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l J
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urna
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(
I
J
P
H
S)
Vo
l.
15
,
No
.
3
,
Sep
tem
b
er
20
26
,
p
p
.
6
7
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6
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I
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co
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ea
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locus
of co
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M
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p
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icts
m
u
lt
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ime
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si
o
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h
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b
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lf
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o
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o
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ime
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a
n
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e
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lt
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h
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v
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o
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les
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li
a
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it
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tes
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g
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e
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rip
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e
sta
ti
stics
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P
e
a
rso
n
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o
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re
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s
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u
lt
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li
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n
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e
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OV
A
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a
se
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o
n
d
o
m
in
a
n
t
HLOC
ty
p
e
we
re
c
o
n
d
u
c
ted
.
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n
tern
a
l
a
n
d
p
o
we
rfu
l
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o
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h
e
rs
HLOC
p
o
siti
v
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y
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re
d
icte
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t
o
tal
h
e
a
lt
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h
a
v
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s
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n
c
e
HLOC
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s
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sig
n
ifi
c
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n
t
;
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o
we
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e
r,
th
e
o
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ll
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x
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lan
a
t
o
r
y
p
o
we
r
wa
s
sm
a
ll
(R²
=
0
.
0
4
8
).
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a
lt
h
b
e
h
a
v
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o
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d
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t
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iffer
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e
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ty
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with
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ll
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t
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n
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n
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e
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ise
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<
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se
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s
su
g
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st
th
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t
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ti
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ly
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tro
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fs
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t
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t
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rm
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ss
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se
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li
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re
n
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.
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a
m
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ly
-
b
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se
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e
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u
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ti
o
n
,
c
o
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m
u
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it
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in
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e
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t,
a
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d
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c
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m
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a
ig
n
s a
re
re
c
o
m
m
e
n
d
e
d
.
K
ey
w
o
r
d
s
:
C
o
llectiv
is
tic
cu
ltu
r
e
Hea
lth
b
eh
av
io
u
r
Hea
lth
lo
cu
s
o
f
co
n
tr
o
l
Me
tab
o
lic
d
is
o
r
d
er
s
Min
an
g
k
ab
a
u
T
h
is i
s
a
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o
p
e
n
a
c
c
e
ss
a
rticle
u
n
d
e
r th
e
CC B
Y
-
SA
li
c
e
n
se
.
C
o
r
r
e
s
p
o
nd
ing
A
uth
o
r
:
R
id
a
Yan
n
a
Prim
an
ita
Dep
ar
tm
en
t o
f
Ps
y
ch
o
lo
g
y
,
Fa
cu
lty
o
f
Ps
y
ch
o
l
o
g
y
a
n
d
Hea
lt
h
,
Un
iv
er
s
itas
Neg
er
i Pad
an
g
Pad
an
g
,
W
est Su
m
atr
a,
I
n
d
o
n
esia
E
m
ail:
y
an
n
ap
r
im
an
ita@
f
ip
.
u
n
p
.
ac
.
id
1.
I
NT
RO
D
UCT
I
O
N
Me
tab
o
lic
d
is
o
r
d
er
s
,
in
clu
d
in
g
d
iab
etes
m
ellitu
s
,
h
y
p
er
ten
s
io
n
,
h
y
p
er
c
h
o
lest
er
o
le
m
ia,
an
d
o
v
er
weig
h
t,
r
em
ain
m
ajo
r
p
u
b
lic
h
ea
lth
ch
allen
g
es
b
ec
a
u
s
e
th
ey
ar
e
clo
s
ely
lin
k
e
d
to
n
o
n
co
m
m
u
n
ica
b
le
d
is
ea
s
e
m
o
r
b
id
ity
,
p
r
e
m
atu
r
e
m
o
r
tality
,
an
d
lo
n
g
-
te
r
m
d
is
ab
ilit
y
[
1
]
.
T
h
e
I
n
d
o
n
esia
Hea
lth
Su
r
v
ey
(
S
u
r
ve
i
K
eseh
a
ta
n
I
n
d
o
n
esia
)
2
0
2
3
s
h
o
ws
th
at
n
o
n
co
m
m
u
n
icab
le
d
is
ea
s
e
in
d
icato
r
s
,
b
e
h
av
io
r
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r
is
k
f
ac
to
r
s
,
a
n
d
ca
r
d
io
m
etab
o
lic
m
ea
s
u
r
em
e
n
ts
co
n
tin
u
e
to
b
e
k
ey
p
u
b
l
ic
h
ea
lth
co
n
ce
r
n
s
at
th
e
n
atio
n
al
lev
el
[
2
]
.
Hy
p
er
ten
s
io
n
a
n
d
d
iab
etes
also
r
eq
u
ir
e
s
u
s
tain
ed
life
s
ty
le
m
an
ag
em
en
t
b
ec
au
s
e
c
o
n
tr
o
l
d
ep
en
d
s
n
o
t
o
n
ly
o
n
m
ed
icatio
n
b
u
t
also
o
n
r
ep
ea
t
ed
ev
er
y
d
ay
b
eh
av
io
r
s
s
u
ch
a
s
d
iet,
p
h
y
s
ical
ac
tiv
ity
,
s
leep
,
s
m
o
k
in
g
c
o
n
tr
o
l,
an
d
ad
h
er
en
ce
t
o
h
ea
lth
a
d
v
ic
e
[
3
]
,
[
4
]
.
Fo
r
p
atie
n
ts
with
m
etab
o
lic
d
is
o
r
d
e
r
s
,
th
er
ef
o
r
e
,
h
ea
lth
b
e
h
av
io
r
is
n
o
t simp
ly
a
p
r
ev
en
tiv
e
ch
o
ice
b
u
t a
co
n
tin
u
in
g
elem
en
t o
f
d
i
s
ea
s
e
m
an
ag
em
en
t.
On
e
p
s
y
ch
o
l
o
g
ical
co
n
ce
p
t
c
o
m
m
o
n
l
y
ap
p
lied
to
u
n
d
er
s
tan
d
h
ea
lth
b
eh
av
io
r
is
th
e
h
ea
l
th
lo
cu
s
o
f
co
n
tr
o
l
(
HL
OC
)
.
T
h
is
co
n
s
tr
u
ct
is
d
er
iv
ed
f
r
o
m
R
o
tter
’
s
s
o
cial
lear
n
in
g
th
eo
r
y
,
w
h
ich
s
u
g
g
es
ts
th
at
p
eo
p
le
v
ar
y
in
th
eir
g
e
n
er
al
ex
p
ec
tatio
n
s
ab
o
u
t
wh
eth
er
o
u
tco
m
es
a
r
e
d
eter
m
in
e
d
b
y
th
eir
o
wn
ac
tio
n
s
o
r
b
y
ex
ter
n
al
in
f
lu
en
ce
s
[
5
]
.
W
alls
to
n
an
d
c
o
lleag
u
es
later
ex
p
an
d
ed
th
is
co
n
ce
p
t
b
y
d
ev
elo
p
in
g
a
m
u
ltid
im
en
s
io
n
al
m
o
d
e
l
o
f
HL
OC
,
wh
ich
d
if
f
er
en
ti
ate
s
th
r
ee
d
im
en
s
io
n
s
:
in
ter
n
al,
p
o
wer
f
u
l
-
o
th
er
s
,
a
n
d
c
h
an
ce
HL
OC
[
6
]
,
[
7
]
.
T
h
e
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
Hea
lth
lo
cu
s
o
f c
o
n
tr
o
l a
n
d
h
e
a
lth
b
eh
a
vio
u
r
in
Min
a
n
g
ka
b
a
u
meta
b
o
lic
…
(
R
i
d
a
Ya
n
n
a
P
r
ima
n
ita
)
679
in
ter
n
al
d
im
en
s
io
n
r
ef
lects
th
e
p
er
ce
p
tio
n
th
at
h
ea
lth
o
u
tco
m
es
ar
e
p
r
im
ar
ily
s
h
ap
ed
b
y
an
in
d
iv
id
u
al’
s
o
wn
ac
tio
n
s
an
d
b
eh
av
io
r
s
.
T
h
e
p
o
wer
f
u
l
-
o
th
e
r
s
d
im
en
s
io
n
r
ef
er
s
to
th
e
b
elief
th
at
h
ea
lth
is
in
f
lu
en
ce
d
b
y
ex
te
r
n
al
ag
en
ts
s
u
ch
as
p
h
y
s
ician
s
,
f
a
m
ily
m
em
b
er
s
,
o
r
o
th
er
s
ig
n
if
ican
t
p
eo
p
le.
Me
an
wh
ile,
th
e
ch
an
ce
d
im
en
s
io
n
d
escr
ib
es th
e
v
iew
th
at
h
ea
lth
is
lar
g
ely
d
eter
m
in
ed
b
y
f
ate,
l
u
ck
,
o
r
o
th
e
r
u
n
c
o
n
tr
o
llab
le
ci
r
cu
m
s
tan
ce
s
[
8
].
