with
th
e
r
esear
ch
o
b
jectiv
es.
T
h
e
s
u
r
v
ey
is
th
e
n
d
esig
n
ed
u
s
in
g
th
e
u
s
er
-
f
r
ien
d
ly
o
n
lin
e
p
latf
o
r
m
(
J
o
tFo
r
m
)
with
clea
r
q
u
esti
o
n
s
tailo
r
ed
to
th
e
r
esp
o
n
d
e
n
ts
’
liter
ac
y
lev
el
,
an
d
ca
n
b
e
ac
ce
s
s
ed
ac
r
o
s
s
d
ev
ices
.
T
h
e
u
s
e
o
f
J
o
tFo
r
m
f
o
r
d
at
a
co
llectio
n
en
s
u
r
ed
ac
ce
s
s
ib
ilit
y
,
esp
ec
ially
d
u
r
i
n
g
a
p
an
d
em
ic
wh
en
in
-
p
e
r
s
o
n
s
u
r
v
ey
s
we
r
e
im
p
r
ac
tical.
T
h
e
s
u
r
v
ey
lin
k
is
s
h
ar
ed
v
ia
s
o
cial
m
ed
ia
to
r
ea
ch
r
esp
o
n
d
e
n
ts
co
n
v
en
ien
tly
.
R
em
in
d
er
s
ar
e
s
en
t
p
er
io
d
ically
b
ef
o
r
e
th
e
d
ea
d
lin
e
t
o
e
n
h
an
ce
p
ar
tic
ip
atio
n
.
T
h
r
o
u
g
h
o
u
t
t
h
e
d
is
tr
ib
u
tio
n
p
e
r
io
d
,
r
esp
o
n
s
e
r
ates
ar
e
m
o
n
ito
r
e
d
u
s
in
g
th
e
J
o
tFo
r
m
p
latf
o
r
m
’
s
an
aly
ti
cs
.
E
n
s
u
r
in
g
d
ata
p
r
iv
ac
y
an
d
in
f
o
r
m
e
d
co
n
s
en
t
ar
e
p
r
io
r
itized
an
d
en
c
o
u
r
a
g
in
g
h
o
n
est
r
esp
o
n
s
es.
T
h
is
s
y
s
t
e
m
atic
ap
p
r
o
ac
h
m
a
x
im
izes
r
ea
ch
an
d
co
llects
h
ig
h
-
q
u
ality
d
ata
ef
f
icien
tly
.
T
h
e
d
escr
ip
tiv
e
s
tatis
tical
m
eth
o
d
s
wer
e
s
elec
ted
f
o
r
th
eir
s
u
it
ab
ilit
y
in
s
u
m
m
ar
izi
n
g
p
er
ce
p
tio
n
s
an
d
d
er
iv
i
n
g
m
ea
n
in
g
f
u
l
in
s
ig
h
ts
f
r
o
m
th
e
d
ata.
B
y
em
p
lo
y
in
g
th
e
GA
ME
B
C
m
o
d
el,
th
e
s
tu
d
y
ad
d
r
ess
es
th
e
n
ee
d
f
o
r
a
s
tr
u
ctu
r
ed
f
r
a
m
ewo
r
k
to
ev
alu
ate
g
am
if
ied
e
lem
en
ts
in
h
ea
lth
ca
m
p
aig
n
s
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Ga
me
o
n
fo
r
h
e
a
lth
:
d
esig
n
i
n
g
g
a
mified
ca
mp
a
i
g
n
s
to
d
r
ive
b
eh
a
vio
r
a
l
…
(
N
u
r
u
l H
id
a
y
a
h
Ma
t Za
in
)
75
T
ab
le
1
.
GAM
E
B
C
m
o
d
el
item
I
t
e
ms
C
o
d
e
I
t
e
m
I
t
e
ms
C
o
d
e
I
t
e
m
A
u
t
o
n
o
m
y
A1
I
c
a
n
c
r
e
a
t
e
a
c
u
s
t
o
m
i
z
a
t
i
o
n
p
r
o
f
i
l
e
.
R
e
l
a
t
e
d
n
e
s
s
R1
I
c
a
n
b
e
i
n
v
o
l
v
e
d
i
n
s
o
c
i
a
l
i
n
t
e
r
a
c
t
i
o
n
s
.
A2
I
c
a
n
c
h
o
o
s
e
t
h
e
a
c
t
i
v
i
t
y
i
n
t
h
e
g
a
m
e
.
R2
I
c
a
n
s
h
a
r
e
t
h
e
i
n
f
o
r
ma
t
i
o
n
t
h
r
o
u
g
h
s
o
c
i
a
l
i
n
t
e
r
a
c
t
i
o
n
.
A3
I
c
a
n
c
o
n
t
r
o
l
i
n
t
e
r
a
c
t
i
o
n
i
n
t
h
e
g
a
m
e
.
R3
I
c
a
n
j
o
i
n
t
h
e
g
a
me
c
o
mm
u
n
i
t
y
.
A4
I
c
a
n
c
o
n
t
r
o
l
t
h
e
i
n
t
e
r
f
a
c
e
g
a
me.
R4
I
h
a
v
e
e
x
p
e
r
i
e
n
c
e
d
v
a
r
i
o
u
s t
y
p
e
s
o
f
s
o
c
i
a
l
i
n
t
e
r
a
c
t
i
o
n
s.
A5
I
h
a
v
e
a
s
e
n
se
o
f
c
o
n
t
r
o
l
o
v
e
r
t
h
e
g
a
m
e
.
R5
I
f
e
e
l
c
o
o
p
e
r
a
t
i
v
e
t
o
w
a
r
d
o
t
h
e
r
u
s
e
r
s.
A6
I
f
r
e
e
l
y
p
l
a
y
t
h
e
g
a
me
t
h
e
w
a
y
I
w
a
n
t
.
R6
I
c
a
n
c
o
l
l
a
b
o
r
a
t
e
w
i
t
h
o
t
h
e
r
u
sers
.
C
o
m
p
e
t
e
n
c
e
C1
I
h
a
v
e
d
i
f
f
e
r
e
n
t
l
e
v
e
l
s
o
f
c
h
a
l
l
e
n
g
e
s
.
En
g
a
g
e
m
e
n
t
E1
I
f
e
e
l
a
s
t
a
t
e
o
f
c
u
r
i
o
s
i
t
y
.
C2
I
h
a
v
e
r
e
c
e
i
v
e
d
f
e
e
d
b
a
c
k
o
n
t
h
e
p
r
o
g
r
e
ss.
E2
I
f
e
e
l
a
s
t
a
t
e
o
f
f
l
o
w
i
n
t
h
e
g
a
me
p
l
a
y
.
C3
I
c
a
n
r
e
f
e
r
t
o
t
h
e
p
e
r
f
o
r
m
a
n
c
e
b
a
r
.
E3
I
f
e
e
l
a
n
i
n
t
e
n
se
s
e
n
sa
t
i
o
n
o
f
s
u
c
c
e
ss
.
C4
I
h
a
v
e
a
b
a
d
g
e
a
s
a
r
e
w
a
r
d
f
o
r
a
c
h
i
e
v
e
me
n
t
.
E4
I
u
n
d
e
r
st
a
n
d
t
h
e
g
a
me
c
o
n
t
e
n
t
.
C5
I
c
a
n
g
e
t
t
h
e
p
o
i
n
t
a
s
a
r
e
w
a
r
d
sy
st
e
m.
E5
I
f
e
e
l
a
p
o
si
t
i
v
e
e
m
o
t
i
o
n
i
n
a
l
e
a
r
n
i
n
g
e
x
p
e
r
i
e
n
c
e
.
C6
I
c
a
n
r
e
f
e
r
t
o
t
h
e
l
e
a
d
e
r
b
o
a
r
d
.
E6
Th
e
g
a
me
i
s
c
o
mp
l
i
a
n
t
w
i
t
h
t
h
e
t
r
e
a
t
men
t
.
4.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
4
.
1
.
De
m
o
g
r
a
ph
ic
r
esp
o
nd
e
nts
T
ab
le
2
s
h
o
ws
th
e
d
em
o
g
r
ap
h
ic
r
esu
lts
o
f
th
e
r
esp
o
n
d
en
ts
.
Mo
r
e
th
an
h
alf
o
f
th
e
r
esp
o
n
d
en
ts
wer
e
f
em
ales,
with
N
=
1
0
8
(
6
0
%).
Mo
s
t
r
esp
o
n
d
en
ts
wer
e
b
etwe
en
2
2
an
d
2
5
(
6
3
.
3
%),
wh
ile
3
5
.
6
%
wer
e
b
etwe
en
1
8
an
d
2
1
.
Fo
r
ed
u
ca
tio
n
lev
el,
4
0
(
2
2
.
2
%)
o
f
th
e
r
esp
o
n
d
en
ts
h
ad
a
d
ip
lo
m
a
,
wh
ile
o
n
e
r
esp
o
n
d
en
t
was
p
u
r
s
u
in
g
a
p
o
s
tg
r
a
d
u
ate
s
tu
d
y
.
6
8
(
3
7
.
8
%)
o
f
t
h
e
r
esp
o
n
d
en
ts
p
lay
ed
v
id
e
o
g
am
es
ev
e
r
y
d
ay
,
1
9
(
1
0
.
6
%)
o
f
th
e
r
esp
o
n
d
en
ts
p
lay
e
d
d
ig
ital
g
am
es
o
n
ce
a
wee
k
,
an
d
4
1
(
2
2
.
8
%)
o
f
th
e
r
esp
o
n
d
en
ts
p
la
y
ed
m
o
r
e
th
a
n
o
n
ce
a
wee
k
.
I
n
r
eg
a
r
d
to
t
h
eir
g
a
m
in
g
lev
el,
a
to
tal
o
f
1
1
6
(
6
4
.
4
%)
r
esp
o
n
d
en
ts
c
o
n
s
id
er
ed
t
h
em
s
elv
es
m
o
d
e
r
ate
g
am
er
s
.
I
n
co
m
p
ar
is
o
n
,
5
0
(
2
7
.