Pre
v
io
u
s
wo
r
k
h
as
o
f
te
n
tr
ea
t
ed
in
ter
n
al
HL
OC
as
a
p
r
o
tec
tiv
e
o
r
ien
tatio
n
.
Me
ta
-
an
aly
ti
c
ev
id
en
ce
in
d
icate
s
th
at
HL
OC
is
ass
o
c
iated
with
s
p
ec
if
ic
h
ea
lth
b
eh
av
io
r
s
,
alth
o
u
g
h
th
e
m
a
g
n
itu
d
e
an
d
d
ir
ec
tio
n
o
f
ass
o
ciatio
n
v
ar
y
b
y
b
eh
av
io
r
an
d
p
o
p
u
latio
n
[
9
]
.
Stu
d
ies
o
n
m
ed
icatio
n
ad
h
er
en
ce
a
n
d
c
h
r
o
n
ic
d
is
ea
s
e
s
elf
-
m
an
ag
em
en
t
f
u
r
th
er
s
h
o
w
th
a
t
co
n
tr
o
l
b
elief
s
m
ay
r
elate
to
ad
h
er
en
ce
,
em
p
o
wer
m
en
t,
an
d
s
elf
-
ef
f
icac
y
[
1
0
]
,
[
1
1
]
.
Ho
wev
e
r
,
th
ese
f
in
d
in
g
s
d
o
n
o
t
n
ec
ess
ar
ily
im
p
ly
th
at
in
ter
n
al
HL
OC
is
u
n
if
o
r
m
ly
s
tr
o
n
g
o
r
u
n
iv
er
s
ally
p
r
o
tectiv
e
ac
r
o
s
s
cu
ltu
r
al
s
ettin
g
s
.
T
h
e
th
eo
r
etica
l
ass
u
m
p
tio
n
t
h
at
p
e
r
s
o
n
al
c
o
n
tr
o
l
d
ir
ec
tly
p
r
o
m
o
tes
h
ea
lth
ier
b
eh
a
v
io
r
m
a
y
f
it b
est
in
s
o
cial
co
n
tex
ts
wh
er
e
in
d
iv
id
u
al
ag
en
c
y
is
cu
ltu
r
ally
em
p
h
asized
.
C
u
ltu
r
e
is
th
er
ef
o
r
e
a
cr
itica
l
is
s
u
e.
I
n
in
d
iv
i
d
u
alis
tic
cu
ltu
r
es,
au
to
n
o
m
y
a
n
d
i
n
d
ep
e
n
d
en
t
s
elf
-
co
n
s
tr
u
al
ar
e
ce
n
tr
al
v
alu
es,
wh
er
ea
s
in
co
llectiv
is
tic
cu
ltu
r
es
b
eh
av
io
r
is
o
f
ten
r
eg
u
late
d
th
r
o
u
g
h
r
elatio
n
al
o
b
lig
atio
n
,
f
am
ily
ex
p
ec
tatio
n
s
,
s
o
cial
n
o
r
m
s
,
an
d
r
esp
ec
t
f
o
r
au
th
o
r
ity
[
1
2
]
-
[1
4
]
.
So
cial
s
u
p
p
o
r
t
its
elf
is
also
cu
ltu
r
ally
p
atter
n
ed
;
in
s
o
m
e
Asi
an
co
n
tex
ts
,
im
p
licit
s
u
p
p
o
r
t,
r
elatio
n
al
h
a
r
m
o
n
y
,
a
n
d
s
o
cially
em
b
ed
d
ed
d
ec
is
io
n
-
m
ak
in
g
m
ay
b
e
m
o
r
e
s
alien
t
th
an
e
x
p
licit
in
d
i
v
id
u
al
ass
er
tio
n
[
1
5
]
.
C
r
o
s
s
-
cu
ltu
r
al
r
esear
ch
o
n
p
er
ce
iv
ed
c
o
n
tr
o
l
s
u
g
g
ests
th
at
th
e
m
ea
n
i
n
g
an
d
ad
a
p
tiv
en
ess
o
f
co
n
tr
o
l
b
elief
s
v
a
r
y
ac
r
o
s
s
cu
ltu
r
a
l
r
eg
io
n
s
[
1
6
]
.
T
h
ese
f
in
d
in
g
s
im
p
ly
th
at
p
o
wer
f
u
l
-
o
t
h
er
s
HL
OC
s
h
o
u
ld
n
o
t
au
to
m
atica
lly
b
e
in
ter
p
r
eted
as
d
ep
en
d
e
n
cy
o
r
p
ass
iv
ity
in
co
l
lectiv
is
tic
s
o
cietie
s
.
T
h
e
p
r
ese
n
t
s
tu
d
y
f
o
cu
s
es
o
n
Min
an
g
k
ab
a
u
ad
u
lts
with
m
et
ab
o
lic
d
is
o
r
d
e
r
s
.
Min
an
g
k
ab
a
u
s
o
ciety
is
k
n
o
wn
f
o
r
a
m
atr
ilin
ea
l
k
in
s
h
ip
s
y
s
tem
an
d
s
tr
o
n
g
a
d
at,
r
eli
g
io
u
s
,
an
d
co
m
m
u
n
al
s
tr
u
ct
u
r
es
[
1
7
]
-
[
1
9
]
.
Hea
lth
d
ec
is
io
n
s
m
ay
t
h
er
ef
o
r
e
in
v
o
lv
e
f
am
ily
m
em
b
er
s
,
cu
s
to
m
ar
y
e
x
p
ec
tatio
n
s
,
r
elig
io
u
s
co
n
s
id
er
atio
n
s
,
an
d
c
o
m
m
u
n
i
t
y
f
i
g
u
r
e
s
.
I
n
d
o
n
e
s
i
an
h
e
a
l
t
h
p
r
a
c
t
i
c
es
m
o
r
e
b
r
o
a
d
l
y
h
a
v
e
a
l
s
o
b
e
e
n
d
is
c
u
s
s
e
d
as
b
e
i
n
g
s
h
a
p
e
d
b
y
c
u
l
t
u
r
a
l
m
ea
n
i
n
g
s
,
r
el
i
g
i
o
s
i
t
y
,
a
n
d
s
o
c
i
al
r
e
l
at
i
o
n
s
h
i
p
s
.
I
n
s
u
c
h
a
c
o
n
t
e
x
t
,
p
e
r
s
o
n
a
l
c
o
n
t
r
o
l
b
e
l
i
e
f
s
m
a
y
r
em
ain
r
elev
an
t,
b
u
t h
ea
lth
b
eh
av
io
r
m
ay
also
b
e
g
u
id
ed
b
y
s
o
ciall
y
s
h
ar
ed
n
o
r
m
s
an
d
co
llectiv
e
r
eg
u
latio
n
.
Sev
er
al
u
n
r
eso
lv
ed
p
r
o
b
lem
s
r
em
ain
.
First,
m
o
s
t
s
tu
d
ies
d
o
n
o
t
test
wh
eth
er
in
ter
n
al
HL
O
C
m
ain
tain
s
th
e
s
am
e
p
r
o
tecti
v
e
f
u
n
ctio
n
i
n
co
llectiv
is
tic
p
o
p
u
latio
n
s
with
ch
r
o
n
ic
m
e
tab
o
lic
co
n
d
itio
n
s
.
Seco
n
d
,
p
o
wer
f
u
l
-
o
th
er
s
HL
OC
is
o
f
ten
in
ter
p
r
eted
th
r
o
u
g
h
an
in
d
iv
id
u
alis
tic
len
s
,
alth
o
u
g
h
in
co
m
m
u
n
al
cu
l
tu
r
es
it m
a
y
r
e
p
r
es
en
t
r
ela
ti
o
n
al
em
b
e
d
d
e
d
n
ess
a
n
d
n
o
r
m
-
b
as
ed
s
u
p
p
o
r
t
.
T
h
ir
d
,
f
ew
s
t
u
d
ies
e
x
a
m
i
n
e
HL
OC
alo
n
g
s
i
d
e
m
u
lti
p
l
e
b
e
h
a
v
i
o
r
al
d
o
m
ai
n
s
r
at
h
e
r
t
h
a
n
a
s
in
g
l
e
o
u
tc
o
m
e
.
Fo
u
r
t
h
,
p
r
e
v
i
o
u
s
s
t
u
d
ies
r
ar
el
y
p
o
s
i
ti
o
n
cu
ltu
r
e
as a
b
o
u
n
d
a
r
y
co
n
d
itio
n
th
at
m
ay
lim
it o
r
r
esh
ap
e
th
e
p
r
ed
ictiv
e
s
tr
en
g
t
h
o
f
p
er
s
o
n
a
l c
o
n
tr
o
l b
elief
s
.