8
%)
o
f
th
e
m
claim
ed
to
b
e
at
a
b
eg
in
n
er
le
v
el,
an
d
1
4
(
7
.
8
%)
c
laim
ed
to
b
e
h
ar
d
co
r
e
g
am
er
s
.
As f
o
r
th
e
r
e
s
id
en
tial a
r
ea
,
a
to
tal
o
f
1
2
4
(
6
8
.
9
%)
r
esp
o
n
d
en
ts
liv
ed
in
u
r
b
an
ar
ea
s
,
wh
ile
5
6
(
3
1
.
1
%)
liv
e
d
in
r
u
r
al
ar
ea
s
.
T
ab
le
2
.
Dem
o
g
r
ap
h
y
r
esu
lt
Q
u
e
st
i
o
n
s
R
a
n
g
e
n
%
G
e
n
d
e
r
M
a
l
e
72
40
F
e
mal
e
1
0
8
60
A
g
e
18
-
2
1
y
e
a
r
s
o
l
d
64
3
5
.
6
22
-
2
5
y
e
a
r
s
o
l
d
1
1
4
6
3
.
3
26
-
2
9
y
e
a
r
s
o
l
d
1
0
.
6
M
o
r
e
t
h
a
n
2
9
y
e
a
r
s o
l
d
1
0
.
6
Ed
u
c
a
t
i
o
n
l
e
v
e
l
D
i
p
l
o
m
a
40
2
2
.
2
D
e
g
r
e
e
1
3
9
7
7
.
2
P
o
st
g
r
a
d
u
a
t
e
1
0
.
6
H
o
w
o
f
t
e
n
d
o
y
o
u
p
l
a
y
t
h
e
d
i
g
i
t
a
l
g
a
me?
Ev
e
r
y
d
a
y
68
3
7
.
8
O
n
c
e
a
w
e
e
k
19
1
0
.
6
M
o
r
e
t
h
a
n
o
n
c
e
a
w
e
e
k
41
2
2
.
8
O
n
c
e
a
mo
n
t
h
14
7
.
8
M
o
r
e
t
h
a
n
o
n
e
i
n
a
m
o
n
t
h
13
7
.
2
O
n
e
i
n
h
a
l
f
-
y
e
a
r
7
3
.
9
M
o
r
e
t
h
a
n
o
n
c
e
i
n
a
h
a
l
f
-
y
e
a
r
5
2
.
8
O
n
c
e
a
y
e
a
r
6
3
.
3
I
t
r
y
t
o
p
l
a
y
t
h
e
g
a
me
a
s rare
l
y
a
s
p
o
s
si
b
l
e
7
3
.
9
Ex
p
e
r
i
e
n
c
e
l
e
v
e
l
a
s a
g
a
mer
B
e
g
i
n
n
e
r
50
2
7
.
8
M
o
d
e
r
a
t
e
1
1
6
6
4
.
4
H
a
r
d
c
o
r
e
14
7
.
8
W
h
e
r
e
d
o
y
o
u
r
e
si
d
e
(
l
i
v
e
)
?
R
u
r
a
l
a
r
e
a
(
C
o
u
n
t
r
y
si
d
e
)
56
3
1
.
1
U
r
b
a
n
a
r
e
a
(
T
o
w
n
/
C
i
t
y
)
1
2
4
6
8
.
9
4
.
2
.
De
s
ig
n f
o
r
a
uto
no
m
y
el
em
ent
Fig
u
r
e
1
s
h
o
ws th
at
2
8
.
3
% o
f
r
esp
o
n
d
en
ts
wer
e
n
e
u
tr
al
an
d
4
5
.
6
% a
g
r
ee
d
with
th
e
p
r
o
p
o
s
al
to
cr
ea
te
a
cu
s
to
m
ized
p
r
o
f
ile.
8
1
.
7
%
o
f
r
esp
o
n
d
en
ts
eith
e
r
ag
r
ee
d
o
r
s
tr
o
n
g
ly
a
g
r
ee
d
th
at
th
e
g
a
m
e
s
h
o
u
ld
p
r
o
v
id
e
o
p
tio
n
s
f
o
r
p
lay
e
r
s
to
ch
o
o
s
e
th
eir
ac
tiv
ities
.
I
t
wa
s
al
s
o
f
o
u
n
d
th
at
8
6
.
1
%
o
f
th
e
r
esp
o
n
d
e
n
t
s
wan
ted
to
co
n
tr
o
l
th
e
g
am
e’
s
in
ter
ac
tiv
ity
an
d
6
5
%
wan
ted
to
co
n
tr
o
l
th
e
g
am
e’
s
in
ter
f
ac
e.
7
9
.
5
%
o
f
th
e
r
es
p
o
n
d
e
n
ts
ag
r
ee
d
an
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
20
2
6
:
72
-
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76
s
tr
o
n
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ly
ag
r
ee
d
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at
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am
e
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l.
B
esid
es,
8
2
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%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
ee
d
s
tr
o
n
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ly
ag
r
ee
d
th
at
t
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e
p
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s
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o
u
ld
b
e
ab
le
to
p
lay
th
e
g
am
e
f
r
ee
ly
as th
ey
p
r
ef
e
r
.
T
h
ese
f
in
d
i
n
g
s
em
p
h
asize
th
e
im
p
o
r
tan
ce
o
f
p
r
o
v
id
in
g
u
s
er
s
with
a
s
en
s
e
o
f
co
n
tr
o
l,
alig
n
in
g
wit
h
[
3
0
]
,
s
elf
-
d
eter
m
in
atio
n
th
e
o
r
y
,
wh
ich
id
en
tifie
s
Au
to
n
o
m
y
as
a
k
e
y
m
o
tiv
ato
r
i
n
b
e
h
a
v
io
r
ch
a
n
g
e.
W
h
en
co
m
p
ar
ed
with
p
r
io
r
r
esear
c
h
,
th
ese
f
in
d
in
g
s
alig
n
with
[
24
]
,
wh
o
em
p
h
asized
a
u
to
n
o
m
y
as
a
d
r
iv
er
o
f
en
g
ag
em
e
n
t
in
g
am
if
icatio
n
.
Ad
d
itio
n
ally
,
Ko
iv
is
to
et
a
l.
[
17
]
d
em
o
n
s
tr
ated
h
o
w
au
t
o
n
o
m
y
elem
e
n
ts
in
g
am
if
icatio
n
s
ig
n
if
ica
n
tly
en
h
an
ce
u
s
er
m
o
tiv
atio
n
.
T
h
is
s
tu
d
y
ex
te
n
d
s
th
ese
f
i
n
d
in
g
s
b
y
f
o
cu
s
in
g
o
n
au
to
n
o
m
y
with
in
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
.
A
lim
itatio
n
i
s
th
e
p
o
te
n
tial
o
v
er
em
p
h
asis
o
n
cu
s
to
m
izatio
n
,
wh
ich
m
ig
h
t
n
o
t u
n
i
v
er
s
ally
ap
p
ly
ac
r
o
s
s
d
i
v
er
s
e
d
em
o
g
r
ap
h
ics.
F
i
g
u
r
e
1
.
G
r
a
p
h
f
r
e
q
u
e
n
c
y
(
%
)
t
h
e
p
e
r
c
e
p
t
i
o
n
o
f
d
e
s
i
g
n
f
o
r
t
h
e
a
u
t
o
n
o
m
y
e
l
e
m
e
n
t
4
.
3
.
De
s
ig
n f
o
r
c
o
m
pet
ent
el
em
ent
Fig
u
r
e
2
s
h
o
ws
th
e
r
esp
o
n
d
en
t
s
’
p
er
ce
p
tio
n
o
f
th
e
d
esig
n
f
o
r
th
e
co
m
p
eten
t
elem
e
n
t.
I
t
is
s
h
o
wn
th
at
8
5
%
o
f
th
e
r
esp
o
n
d
e
n
ts
ag
r
ee
d
to
s
tr
o
n
g
ly
a
g
r
ee
d
th
at
g
am
if
ied
ca
m
p
aig
n
s
s
h
o
u
l
d
h
av
e
d
if
f
er
en
t
lev
els
o
f
ch
allen
g
e.
7
0
%
o
f
th
e
m
also
a
g
r
ee
d
to
s
tr
o
n
g
ly
ag
r
ee
d
th
at
u
s
er
s
s
h
o
u
ld
r
ec
eiv
e
f
ee
d
b
ac
k
t
o
b
e
awa
r
e
o
f
th
eir
p
r
o
g
r
ess
wh
ile
p
lay
in
g
th
e
g
am
e.
Mo
r
eo
v
e
r
,
7
9
.
4
%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
ee
d
to
s
tr
o
n
g
ly
ag
r
ee
d
th
at
th
e
p
er
f
o
r
m
an
ce
b
ar
s
h
o
u
l
d
b
e
in
clu
d
ed
t
o
tr
ac
k
u
s
er
p
e
r
f
o
r
m
a
n
ce
p
r
o
g
r
ess
.
I
t
was
also
f
o
u
n
d
th
at
7
0
.
4
%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
ee
d
an
d
s
tr
o
n
g
ly
ag
r
ee
d
th
at
an
ac
h
iev
em
e
n
t
b
ad
g
e
s
h
o
u
ld
b
e
p
r
o
v
id
e
d
,
an
d
8
0
.
5
%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
ee
d
an
d
s
tr
o
n
g
ly
ag
r
ee
d
th
at
p
o
in
ts
s
h
o
u
ld
als
o
b
e
in
clu
d
e
d
as
a
r
ewa
r
d
s
y
s
tem
f
o
r
ac
h
ie
v
em
en
t
to
b
o
o
s
t m
o
tiv
atio
n
f
o
r
th
e
u
s
er
.
Ko
iv
is
to
et
a
l.
[
17
]
also
h
ig
h
lig
h
ted
th
e
im
p
o
r
tan
ce
o
f
f
ee
d
b
ac
k
an
d
c
h
allen
g
es
in
g
am
if
icatio
n
to
s
u
s
tain
m
o
tiv
atio
n
.