T
o
ad
d
r
ess
th
ese
g
ap
s
,
t
h
is
s
tu
d
y
e
x
am
in
es
th
e
r
elatio
n
s
h
i
p
b
etwe
en
th
r
ee
HL
OC
d
im
e
n
s
io
n
s
an
d
m
u
ltid
im
en
s
io
n
al
h
ea
lth
b
eh
a
v
io
r
am
o
n
g
Min
an
g
k
ab
au
ad
u
lts
with
m
etab
o
lic
d
is
o
r
d
er
s
.
T
h
is
s
tu
d
y
m
ak
es
th
r
ee
m
ain
co
n
tr
ib
u
tio
n
s
to
t
h
e
ex
is
tin
g
liter
atu
r
e
.
First,
it
t
ests
wh
eth
er
in
ter
n
al
HL
OC
r
eta
in
s
a
p
r
o
tectiv
e
ass
o
ciatio
n
in
a
c
o
llectiv
is
tic
co
n
tex
t.
Seco
n
d
,
it
ev
alu
ates
w
h
eth
er
p
o
wer
f
u
l
-
o
th
er
s
HL
OC
s
h
o
ws
a
n
e
u
tr
al
o
r
p
o
s
itiv
e
p
atter
n
r
ath
er
th
an
a
m
alad
ap
tiv
e
o
n
e.
T
h
ir
d
,
it
in
ter
p
r
ets
th
e
m
ag
n
itu
d
e
o
f
ass
o
ciatio
n
an
d
g
r
o
u
p
d
if
f
er
en
ce
s
to
d
eter
m
i
n
e
wh
e
th
er
HL
OC
is
a
d
o
m
i
n
an
t
p
r
ed
icto
r
o
r
o
n
ly
a
lim
ited
co
m
p
o
n
e
n
t
with
in
a
b
r
o
ad
e
r
s
o
cio
-
cu
ltu
r
al
s
y
s
tem
.
T
h
e
co
n
ce
p
tu
al
f
r
am
ewo
r
k
is
s
h
o
wn
in
Fig
u
r
e
1
.
HL
OC
d
i
m
en
s
io
n
s
ar
e
ex
p
ec
ted
t
o
r
ela
te
to
h
ea
lth
b
eh
av
io
r
,
b
u
t
th
e
Min
an
g
k
ab
au
co
llectiv
is
tic
co
n
tex
t
is
tr
ea
ted
as
a
b
o
u
n
d
ar
y
c
o
n
d
itio
n
th
at
m
ay
s
h
ap
e
th
e
s
tr
en
g
th
an
d
m
ea
n
i
n
g
o
f
th
is
r
elatio
n
s
h
ip
.
T
h
e
f
o
llo
win
g
s
ec
tio
n
s
d
em
o
n
s
tr
ate
th
is
f
r
am
ewo
r
k
th
r
o
u
g
h
a
cr
o
s
s
-
s
ec
tio
n
al
co
r
r
elatio
n
al
d
esig
n
,
r
eliab
ilit
y
ass
ess
m
en
t,
r
eg
r
ess
io
n
test
in
g
,
ANOV
A
b
ased
o
n
d
o
m
in
an
t
HL
OC
ty
p
e,
an
d
d
is
cu
s
s
io
n
o
f
th
eo
r
etica
l a
n
d
p
r
ac
tical
im
p
li
ca
tio
n
s
.
T
h
e
h
y
p
o
th
eses
wer
e
as
f
o
llo
ws:
H1
,
p
r
o
p
o
s
es
th
at
in
ter
n
a
l
HL
OC
h
as
a
p
o
s
itiv
e
a
s
s
o
ci
atio
n
with
m
u
ltid
im
en
s
io
n
al
h
ea
lth
b
eh
a
v
io
r
;
H2
,
p
o
wer
f
u
l
-
o
t
h
er
s
HL
OC
s
h
o
ws
a
n
eu
tr
al
o
r
p
o
s
i
tiv
e
ass
o
ciatio
n
with
h
ea
lth
b
eh
av
i
o
r
in
a
co
llecti
v
is
tic
cu
ltu
r
al
co
n
tex
t;
H3
,
c
h
an
ce
HL
OC
is
n
eg
ativ
ely
o
r
n
o
n
-
s
ig
n
if
ican
tly
ass
o
ciate
d
with
h
ea
lth
b
eh
av
io
r
;
an
d
H4
,
d
if
f
er
e
n
ce
s
in
h
ea
lth
b
eh
av
io
r
ac
r
o
s
s
d
o
m
in
an
t
HL
OC
ty
p
es
ar
e
n
o
t
ex
p
ec
ted
to
b
e
lar
g
e
,
r
ef
lectin
g
th
e
p
o
s
s
ib
ilit
y
th
at
s
o
cial
r
e
g
u
latio
n
m
ay
b
e
m
o
r
e
in
f
l
u
en
tial
th
an
in
d
iv
id
u
al
co
n
tr
o
l b
elief
s
alo
n
e.
2.
M
E
T
H
O
D
2
.
1
.
Resea
rc
h desi
g
n
T
h
is
s
tu
d
y
e
m
p
lo
y
e
d
a
q
u
an
titativ
e
cr
o
s
s
-
s
ec
tio
n
al
d
es
ig
n
with
a
n
e
x
p
lan
ato
r
y
c
o
r
r
elatio
n
al
ap
p
r
o
ac
h
.
T
h
e
d
esig
n
was
ch
o
s
en
b
ec
au
s
e
th
e
m
ain
o
b
jectiv
e
o
f
th
e
s
tu
d
y
was
to
in
v
es
tig
ate
ass
o
ciatio
n
s
b
etwe
en
HL
OC
d
im
en
s
io
n
s
an
d
h
ea
lth
b
eh
av
i
o
r
at
a
s
in
g
le
tim
e
p
o
in
t,
r
ath
er
t
h
an
t
o
d
eter
m
in
e
ca
u
s
al
r
elatio
n
s
h
ip
s
.
T
h
e
r
ep
o
r
tin
g
s
tr
u
ctu
r
e
was
alig
n
ed
with
th
e
lo
g
ic
o
f
o
b
s
er
v
atio
n
al
s
tu
d
y
r
ep
o
r
tin
g
,
in
wh
ich
th
e
p
o
p
u
latio
n
,
v
ar
i
ab
les,
in
s
tr
u
m
en
ts
,
p
r
o
ce
d
u
r
e,
an
d
an
aly
s
is
ar
e
d
escr
ib
ed
s
u
f
f
icien
tly
to
allo
w
r
ep
licatio
n
[
2
0
].
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.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
6
7
8
-
686
680
2
.
2
.
Co
ncept
ua
l a
nd
a
na
ly
t
ic
f
ra
m
ewo
rk
T
h
e
an
aly
tic
f
r
am
ewo
r
k
co
n
s
is
ted
o
f
th
r
ee
p
r
ed
icto
r
v
a
r
iab
l
es
an
d
o
n
e
m
u
ltid
im
e
n
s
io
n
al
o
u
tco
m
e
v
ar
iab
le.
T
h
e
p
r
ed
icto
r
s
wer
e
ch
an
ce
HL
OC
,
p
o
wer
f
u
l
-
o
t
h
e
r
s
HL
OC
,
an
d
in
ter
n
al
HL
OC
.
T
h
e
o
u
tco
m
e
was
to
tal
h
ea
lth
b
eh
a
v
io
r
,
ca
lc
u
lated
f
r
o
m
f
iv
e
b
e
h
av
io
r
al
d
o
m
ain
s
:
d
iet,
s
leep
,
s
m
o
k
in
g
,
r
is
k
y
b
e
v
er
ag
e
co
n
s
u
m
p
tio
n
,
an
d
e
x
er
cise.
C
u
ltu
r
e
was
n
o
t
en
ter
e
d
as
a
m
e
asu
r
ed
s
tatis
tical
v
ar
iab
le
b
ec
au
s
e
all
p
ar
ticip
an
ts
wer
e
s
elec
ted
f
r
o
m
th
e
Min
a
n
g
k
ab
au
co
llectiv
is
tic
co
n
tex
t;
in
s
tead
,
it
was
u
s
ed
as
th
e
in
t
er
p
r
etiv
e
b
o
u
n
d
ar
y
co
n
d
itio
n
f
o
r
ev
alu
atin
g
th
e
m
ea
n
in
g
an
d
m
ag
n
itu
d
e
o
f
t
h
e
s
tatis
tical
r
elatio
n
s
h
ip
s
.
Fi
g
u
r
e
1
p
r
esen
ts
th
e
co
n
ce
p
tu
al
f
r
am
ewo
r
k
g
u
id
in
g
th
e
an
aly
s
is
.