Ho
wev
er
,
t
h
is
s
tu
d
y
em
p
h
asizes
co
m
p
eten
ce
as
a
d
r
iv
er
o
f
b
eh
av
io
r
ch
a
n
g
e
,
s
p
ec
if
ically
in
g
am
if
ied
h
ea
lth
ca
m
p
aig
n
s
.
A
k
ey
s
tr
en
g
th
o
f
th
is
s
tu
d
y
is
it
s
ap
p
licatio
n
o
f
co
m
p
ete
n
ce
to
p
u
b
lic
h
ea
lth
ch
allen
g
es
lik
e
C
OVI
D
-
1
9
,
b
u
t
a
lim
itatio
n
lies
in
th
e
ab
s
en
c
e
o
f
lo
n
g
itu
d
in
al
d
ata
to
ev
al
u
a
te
s
u
s
tain
ed
ef
f
ec
ts
.
F
i
g
u
r
e
2
.
G
r
a
p
h
f
r
e
q
u
e
n
c
y
(
%
)
o
f
t
h
e
p
e
r
c
e
p
t
i
o
n
o
f
d
e
s
i
g
n
f
o
r
t
h
e
c
o
m
p
e
t
e
n
t
e
le
m
e
n
t
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t J Pu
b
lic
Hea
lth
Sci
I
SS
N:
2252
-
8
8
0
6
Ga
me
o
n
fo
r
h
e
a
lth
:
d
esig
n
i
n
g
g
a
mified
ca
mp
a
i
g
n
s
to
d
r
ive
b
eh
a
vio
r
a
l
…
(
N
u
r
u
l H
id
a
y
a
h
Ma
t Za
in
)
77
4
.
4
.
De
s
ig
n f
o
r
re
l
a
t
ednes
s
elem
ent
Fig
u
r
e
3
p
r
esen
ts
th
e
d
ata
o
f
t
h
e
R
elate
d
n
ess
elem
en
t.
T
h
e
d
ata
s
h
o
ws
th
at
7
2
.
3
%
o
f
th
e
r
e
s
p
o
n
d
en
ts
ag
r
ee
d
to
s
tr
o
n
g
ly
a
g
r
ee
d
th
at
th
ey
ca
n
in
ter
ac
t
o
n
s
o
cial
n
etwo
r
k
s
wh
ile
u
s
in
g
th
e
g
am
e.
B
esid
es,
th
e
r
esp
o
n
d
en
ts
c
o
u
ld
s
h
ar
e
in
f
o
r
m
atio
n
th
r
o
u
g
h
s
o
cial
n
etwo
r
k
s
.
I
n
a
d
d
itio
n
,
it
was
also
p
r
o
v
en
th
at
7
2
.
8
%
o
f
t
h
e
r
esp
o
n
d
en
ts
ag
r
ee
d
to
s
tr
o
n
g
l
y
ag
r
ee
d
with
th
e
s
tatem
en
t.
R
eg
ar
d
in
g
co
m
m
u
n
ity
co
n
n
ec
tio
n
,
7
3
.
9
%
o
f
th
e
r
esp
o
n
d
en
ts
s
tr
o
n
g
ly
ag
r
ee
d
th
at
th
ey
c
o
u
ld
jo
in
t
h
e
co
m
m
u
n
ity
wh
ile
p
lay
in
g
th
e
g
am
e
.
Fu
r
th
er
m
o
r
e
,
in
ter
m
s
o
f
ex
p
er
ie
n
ce
an
d
co
o
p
er
atio
n
,
7
1
.
7
% o
f
th
e
r
esp
o
n
d
en
ts
co
u
ld
f
ee
l th
e
v
ar
io
u
s
ty
p
es o
f
s
o
cial
in
ter
ac
tio
n
an
d
co
o
p
er
atio
n
with
o
th
e
r
p
la
y
er
s
.
Fin
ally
,
7
2
.
8
%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
ee
d
to
s
tr
o
n
g
ly
ag
r
ee
d
th
at
th
ey
co
u
l
d
co
llab
o
r
ate
with
o
th
e
r
p
lay
e
r
s
d
u
r
in
g
th
e
g
am
e
.
T
h
ese
f
in
d
in
g
s
ar
e
c
o
n
s
is
ten
t w
ith
[
3
1
]
wo
r
k
,
wh
ich
em
p
h
asized
th
e
r
o
le
o
f
r
elate
d
n
ess
in
f
o
s
ter
in
g
a
s
en
s
e
o
f
co
m
m
u
n
ity
a
n
d
c
o
n
n
ec
tio
n
in
g
a
m
if
ied
a
p
p
licatio
n
s
.
T
h
is
s
tu
d
y
ex
p
an
d
s
th
ese
in
s
ig
h
ts
b
y
c
o
n
f
ir
m
i
n
g
th
e
r
elev
an
ce
o
f
r
elate
d
n
ess
i
n
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
.
A
lim
itatio
n
is
th
at
r
elat
ed
n
ess
m
ay
r
eso
n
ate
d
if
f
er
en
tly
with
i
n
d
iv
id
u
als wh
o
ar
e
less
s
o
cially
in
clin
ed
.
F
i
g
u
r
e
3
.