C
u
ltu
r
e
in
th
is
f
ig
u
r
e
is
in
ter
p
r
eted
as
a
b
o
u
n
d
ar
y
c
o
n
d
itio
n
f
o
r
th
e
HL
OC
-
h
ea
lth
b
eh
av
io
r
r
el
atio
n
s
h
ip
.
Fig
u
r
e
1
.
C
o
n
ce
p
tu
al
f
r
a
m
ewo
r
k
s
h
o
win
g
t
h
e
ass
o
ciatio
n
b
et
wee
n
HL
OC
an
d
m
u
ltid
im
en
s
io
n
al
h
ea
lth
b
eh
av
io
r
in
a
co
llectiv
is
tic
cu
l
tu
r
al
s
ettin
g
2
.
3
.
P
a
rt
icipa
nts a
nd
s
a
m
pli
ng
Par
ticip
an
ts
wer
e
2
7
4
a
d
u
lts
wh
o
s
elf
-
id
e
n
tifie
d
as
Min
a
n
g
k
ab
au
,
wer
e
o
ld
er
th
an
1
8
y
ea
r
s
,
r
esid
ed
in
W
est
Su
m
atr
a,
R
iau
,
o
r
J
am
b
i,
an
d
r
ep
o
r
te
d
at
least
o
n
e
m
eta
b
o
lic
d
is
o
r
d
er
d
iag
n
o
s
is
o
r
c
o
n
d
itio
n
,
in
clu
d
in
g
d
iab
etes
m
ellitu
s
,
h
y
p
er
ten
s
io
n
,
h
y
p
er
ch
o
lest
er
o
l
em
ia,
an
d
/o
r
o
v
e
r
weig
h
t
s
tatu
s
.
Par
ticip
an
ts
wer
e
r
ec
r
u
ited
p
u
r
p
o
s
iv
ely
t
h
r
o
u
g
h
co
m
m
u
n
ity
n
etwo
r
k
s
an
d
h
ea
l
th
ca
r
e
-
r
elat
ed
co
n
tacts.
I
n
d
iv
i
d
u
als
wer
e
elig
ib
le
wh
en
th
ey
m
et
th
e
c
u
ltu
r
al,
a
g
e,
r
esid
en
ce
,
an
d
h
ea
lth
-
c
o
n
d
itio
n
cr
iter
ia
a
n
d
wer
e
ab
le
t
o
p
r
o
v
id
e
i
n
f
o
r
m
ed
co
n
s
en
t.
T
h
e
n
u
m
b
er
o
f
p
a
r
t
icip
an
ts
was
co
n
s
id
er
ed
ad
eq
u
ate
to
co
n
d
u
ct
m
u
ltip
le
r
eg
r
ess
io
n
with
th
r
ee
in
d
ep
en
d
en
t
v
a
r
iab
les.
Usi
n
g
C
o
h
en
'
s
p
o
wer
g
u
id
elin
e,
a
s
am
p
le
o
f
2
7
4
p
r
o
v
id
es
s
u
f
f
icie
n
t
p
o
wer
t
o
d
etec
t
s
m
all
-
to
-
m
o
d
er
ate
ef
f
ec
ts
at
α
=
0
.
0
5
[
2
1
].
2
.
4
.
I
ns
t
rum
ent
s
HL
OC
was
as
s
es
s
ed
u
s
in
g
a
m
u
ltid
im
en
s
io
n
al
s
ca
le
co
n
s
is
tin
g
o
f
in
ter
n
al
HL
OC
(
9
item
s
)
,
p
o
wer
f
ul
-
o
th
er
s
HL
OC
(
8
item
s
)
,
an
d
ch
an
ce
HL
OC
(
7
item
s
)
.
R
esp
o
n
s
es
wer
e
m
ea
s
u
r
ed
u
s
in
g
a
4
-
p
o
in
t
L
ik
er
t
s
ca
le,
r
an
g
in
g
f
r
o
m
1
(
s
tr
o
n
g
ly
d
is
ag
r
ee
)
to
4
(
s
tr
o
n
g
l
y
ag
r
ee
)
.
E
ac
h
d
im
en
s
io
n
s
co
r
e
was
co
m
p
u
ted
as
th
e
av
er
a
g
e
o
f
its
co
r
r
esp
o
n
d
in
g
item
s
,
wh
e
r
e
h
i
g
h
er
v
a
lu
es
in
d
icate
a
s
tr
o
n
g
er
o
r
ie
n
tatio
n
to
war
d
th
at
s
p
ec
if
ic
co
n
tr
o
l
d
im
en
s
io
n
.
T
h
e
m
u
ltid
im
en
s
io
n
al
s
tr
u
ctu
r
e
was
th
eo
r
etica
lly
g
r
o
u
n
d
ed
in
th
e
HL
OC
m
o
d
el
[
6
]
-
[
8
]
.
I
n
ter
n
al
co
n
s
is
ten
cy
was
ex
am
in
ed
b
ef
o
r
e
h
y
p
o
th
esis
test
in
g
;
all
HL
OC
d
im
en
s
io
n
s
s
h
o
wed
g
o
o
d
r
eliab
ilit
y
(
C
r
o
n
b
ac
h
'
s
α
>
0
.
8
0
)
.
Hea
lth
b
eh
av
io
r
was
m
ea
s
u
r
e
d
u
s
in
g
a
m
u
ltid
im
en
s
io
n
al
s
ca
le
co
v
er
in
g
d
iet
(
1
0
item
s
)
,
s
leep
(
7
item
s
)
,
s
m
o
k
in
g
(
5
item
s
)
,
r
is
k
y
b
e
v
er
ag
e
co
n
s
u
m
p
tio
n
i
n
clu
d
in
g
s
u
g
ar
y
an
d
alco
h
o
lic
d
r
in
k
s
(
5
item
s
)
,
an
d
ex
er
cise
(
5
item
s
)
.
R
esp
o
n
s
es
wer
e
r
ec
o
r
d
ed
u
s
in
g
a
4
-
p
o
i
n
t
L
ik
er
t
s
ca
le.
Un
f
av
o
r
ab
le
i
tem
s
wer
e
r
ev
er
s
e
-
co
d
ed
s
o
th
at
h
ig
h
er
s
co
r
es
co
n
s
is
ten
tly
r
ep
r
esen
ted
h
ea
lth
ie
r
b
e
h
av
io
r
.
E
ac
h
d
o
m
ain
s
co
r
e
was
ca
lcu
lated
as
th
e
item
m
ea
n
,
an
d
to
tal
h
ea
lt
h
b
eh
av
io
r
was c
alcu
lated
as t
h
e
m
ea
n
o
f
th
e
f
i
v
e
d
o
m
ain
s
.
All d
o
m
ain
s
s
h
o
wed
s
tr
o
n
g
in
te
r
n
al
c
o
n
s
is
ten
cy
,
w
ith
C
r
o
n
b
ac
h
’
s
alp
h
a
v
alu
es
e
x
ce
ed
in
g
0
.
8
0
.
C
r
o
n
b
ac
h
'
s
alp
h
a
was
in
ter
p
r
eted
as a
n
in
d
ex
o
f
in
ter
n
al
co
n
s
is
ten
cy
r
ath
e
r
th
an
p
r
o
o
f
o
f
u
n
i
d
im
en
s
io
n
al
v
alid
ity
[
2
2
].
2
.
5
.
Da
t
a
c
o
llect
io
n pro
ce
du
re
Data
co
llectio
n
was
ca
r
r
ied
o
u
t
u
s
in
g
b
o
th
o
n
lin
e
a
n
d
o
f
f
li
n
e
q
u
esti
o
n
n
air
es
in
co
llab
o
r
atio
n
with
lo
ca
l
co
m
m
u
n
ity
n
etwo
r
k
s
an
d
h
ea
lth
ca
r
e
-
r
elate
d
co
n
ta
cts.
T
h
e
p
r
o
ce
d
u
r
e
f
o
llo
wed
th
ese
s
tep
s
.
First,
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
Hea
lth
lo
cu
s
o
f c
o
n
tr
o
l a
n
d
h
e
a
lth
b
eh
a
vio
u
r
in
Min
a
n
g
ka
b
a
u
meta
b
o
lic
…
(
R
i
d
a
Ya
n
n
a
P
r
ima
n
ita
)
681
p
o
ten
tial
p
ar
ticip
a
n
ts
r
ec
eiv
ed
in
f
o
r
m
atio
n
a
b
o
u
t
th
e
s
tu
d
y
p
u
r
p
o
s
e,
v
o
l
u
n
tar
y
p
ar
ticip
ati
o
n
,
c
o
n
f
id
e
n
tiality
,
an
d
elig
ib
ilit
y
cr
iter
ia.
Seco
n
d
,
p
ar
ticip
a
n
ts
wh
o
ag
r
ee
d
t
o
p
ar
ticip
ate
p
r
o
v
i
d
ed
in
f
o
r
m
ed
co
n
s
en
t.
T
h
ir
d
,
p
ar
ticip
an
ts
co
m
p
leted
d
e
m
o
g
r
ap
h
ic
an
d
h
ea
lth
-
c
o
n
d
itio
n
q
u
esti
o
n
s
,
f
o
llo
wed
b
y
th
e
HL
OC
an
d
h
ea
lth
b
eh
av
io
r
s
ca
les.
Fo
u
r
th
,
r
es
p
o
n
s
es
wer
e
s
cr
ee
n
ed
f
o
r
co
m
p
leten
ess
an
d
elig
ib
ilit
y
.
Fifth
,
d
ata
wer
e
an
o
n
y
m
ized
b
e
f
o
r
e
an
aly
s
is
s
o
th
at
in
d
i
v
id
u
al
r
esp
o
n
s
es
co
u
ld
n
o
t
b
e
lin
k
ed
to
p
er
s
o
n
al
i
d
en
tity
.
Par
ticip
an
ts
wer
e
ad
v
is
ed
th
at
th
e
y
co
u
l
d
with
d
r
aw
f
r
o
m
th
e
s
tu
d
y
at
an
y
tim
e
with
o
u
t p
e
n
alty
o
r
co
n
s
eq
u
en
ce
s
.
2
.
6
.
Da
t
a
prepa
ra
t
i
o
n a
nd
s
co
ring
Data
p
r
ep
ar
atio
n
in
v
o
lv
e
d
ch
ec
k
in
g
elig
i
b
ilit
y
,
m
is
s
in
g
r
e
s
p
o
n
s
es,
r
esp
o
n
s
e
c
o
n
s
is
ten
cy
,
r
e
v
er
s
e
co
d
in
g
o
f
u
n
f
a
v
o
r
a
b
le
item
s
,
an
d
ca
lcu
latio
n
o
f
d
im
e
n
s
io
n
m
ea
n
s
.
Do
m
in
an
t
HL
OC
ty
p
e
was
d
eter
m
in
ed
b
y
co
m
p
ar
in
g
ea
c
h
p
a
r
ticip
an
t'
s
m
ea
n
s
co
r
e
o
n
in
ter
n
al,
c
h
an
c
e
HL
OC
,
an
d
p
o
wer
f
u
l
-
o
t
h
er
s
.
T
h
e
h
ig
h
est
m
ea
n
s
co
r
e
was
u
s
ed
to
class
if
y
th
e
p
ar
ticip
an
t
in
t
o
a
d
o
m
in
a
n
t
HL
OC
ca
teg
o
r
y
.
C
ases
with
tie
d
h
ig
h
est
HL
OC
d
im
en
s
io
n
s
co
r
es
wer
e
r
etain
ed
f
o
r
co
r
r
elatio
n
an
d
r
eg
r
ess
io
n
an
aly
s
es
b
u
t
ex
clu
d
ed
f
r
o
m
th
e
d
o
m
in
an
t
-
t
y
p
e
ANOV
A
to
av
o
id
ar
b
itra
r
y
cla
s
s
if
icatio
n
.
2
.
7
.
Da
t
a
a
na
ly
s
is
I
B
M
SP
SS
Sta
tis
t
ics
v
er
s
io
n
2
6
was
u
s
ed
f
o
r
all
d
ata
an
al
y
s
es.
T
h
e
an
aly
s
is
was
co
n
d
u
cted
in
s
ix
s
tep
s
.
Fir
s
t,
d
escr
ip
tiv
e
s
tat
is
tics
wer
e
ca
lcu
lated
f
o
r
all
HL
OC
an
d
h
ea
lth
b
eh
av
io
r
d
im
en
s
io
n
s
.
Seco
n
d
,
C
r
o
n
b
ac
h
’
s
alp
h
a
was
u
s
ed
to
ev
alu
ate
in
te
r
n
al
co
n
s
is
ten
cy
r
eliab
ilit
y
.
T
h
ir
d
,
Pear
s
o
n
co
r
r
elatio
n
s
wer
e
u
s
ed
to
d
escr
ib
e
b
iv
ar
iate
ass
o
ciatio
n
s
am
o
n
g
HL
OC
an
d
h
ea
lt
h
b
eh
av
io
r
d
im
en
s
io
n
s
.
Fo
u
r
th
,
m
u
ltip
le
lin
ea
r
r
eg
r
ess
io
n
was
u
s
ed
to
te
s
t
H1
-
H3
,
with
to
tal
h
ea
lth
b
eh
av
io
r
as
th
e
d
ep
en
d
e
n
t
v
ar
iab
le
an
d
in
ter
n
al,
p
o
wer
f
u
l
-
o
th
er
s
,
a
n
d
c
h
an
ce
HL
OC
as
s
im
u
ltan
eo
u
s
p
r
ed
ic
to
r
s
.
Fifth
,
o
n
e
-
way
ANOV
A
was
u
s
ed
to
test
H4
b
y
co
m
p
ar
in
g
h
ea
lth
b
eh
av
io
r
d
o
m
ain
s
ac
r
o
s
s
d
o
m
in
an
t
H
L
OC
ty
p
es.
Six
th
,
ef
f
ec
t
s
izes
wer
e
r
ep
o
r
ted
an
d
in
ter
p
r
eted
to
d
is
tin
g
u
is
h
s
tatis
tical
s
ig
n
if
ican
ce
f
r
o
m
p
r
ac
ti
ca
l
s
ig
n
if
ican
ce
.
A
s
ig
n
if
ican
c
e
th
r
esh
o
ld
o
f
0
.
0
5
was
ap
p
lied
.
3.
RE
SU
L
T
S AN
D
D
I
SCU
SS
I
O
N
3
.
1
.
Descript
iv
e
s
t
a
t
is
t
ics a
nd
re
lia
bil
it
y
E
ac
h
d
im
e
n
s
io
n
e
x
h
ib
ited
s
tr
o
n
g
in
ter
n
al
co
n
s
is
ten
cy
(
C
r
o
n
b
ac
h
’
s
α
>
0
.
8
0
)
.
T
a
b
le
1
s
u
m
m
ar
izes
th
e
m
ea
n
s
,
s
tan
d
ar
d
d
ev
iatio
n
s
,
an
d
co
r
r
elatio
n
s
am
o
n
g
HL
OC
d
im
en
s
io
n
s
an
d
h
ea
lth
b
e
h
av
io
r
d
o
m
ain
s
.
T
h
e
k
ey
p
atter
n
is
th
at
ass
o
ciatio
n
s
b
etwe
en
HL
OC
d
im
en
s
io
n
s
an
d
s
p
ec
if
ic
h
ea
lth
b
eh
av
io
r
d
o
m
ain
s
wer
e
g
en
er
ally
wea
k
,
wh
er
ea
s
co
r
r
e
latio
n
s
am
o
n
g
h
ea
lth
b
eh
a
v
io
r
d
o
m
ain
s
wer
e
m
o
d
er
ate.
T
h
is
in
d
icate
s
th
at
d
iet,
s
leep
,
s
m
o
k
in
g
,
r
is
k
y
b
e
v
er
a
g
e
co
n
s
u
m
p
tio
n
,
an
d
e
x
er
cise
wer
e
r
elate
d
as
h
ea
lth
b
e
h
av
io
r
d
o
m
ain
s
,
b
u
t
HL
OC
was n
o
t a
s
tr
o
n
g
co
r
r
el
ate
o
f
ea
ch
d
o
m
ain
.
T
ab
le
1
.
Descr
ip
tiv
e
s
tatis
tics
an
d
co
r
r
elatio
n
s
am
o
n
g
d
im
e
n
s
io
n
s
No
V
a
r
i
a
b
l
e
M
SD
1
2
3
4
5
6
7
8
1
I
n
t
e
r
n
a
l
2
.
8
7
0
.
4
2
—
2
P
o
w
e
r
f
u
l
2
.
7
4
0
.
4
5
-
0
.
3
4
—
3
C
h
a
n
c
e
2
.
6
9
0
.
4
7
-
0
.
0
2
-
0
.
4
6
—
4
D
i
e
t
2
.
7
2
0
.
3
8
0
.
1
5
0
.
0
7
0
.
0
2
—
5
S
l
e
e
p
2
.
6
0
0
.
4
1
0
.
0
5
0
.
0
7
-
0
.
0
1
0
.
3
4
—
6
S
mo
k
i
n
g
2
.
6
3
0
.
4
4
0
.
0
4
0
.
1
1
0
.
0
6
0
.
3
3
0
.
2
7
—
7
D
r
i
n
k
2
.
7
1
0
.
4
6
0
.
1
8
0
.
0
2
0
.
0
2
0
.
2
8
0
.