G
r
a
p
h
f
r
e
q
u
e
n
c
y
(
%
)
p
e
r
c
e
p
t
i
o
n
o
f
d
e
s
i
g
n
f
o
r
t
h
e
r
e
la
t
e
d
n
e
s
s
e
l
e
m
e
n
t
4
.
5
.
De
s
ig
n f
o
r
eng
a
g
e
m
ent
elem
ent
R
ec
en
tly
,
g
am
if
icatio
n
h
as
b
ec
o
m
e
in
cr
ea
s
in
g
ly
p
o
p
u
lar
am
o
n
g
p
r
o
f
ess
io
n
als
an
d
r
esear
ch
er
s
t
o
in
ce
n
tiv
i
s
e,
in
v
o
l
v
e,
a
n
d
im
p
r
o
v
e
co
n
s
u
m
er
p
ar
ticip
atio
n
an
d
lo
y
alty
with
in
a
p
ar
ticu
lar
b
r
an
d
o
r
c
o
m
m
u
n
ity
[
3
2
]
.
Gen
er
ally
,
g
am
if
icatio
n
u
tili
s
es
g
am
e
co
m
p
o
n
en
ts
an
d
d
esig
n
p
r
in
cip
les in
a
n
o
n
-
g
a
m
e
co
n
te
x
t.
Fig
u
r
e
4
d
ep
icts
th
e
r
esp
o
n
d
en
ts
’
p
er
ce
p
tio
n
o
f
th
e
d
esig
n
co
n
ce
r
n
in
g
th
e
E
n
g
ag
in
g
elem
en
t.
Acc
o
r
d
in
g
to
th
e
f
in
d
in
g
s
,
5
.
1
7
%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
ee
d
,
an
d
3
3
.
3
%
s
tr
o
n
g
ly
ag
r
ee
d
th
at
th
ey
h
ad
a
s
en
s
e
o
f
in
ter
est.
R
eg
ar
d
in
g
th
e
s
tate
o
f
f
lo
w
in
th
e
g
am
ep
lay
,
4
2
.
8
%
o
f
th
e
r
esp
o
n
d
en
ts
ag
r
e
ed
with
th
is
s
tatem
en
t,
wh
ile
4
2
.
2
5
%
f
elt
an
in
ten
s
e
s
en
s
atio
n
o
f
s
u
cc
ess
.
Alm
o
s
t
h
alf
o
f
th
e
r
esp
o
n
d
en
ts
,
7
5
(
4
1
.
7
%),
u
n
d
er
s
to
o
d
th
e
g
am
e
co
n
te
n
t
,
an
d
8
0
(
4
4
.
4
%)
s
tated
th
at
th
ey
f
elt
a
p
o
s
itiv
e
em
o
tio
n
in
a
lear
n
in
g
e
x
p
er
ie
n
ce
.
B
esid
es,
4
0
.
0
%
o
f
th
e
r
e
s
p
o
n
d
en
ts
r
ep
o
r
te
d
th
at
th
e
g
am
e
c
o
m
p
lies
with
tr
ea
tm
en
t.
F
i
g
u
r
e
4
.
G
r
a
p
h
f
r
e
q
u
e
n
c
y
(
%
)
o
f
t
h
e
p
e
r
c
e
p
t
i
o
n
o
f
d
e
s
i
g
n
f
o
r
t
h
e
e
n
g
a
g
e
m
e
n
t
e
l
e
m
e
n
t
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
0
6
I
n
t J Pu
b
lic
Hea
lth
Sci
,
Vo
l.
1
5
,
No
.
1
,
Ma
r
ch
20
2
6
:
72
-
80
78
T
h
is
alig
n
s
with
L
u
an
d
Ho
[
2
4
]
,
wh
o
f
o
u
n
d
e
n
g
ag
em
e
n
t
to
b
e
a
k
e
y
d
r
iv
er
o
f
u
s
er
r
eten
tio
n
in
g
am
if
ied
ap
p
licatio
n
s
.
T
h
is
s
tu
d
y
b
u
ild
s
o
n
th
ese
f
in
d
i
n
g
s
b
y
l
in
k
in
g
en
g
ag
em
e
n
t
to
b
eh
a
v
io
r
al
ch
an
g
e
in
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
.
Stre
n
g
th
is
th
e
s
tu
d
y
’
s
co
m
p
r
eh
en
s
iv
e
ev
alu
atio
n
o
f
en
g
a
g
em
en
t
w
ith
in
th
e
GAM
E
B
C
m
o
d
el,
th
o
u
g
h
en
g
a
g
em
en
t r
at
in
g
s
m
ig
h
t v
a
r
y
b
ased
o
n
g
am
e
co
m
p
lex
ity
a
n
d
p
ar
ticip
an
t g
am
in
g
ex
p
er
ien
ce
.
5.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
s
ee
k
s
to
e
x
am
in
e
h
o
w
d
esig
n
ca
n
ef
f
ec
tiv
ely
p
r
o
m
o
te
b
eh
a
v
io
r
ch
an
g
e
th
r
o
u
g
h
a
g
am
if
ie
d
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
ai
m
ed
at
ad
d
r
ess
in
g
th
e
ch
allen
g
es
p
o
s
ed
b
y
th
e
C
OVI
D
-
1
9
p
an
d
em
ic.