2
7
0
.
5
0
—
8
Ex
e
r
c
i
se
2
.
5
8
0
.
4
3
0
.
0
1
0
.
0
5
0
.
0
0
0
.
4
7
0
.
4
2
0
.
3
2
0
.
3
2
—
3
.
2
.
Reg
re
s
s
io
n a
na
ly
s
is
o
f
H
L
O
C
a
nd
t
o
t
a
l hea
lt
h beha
v
io
r
Mu
ltip
le
lin
ea
r
r
e
g
r
ess
io
n
w
as
co
n
d
u
cte
d
to
test
wh
eth
er
ch
an
ce
,
p
o
wer
f
u
l
-
o
t
h
er
s
,
an
d
in
ter
n
al
HL
OC
p
r
ed
icted
to
tal
h
ea
lth
b
eh
av
io
r
.
T
ab
le
2
p
r
esen
ts
th
e
r
eg
r
ess
io
n
co
ef
f
icien
ts
.
Po
wer
f
u
l
-
o
th
e
r
s
HL
OC
an
d
in
ter
n
al
HL
OC
wer
e
p
o
s
itiv
e
an
d
s
tatis
tically
s
ig
n
if
ican
t
p
r
e
d
icto
r
s
,
wh
e
r
ea
s
ch
an
ce
HL
OC
was
n
o
t
s
tatis
t
ically
s
ig
n
if
ican
t.
Ho
we
v
er
,
th
e
m
o
d
el
as
a
wh
o
le
ex
p
lain
ed
ju
s
t
4
.
8
%
o
f
t
h
e
v
a
r
iatio
n
in
o
v
e
r
all
h
ea
lth
b
eh
av
io
r
.
T
h
er
ef
o
r
e,
th
e
clin
i
ca
l
an
d
p
u
b
lic
h
ea
lth
in
te
r
p
r
e
tatio
n
s
h
o
u
l
d
em
p
h
asize
th
e
s
m
all
m
ag
n
itu
d
e
o
f
p
r
ed
ictio
n
r
ath
er
th
a
n
s
tatis
tic
al
s
ig
n
if
ican
ce
alo
n
e.
T
ab
le
2
.
Mu
ltip
le
lin
ea
r
r
eg
r
ess
io
n
p
r
ed
ictin
g
to
tal
h
ea
lth
b
e
h
av
io
r
P
r
e
d
i
c
t
o
r
B
SE
β
t
p
I
n
t
e
r
n
a
l
0
.
1
6
0
0
.
0
5
1
0
.
1
6
3
.
1
4
0
.
0
0
2
P
o
w
e
r
f
u
l
o
t
h
e
r
s
0
.
1
5
9
0
.
0
5
3
0
.
1
6
2
.
9
9
0
.
0
0
3
C
h
a
n
c
e
0
.
0
9
6
0
.
0
5
1
0
.
1
0
1
.
8
7
0
.
0
6
3
M
o
d
e
l
s
u
mm
a
r
y
I
n
t
e
r
c
e
p
t
=
1
.
5
8
2
S
E
=
0
.
3
0
5
p
<
0
.
0
0
1
R
² =
0
.
0
4
8
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.
15
,
No
.
3
,
Sep
tem
b
er
20
26
:
6
7
8
-
686
682
Fig
u
r
e
2
v
is
u
alize
s
th
e
s
tan
d
ar
d
ized
r
eg
r
ess
io
n
co
ef
f
icien
t
s
.
T
h
e
f
ig
u
r
e
s
h
o
ws
th
at
in
ter
n
al
an
d
p
o
wer
f
u
l
-
o
th
er
s
HL
OC
h
ad
c
o
m
p
ar
ab
le
s
m
all
p
o
s
itiv
e
co
ef
f
icien
ts
,
wh
er
ea
s
c
h
an
ce
HL
OC
h
ad
a
wea
k
e
r
a
n
d
non
-
s
ig
n
if
ica
n
t
p
o
s
itiv
e
co
ef
f
i
cien
t.
T
h
e
r
esu
lts
o
f
f
er
p
ar
tial
s
u
p
p
o
r
t
f
o
r
H1
,
s
u
p
p
o
r
t
H2
,
an
d
s
u
p
p
o
r
t
H3
,
as
ch
an
ce
HL
OC
s
h
o
wed
n
o
s
ig
n
if
ican
t r
elatio
n
s
h
ip
with
h
ea
lth
b
eh
av
io
r
.
Fig
u
r
e
2
.
Stan
d
a
r
d
ized
r
eg
r
ess
io
n
co
ef
f
icien
ts
o
f
HL
OC
d
im
en
s
io
n
s
p
r
ed
ictin
g
t
o
tal
h
ea
lth
b
eh
av
io
r
3
.
3
.
Dif
f
er
ence
s
in hea
lt
h be
ha
v
io
r
by
do
m
ina
nt
H
L
O
C
t
y
pe
Par
ticip
an
ts
wer
e
g
r
o
u
p
e
d
a
cc
o
r
d
in
g
to
th
eir
d
o
m
in
an
t
HL
OC
ty
p
e,
an
d
d
if
f
e
r
en
ce
s
in
h
ea
lth
b
eh
av
io
r
d
o
m
ain
s
ac
r
o
s
s
th
ese
g
r
o
u
p
s
wer
e
an
al
y
ze
d
u
s
in
g
o
n
e
-
way
ANOV
A.
T
ab
le
3
p
r
esen
ts
th
e
ANOV
A
r
esu
lts
.
No
n
e
o
f
t
h
e
h
ea
lth
b
e
h
av
io
r
d
o
m
ain
s
s
h
o
wed
m
ea
n
in
g
f
u
l
d
if
f
er
e
n
ce
s
ac
r
o
s
s
d
o
m
in
an
t
HL
OC
ty
p
es.
All
η
²
v
alu
es
wer
e
b
elo
w
0
.
0
2
,
in
d
icatin
g
v
er
y
s
m
all
ef
f
ec
t
s
izes.
T
h
ese
f
in
d
in
g
s
s
u
p
p
o
r
t
H4
an
d
s
u
g
g
est
th
at
d
o
m
in
an
t H
L
OC
ty
p
e
al
o
n
e
d
o
es n
o
t d
if
f
e
r
en
tiate
h
ea
lth
b
e
h
av
io
r
p
atter
n
s
in
th
is
s
am
p
l
e.
T
ab
le
3
.
ANOV
A
r
esu
lts
f
o
r
h
ea
lth
b
eh
av
io
r
b
y
d
o
m
i
n
an
t H
L
OC
ty
p
e
H
e
a
l
t
h
b
e
h
a
v
i
o
r
d
o
m
a
i
n
F
p
η²
D
i
e
t
1
.
7
3
0
.
1
7
9
0
.
0
1
3
S
l
e
e
p
0
.
1
8
0
.
8
3
2
0
.
0
0
1
S
mo
k
i
n
g
0
.
2
4
0
.
7
8
6
0
.
0
0
2
R
i
s
k
y
b
e
v
e
r
a
g
e
c
o
n
s
u
m
p
t
i
o
n
1
.
1
4
0
.
3
2
0
0
.
0
0
8
Ex
e
r
c
i
se
0
.
1
9
0
.
8
2
3
0
.
0
0
1
3
.
4
.
Su
mm
a
ry
o
f
hy
po
t
hes
es
T
ab
le
4
s
u
m
m
ar
izes
th
e
h
y
p
o
th
esis
-
lev
el
in
ter
p
r
etatio
n
.
T
h
e
f
i
n
d
in
g
s
s
h
o
w
th
at
H
L
OC
h
ad
s
tatis
t
ically
d
etec
tab
le
b
u
t
p
r
ac
tically
lim
ited
as
s
o
ciatio
n
s
with
h
ea
lth
b
eh
av
io
r
.
T
h
is
is
im
p
o
r
tan
t
b
ec
au
s
e
a
s
ig
n
if
ican
t
p
-
v
alu
e
ca
n
o
b
s
c
u
r
e
th
e
b
r
o
ad
er
p
atter
n
:
HL
OC
was
n
o
t
a
d
o
m
in
an
t
ex
p
lan
ato
r
y
f
ac
t
o
r
f
o
r
m
u
ltid
im
en
s
io
n
al
h
ea
lth
b
eh
a
v
io
r
am
o
n
g
Min
a
n
g
k
a
b
au
a
d
u
lts
with
m
etab
o
lic
d
is
o
r
d
er
s
.
T
ab
le
4
.