B
esid
es,
th
is
s
tu
d
y
h
i
g
h
lig
h
ts
t
h
e
cr
itica
l
r
o
le
o
f
au
to
n
o
m
y
,
co
m
p
eten
c
e,
r
elate
d
n
ess
,
a
n
d
en
g
a
g
em
en
t
in
g
am
if
ied
h
ea
lth
awa
r
en
ess
ca
m
p
aig
n
s
.
B
y
ad
d
r
ess
in
g
th
ese
elem
en
ts
th
r
o
u
g
h
th
e
GAM
E
B
C
m
o
d
el,
g
am
if
ied
in
ter
v
en
tio
n
s
ca
n
ef
f
ec
tiv
ely
p
r
o
m
o
te
b
eh
a
v
io
r
a
l
ch
an
g
e.
T
h
ese
f
in
d
in
g
s
ar
e
p
ar
ticu
lar
ly
r
ele
v
an
t
f
o
r
p
u
b
li
c
h
ea
lth
ch
allen
g
es
wh
er
e
in
n
o
v
ativ
e
s
tr
ateg
ies
ar
e
r
eq
u
i
r
ed
t
o
en
h
an
ce
awa
r
en
ess
an
d
co
m
p
lian
ce
.
B
ased
o
n
th
is
s
tu
d
y
,
f
u
tu
r
e
r
elate
d
s
tu
d
ies
m
ay
co
n
s
id
er
u
n
d
er
ta
k
in
g
cr
iter
ia
d
esig
n
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8
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D
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[
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1
3
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Ma
r
ch
20
2
6
:
72
-
80
80
S
iti
Nur
a
m
a
li
n
a
J
o
h
a
r
i
re
c
e
iv
e
d
a
n
M
.
Sc
.
in
Co
m
p
u
ter
S
c
ien
c
e
s
a
n
d
a
Ba
c
h
e
l
o
r
o
f
Co
m
p
u
ter
S
c
ien
c
e
(
m
u
l
ti
m
e
d
i
a
c
o
m
p
u
ti
n
g
)
fr
o
m
Un
i
v
e
rsiti
Te
k
n
o
lo
g
i
M
ARA
(UiT
M
)
i
n
2
0
1
2
a
n
d
2
0
1
0
,
re
sp
e
c
ti
v
e
ly
.
S
h
e
is
a
lec
tu
re
r
a
t
t
h
e
De
p
a
rtme
n
t
o
f
Co
m
p
u
ter
S
c
ien
c
e
(M
u
lt
i
-
m
e
d
ia
Co
m
p
u
t
in
g
),
Ui
TM
Ca
wa
n
g
a
n
M
e
lak
a
,
Ca
m
p
u
s
Ja
sin
.
S
h
e
p
u
b
li
s
h
e
d
se
v
e
ra
l
S
c
o
p
u
s
-
in
d
e
x
e
d
p
u
b
li
c
a
ti
o
n
s,
i
n
c
lu
d
in
g
jo
u
rn
a
ls,
p
r
o
c
e
e
d
in
g
s,
b
o
o
k
m
a
n
u
a
l
s,
a
n
d
a
rti
c
les
.
S
h
e
h
a
s
a
ls
o
wo
n
se
v
e
ra
l
g
o
l
d
m
e
d
a
ls
a
n
d
a
wa
rd
s
a
t
re
se
a
r
c
h
a
n
d
in
n
o
v
a
ti
o
n
e
x
h
i
b
it
i
o
n
s.
S
h
e
is
a
lso
a
re
v
iew
e
r
fo
r
n
a
ti
o
n
a
l
a
n
d
in
ter
n
a
ti
o
n
a
l
j
o
u
r
n
a
ls.
He
r
re
se
a
rc
h
i
n
tere
sts
a
re
v
irt
u
a
l
re
a
li
t
y
,
a
u
g
m
e
n
ted
re
a
li
t
y
,
g
a
m
e
d
e
sig
n
,
g
a
m
ifi
c
a
ti
o
n
,
g
a
m
e
tec
h
n
o
lo
g
y
,
u
se
r
e
x
p
e
rien
c
e
,
h
u
m
a
n
-
c
o
m
p
u
ter
i
n
tera
c
ti
o
n
,
a
n
d
m
ix
e
d
re
a
li
ty
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
a
m
a
li
n
a
_
jo
h
a
ri@
u
it
m
.
e
d
u
.
m
y
.
No
r
sha
h
id
a
tu
l
H
a
sa
n
a
Is
h
a
k
re
c
e
iv
e
d
t
h
e
M
.
Sc
.
(
in
fo
rm
a
ti
o
n
a
n
d
c
o
m
m
u
n
ica
ti
o
n
tec
h
n
o
l
o
g
y
)
fr
o
m
Un
i
v
e
rsiti
Te
k
n
i
k
a
l
M
a
lay
sia
M
e
lak
a
(UTe
M
)
in
2
0
1
3
.