Su
m
m
a
r
y
o
f
h
y
p
o
th
e
s
es a
n
d
in
ter
p
r
etatio
n
H
y
p
o
t
h
e
s
i
s
R
e
s
u
l
t
I
n
t
e
r
p
r
e
t
a
t
i
o
n
H
1
:
I
n
t
e
r
n
a
l
H
LO
C
p
o
s
i
t
i
v
e
l
y
p
r
e
d
i
c
t
s
h
e
a
l
t
h
b
e
h
a
v
i
o
r
P
a
r
t
i
a
l
l
y
s
u
p
p
o
r
t
e
d
I
n
t
e
r
n
a
l
H
LO
C
w
a
s
si
g
n
i
f
i
c
a
n
t
,
b
u
t
t
h
e
e
f
f
e
c
t
w
a
s sm
a
l
l
.
H
2
:
P
o
w
e
r
f
u
l
-
o
t
h
e
r
s HLO
C
i
s
n
e
u
t
r
a
l
o
r
p
o
si
t
i
v
e
S
u
p
p
o
r
t
e
d
P
o
w
e
r
f
u
l
-
o
t
h
e
r
s HLO
C
w
a
s
p
o
si
t
i
v
e
a
n
d
si
g
n
i
f
i
c
a
n
t
,
su
g
g
e
st
i
n
g
p
o
ssi
b
l
e
s
o
c
i
a
l
-
r
e
g
u
l
a
t
o
r
y
mea
n
i
n
g
.
H
3
:
C
h
a
n
c
e
H
LO
C
i
s
n
e
g
a
t
i
v
e
o
r
n
o
n
-
s
i
g
n
i
f
i
c
a
n
t
S
u
p
p
o
r
t
e
d
C
h
a
n
c
e
H
LO
C
w
a
s
n
o
t
s
t
a
t
i
st
i
c
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D
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s.
3
.
5
.
Dis
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T
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-
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x
am
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m
p
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in
ter
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H
L
OC
is
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iv
er
s
ally
p
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tecti
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am
o
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in
d
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with
m
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r
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in
a
co
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tic
Min
an
g
k
ab
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u
co
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te
x
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T
h
e
f
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n
d
in
g
s
p
r
o
v
id
e
a
n
u
a
n
ce
d
an
s
wer
.
I
n
ter
n
al
HL
OC
s
h
o
wed
a
p
o
s
itiv
e
ass
o
ciatio
n
with
o
v
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all
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eh
a
v
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r
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o
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8
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o
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683
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p
o
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elatio
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ip
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also
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b
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ed
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f
u
l
-
o
th
e
r
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OC
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d
h
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lth
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eh
av
io
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er
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ig
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ican
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ass
o
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atio
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was
f
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n
d
f
o
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c
h
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ce
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OC
.
Mo
r
eo
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h
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lth
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io
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id
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o
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if
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lly
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a
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OC
ty
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es.
T
h
u
s
,
th
e
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lt
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o
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o
t
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ejec
t
HL
OC
th
eo
r
y
b
u
t
in
d
icate
th
at
its
ex
p
lan
ato
r
y
p
o
we
r
m
ay
b
e
co
n
tex
t
-
b
o
u
n
d
.
T
h
e
s
m
all
p
o
s
itiv
e
ass
o
ciatio
n
b
etwe
en
in
ter
n
al
HL
OC
an
d
h
ea
lth
b
e
h
av
io
r
is
co
n
s
i
s
ten
t
with
t
h
e
o
r
i
e
s
e
m
p
h
a
s
iz
i
n
g
a
g
e
n
c
y
,
s
e
l
f
-
r
e
g
u
l
a
t
i
o
n
,
a
n
d
p
e
r
c
e
i
v
e
d
p
e
r
s
o
n
a
l
i
n
f
l
u
e
n
c
e
i
n
h
e
a
lt
h
b
e
h
a
v
i
o
r
[
5
]
,
[
8
]
,
[
2
3
]
.
Ho
wev
er
,
th
e
lo
w
p
r
o
p
o
r
tio
n
o
f
ex
p
lain
e
d
v
ar
ian
ce
in
d
icate
s
th
at
b
elief
s
ab
o
u
t
p
er
s
o
n
al
c
o
n
tr
o
l
alo
n
e
a
r
e
n
o
t
s
u
f
f
icien
t
to
ac
co
u
n
t
f
o
r
s
u
s
tain
ed
h
ea
lth
b
eh
av
io
r
in
th
is
p
o
p
u
latio
n
.
T
h
is
f
i
n
d
in
g
alig
n
s
with
m
eta
-
an
aly
tic
ev
id
e
n
ce
th
at
t
h
e
r
elatio
n
s
h
ip
b
etwe
en
HL
OC
an
d
h
ea
lth
b
e
h
av
io
r
v
ar
ies
ac
r
o
s
s
b
eh
av
io
r
s
a
n
d
m
o
d
er
ato
r
s
[
9
]
.
I
t
also
s
u
p
p
o
r
ts
ch
r
o
n
ic
d
is
ea
s
e
r
esear
ch
s
h
o
win
g
th
at
HL
OC
m
ay
o
p
er
ate
to
g
eth
er
with
em
p
o
wer
m
en
t,
s
elf
-
ef
f
ic
ac
y
,
an
d
b
r
o
a
d
er
p
s
y
ch
o
s
o
cia
l
f
ac
to
r
s
r
ath
er
t
h
an
f
u
n
ctio
n
in
g
as
an
is
o
lated
p
r
ed
icto
r
[
1
1
]
.
A
th
eo
r
etica
lly
im
p
o
r
tan
t
f
in
d
in
g
is
th
at
p
o
wer
f
u
l
-
o
th
er
s
HL
OC
s
h
o
wed
a
p
o
s
itiv
e
r
ath
er
th
an
m
alad
ap
tiv
e
ass
o
ciatio
n
.
I
n
a
n
in
d
iv
i
d
u
alis
tic
in
ter
p
r
etatio
n
,
r
elian
ce
o
n
p
o
wer
f
u
l
o
t
h
er
s
m
ay
b
e
v
iewe
d
as
d
ep
en
d
e
n
cy
.
I
n
a
co
llectiv
is
tic
co
n
tex
t,
h
o
wev
er
,
in
f
lu
e
n
t
ial
o
th
er
s
m
a
y
p
r
o
v
id
e
le
g
itima
cy
,
r
e
m
in
d
er
s
,
ad
v
ice,
an
d
n
o
r
m
ativ
e
p
r
ess
u
r
e
th
at
s
u
p
p
o
r
t
b
eh
a
v
io
r
c
h
an
g
e.
I
n
Min
an
g
k
ab
au
co
m
m
u
n
ities
,
f
am
ily
m
em
b
er
s
,
h
ea
lth
wo
r
k
er
s
,
r
el
ig
io
u
s
f
ig
u
r
es,
an
d
co
m
m
u
n
i
ty
lead
er
s
m
ay
f
u
n
ctio
n
as
s
o
cially
r
ec
o
g
n
ized
s
o
u
r
ce
s
o
f
g
u
i
d
an
ce
.
T
h
is
in
te
r
p
r
etatio
n
is
co
n
s
is
ten
t
with
c
u
ltu
r
al
p
s
y
c
h
o
lo
g
y
,
wh
ich
e
m
p
h
asizes
th
at
ag
e
n
cy
ca
n
b
e
r
elatio
n
al
an
d
s
o
cially
em
b
ed
d
e
d
r
ath
er
th
an
o
n
ly
in
d
iv
id
u
al
[
1
2
]
,
[
1
5
]
,
[
1
6
]
.
T
h
e
n
o
n
-
s
ig
n
i
f
ican
t
ef
f
ec
t
o
f
ch
an
ce
HL
OC
also
r
eq
u
ir
es
c
ar
ef
u
l
in
ter
p
r
etatio
n
.
C
h
an
ce
o
r
ien
tatio
n
is
o
f
ten
ass
o
ciate
d
wi
th
f
atali
s
m
,
b
u
t
r
el
ig
io
u
s
o
r
d
esti
n
y
-
r
elate
d
b
elief
s
d
o
n
o
t
alwa
y
s
p
r
o
d
u
ce
p
ass
iv
ity
.
I
n
r
elig
io
u
s
ly
g
r
o
u
n
d
ed
co
m
m
u
n
ities
,
ac
ce
p
tan
ce
o
f
d
esti
n
y
m
ay
co
ex
is
t
with
ac
tiv
e
ef
f
o
r
t,
s
o
cial
r
esp
o
n
s
ib
ilit
y
,
an
d
tr
ea
tm
e
n
t
-
s
ee
k
in
g
.
T
h
er
e
f
o
r
e,
c
h
an
ce
HL
OC
m
a
y
n
o
t
b
e
a
s
im
p
le
in
d
icato
r
o
f
d
is
en
g
ag
em
en
t
u
n
less
it
is
ac
co
m
p
an
ied
b
y
lo
w
s
elf
-
ef
f
i
ca
cy
,
p
o
o
r
h
ea
lth
liter
ac
y
,
li
m
ited
h
ea
lth
ca
r
e
ac
ce
s
s
,
o
r
d
is
co
u
r
ag
in
g
illn
ess
ex
p
er
ien
ce
s
.