S
h
e
c
o
m
p
lete
d
h
e
r
Ba
c
h
e
lo
r
o
f
Co
m
p
u
ter
S
c
ien
c
e
(
in
tera
c
ti
v
e
m
e
d
ia
)
in
2
0
1
0
a
n
d
sta
rted
b
e
c
o
m
in
g
a
lec
tu
re
r
a
t
Un
i
v
e
rsiti
Te
k
n
o
lo
g
i
M
a
ra
(UiT
M
)
Ca
wa
n
g
a
n
M
e
lak
a
,
Ka
m
p
u
s
Ja
sin
,
in
2
0
1
5
.
S
h
e
is
c
u
rre
n
tl
y
wo
r
k
in
g
i
n
th
e
C
o
m
p
u
ter
S
c
ien
c
e
De
p
a
rtme
n
t
(M
u
lt
ime
d
ia
Co
m
p
u
ti
n
g
).
S
h
e
p
u
b
li
sh
e
d
p
a
p
e
rs
re
late
d
to
m
u
lt
ime
d
ia
tec
h
n
o
l
o
g
y
,
in
c
l
u
d
i
n
g
j
o
u
r
n
a
ls,
p
ro
c
e
e
d
in
g
s,
a
n
d
m
o
d
u
les
,
a
n
d
d
e
v
e
l
o
p
e
d
e
-
lea
rn
i
n
g
c
o
n
te
n
t
(M
OO
C).
S
h
e
is
a
lso
a
re
v
iew
e
r
fo
r
n
a
ti
o
n
a
l
a
n
d
in
tern
a
ti
o
n
a
l
j
o
u
r
n
a
ls,
a
ju
d
g
e
i
n
th
e
c
o
m
p
e
ti
ti
o
n
,
a
n
d
a
c
ti
v
e
ly
i
n
v
o
lv
e
d
in
se
v
e
ra
l
g
ra
n
ts
a
s
a
co
-
re
se
a
rc
h
e
r.
He
r
re
se
a
rc
h
in
tere
sts
in
c
lu
d
e
v
irt
u
a
l
re
a
li
ty
,
h
u
m
a
n
-
ro
b
o
t
i
n
tera
c
ti
o
n
,
m
u
lt
ime
d
ia
tec
h
n
o
lo
g
y
,
a
n
d
a
p
p
li
c
a
ti
o
n
s.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
h
a
sa
n
a
@u
it
m
.
e
d
u
.
m
y.
S
iti
Ra
h
a
y
u
Abd
u
l
Az
iz
is
a
se
n
io
r
lec
tu
re
r
in
th
e
De
p
a
rtme
n
t
o
f
Co
m
p
u
ter
Tec
h
n
o
l
o
g
y
a
n
d
Ne
two
r
k
in
g
,
F
a
c
u
lt
y
o
f
Co
m
p
u
ter
a
n
d
M
a
th
e
m
a
ti
c
a
l
S
c
ien
c
e
s
(F
S
KM),
Un
iv
e
rsiti
Te
k
n
o
lo
g
i
M
ARA
(
UiTM
)
S
e
lan
g
o
r,
M
a
lay
sia
.
S
h
e
re
c
e
iv
e
d
h
e
r
Do
c
to
r
o
f
P
h
il
o
so
p
h
y
i
n
In
f
o
rm
a
ti
o
n
a
n
d
Co
m
m
u
n
ica
ti
o
n
Tec
h
n
o
l
o
g
y
fr
o
m
th
e
U
n
iv
e
rsit
y
o
f
P
e
n
d
id
ik
a
n
S
u
lt
a
n
I
d
ris
(UPS
I),
M
a
lay
sia
,
in
2
0
1
9
.
S
h
e
h
a
d
o
v
e
r
2
0
y
e
a
rs
o
f
e
x
p
e
rien
c
e
in
th
e
IT
fiel
d
(2
y
e
a
rs
in
in
d
u
str
y
a
n
d
m
o
re
t
h
a
n
1
7
y
e
a
rs
in
a
c
a
d
e
m
ia).
He
r
re
se
a
rc
h
in
tere
sts
in
c
lu
d
e
in
fo
rm
a
ti
o
n
a
n
d
c
o
m
m
u
n
ica
ti
o
n
tec
h
n
o
l
o
g
y
(ICT)
,
d
istr
ib
u
ted
c
o
m
p
u
ti
n
g
,
th
e
I
n
tern
e
t
o
f
Th
in
g
s,
C
y
b
e
rse
c
u
rit
y
,
a
n
d
c
ro
wd
so
u
rc
in
g
.
S
h
e
is
a
lso
a
Cisc
o
Ne
tw
o
rk
i
n
g
Ac
a
d
e
m
y
in
str
u
c
to
r
fo
r
Cisc
o
Ce
rti
fied
Ne
two
rk
As
s
o
c
iate
(CCNA
),
In
tern
e
t
o
f
Th
in
g
s
(Io
T),
IT
Esse
n
ti
a
ls:
P
C
h
a
rd
wa
re
a
n
d
so
f
twa
re
,
a
n
d
c
y
b
e
rse
c
u
ri
ty
e
ss
e
n
ti
a
ls
.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
ra
h
a
y
u
7
4
8
@
u
it
m
.
e
d
u
.
m
y
.
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