T
h
ese
r
esu
lts
s
u
g
g
est
th
at
o
t
h
er
f
ac
to
r
s
m
ay
b
e
m
o
r
e
in
f
l
u
en
tial
th
an
HL
OC
in
ex
p
lain
in
g
h
ea
lth
b
eh
av
io
r
.
Po
s
s
ib
le
s
tr
o
n
g
er
d
eter
m
in
an
ts
in
clu
d
e
s
elf
-
ef
f
ic
ac
y
,
h
ea
lth
liter
ac
y
,
d
is
ea
s
e
s
ev
er
ity
,
s
y
m
p
to
m
b
u
r
d
e
n
,
f
a
m
ily
s
u
p
p
o
r
t,
ec
o
n
o
m
ic
r
eso
u
r
ce
s
,
f
o
o
d
a
v
ailab
ilit
y
,
ac
ce
s
s
to
h
ea
lth
ca
r
e,
g
en
d
er
ed
h
o
u
s
eh
o
ld
r
o
les,
p
ee
r
n
o
r
m
s
,
an
d
co
m
m
u
n
ity
-
lev
el
r
ein
f
o
r
ce
m
en
t.
So
cial
s
u
p
p
o
r
t
h
as
r
e
p
ea
ted
ly
b
e
en
lin
k
e
d
to
ch
r
o
n
ic
illn
ess
s
elf
-
m
an
ag
em
en
t
[
2
4
]
.
R
ec
en
t
d
iab
etes
liter
atu
r
e
als
o
in
d
icate
s
th
at
f
a
m
ily
s
u
p
p
o
r
t
an
d
f
a
m
ily
-
b
ased
in
ter
v
en
tio
n
s
ca
n
im
p
r
o
v
e
s
elf
-
m
an
ag
em
e
n
t a
n
d
g
ly
ce
m
ic
o
u
tco
m
es [
2
5
]
-
[
28
]
.
T
h
u
s
,
in
co
llectiv
is
tic
s
ettin
g
s
,
th
e
p
ath
way
f
r
o
m
co
n
tr
o
l
b
e
lief
s
to
b
eh
av
io
r
m
a
y
b
e
i
n
d
ir
ec
t
an
d
m
e
d
iated
b
y
r
elatio
n
al
an
d
s
tr
u
ct
u
r
al
co
n
d
itio
n
s
.
T
h
e
th
e
o
r
etica
l
co
n
tr
ib
u
tio
n
o
f
th
is
s
tu
d
y
is
t
h
e
p
r
o
p
o
s
itio
n
th
at
HL
OC
s
h
o
u
ld
b
e
t
r
ea
ted
as
cu
ltu
r
ally
s
en
s
itiv
e
r
a
th
er
th
a
n
u
n
iv
er
s
ally
p
r
ed
ictiv
e.
I
n
te
r
n
al
HL
OC
r
em
ain
s
r
elev
an
t,
b
u
t
its
p
r
o
tectiv
e
f
u
n
ctio
n
a
p
p
ea
r
s
lim
ited
wh
en
b
eh
av
io
r
is
em
b
ed
d
ed
in
co
m
m
u
n
al
n
o
r
m
s
an
d
s
o
cial
ex
p
ec
tatio
n
s
.
Po
wer
f
u
l
-
o
th
er
s
HL
OC
m
ay
n
ee
d
to
b
e
r
ein
te
r
p
r
eted
in
co
llectiv
i
s
tic
co
n
tex
ts
as
a
p
o
te
n
tial
in
d
icato
r
o
f
s
o
cial
r
eg
u
latio
n
r
ath
er
th
a
n
m
e
r
ely
ex
ter
n
al
d
ep
en
d
en
cy
.
T
h
is
ex
p
an
d
s
HL
OC
th
eo
r
y
b
y
s
h
o
wi
n
g
th
at
th
e
m
ea
n
in
g
o
f
co
n
t
r
o
l d
e
p
en
d
s
o
n
th
e
s
o
ci
al
s
y
s
tem
in
wh
ich
co
n
tr
o
l b
el
ief
s
o
p
er
ate.
3
.
6
.
P
r
a
ct
ica
l i
m
pli
ca
t
io
ns
T
h
ese
r
esu
lts
h
av
e
p
r
ac
tical
r
elev
an
ce
f
o
r
p
u
b
lic
h
ea
lth
p
r
o
g
r
am
s
f
o
cu
s
ed
o
n
m
etab
o
lic
d
is
o
r
d
er
s
with
in
co
llectiv
is
tic
p
o
p
u
latio
n
s
.
First,
p
atien
t
ed
u
ca
tio
n
s
h
o
u
ld
n
o
t
f
o
c
u
s
s
o
lely
o
n
in
d
iv
id
u
al
r
esp
o
n
s
ib
ilit
y
.
I
t sh
o
u
ld
also
in
v
ite
f
am
ily
m
em
b
er
s
to
u
n
d
er
s
tan
d
d
iet,
p
h
y
s
ical
ac
tiv
ity
,
s
leep
,
m
ed
icatio
n
r
o
u
tin
es,
an
d
r
is
k
b
eh
av
io
r
s
s
o
t
h
at
h
o
u
s
eh
o
ld
r
o
u
tin
es
s
u
p
p
o
r
t
h
ea
lth
ier
ch
o
ices.
Seco
n
d
,
h
ea
lth
ca
m
p
ai
g
n
s
s
h
o
u
ld
i
n
v
o
lv
e
tr
u
s
ted
co
m
m
u
n
ity
ac
t
o
r
s
,
s
u
ch
as
r
elig
io
u
s
lead
er
s
,
cu
s
to
m
ar
y
lead
er
s
,
wo
m
e
n
'
s
g
r
o
u
p
s
,
an
d
co
m
m
u
n
ity
h
ea
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ig
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ay
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itima
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clin
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ice
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ce
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le
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o
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tin
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s
u
ch
as
f
am
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p
lan
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co
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p
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ased
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g
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a
n
d
l
o
ca
lly
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f
u
l
m
ess
ag
es
ab
o
u
t
c
ar
in
g
f
o
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th
e
b
o
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y
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Fo
u
r
th
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p
r
o
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r
am
s
s
h
o
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l
d
av
o
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lam
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p
atien
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wea
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o
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ar
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ch
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co
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cc
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p
ec
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,
an
d
th
e
av
ailab
ilit
y
o
f
h
ea
lth
y
o
p
tio
n
s
.
4.
CO
NCLU
SI
O
N
T
h
is
s
tu
d
y
in
d
icate
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th
at
in
ter
n
al
HL
OC
is
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o
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itiv
ely
r
elate
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ea
lth
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eh
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i
o
r
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m
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g
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Po
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u
l
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s
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s
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ws
a
s
m
all
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o
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itiv
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n
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ile
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a
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ig
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p
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ed
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.
Hea
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e
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er
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n
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h
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g
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at
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s
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t
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u
f
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p
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io
n
al
h
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lth
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eh
av
io
r
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a
co
llectiv
is
tic
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n
tex
t.
T
h
e
s
tu
d
y
ex
ten
d
s
HL
OC
th
eo
r
y
b
y
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
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:
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2
5
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I
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15
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3
,
Sep
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20
26
:
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7
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684
p
o
s
itio
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g
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a
b
o
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n
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ar
y
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n
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g
an
d
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tr
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n
tr
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Fo
r
p
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ter
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ld
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m
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i
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ca
tio
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ased
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m
m
u
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h
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ied
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ath
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ter
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ets.
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o
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e
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o
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u
t
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n
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o
t
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eter
m
in
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et
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ce
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o
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ar
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ay
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o
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ce
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ias
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ias.
Fo
u
r
th
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ltu
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ter
p
r
eted
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o
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g
h
t
h
e
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an
g
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a
u
s
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n
tex
t
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er
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an
m
ea
s
u
r
e
d
d
ir
ec
t
ly
th
r
o
u
g
h
v
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ated
in
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iv
id
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a
l
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lev
el
co
llectiv
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m
o
r
n
o
r
m
s
ca
les.
Fu
tu
r
e
r
ese
ar
ch
s
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o
u
ld
u
s
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lo
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g
itu
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in
a
l
d
esig
n
s
,
clin
ical
v
er
if
icatio
n
,
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d
m
u
ltil
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m
o
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at
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e
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i
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am
ily
s
u
p
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o
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h
ea
lth
liter
ac
y
,
r
elig
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ity
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d
co
m
m
u
n
ity
n
o
r
m
s
as
m
ed
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o
r
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o
d
er
at
o
r
s
.
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th
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e
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RE
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E
NC
E
S
[
1
]
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
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“
N
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mm
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i
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”
W
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.
A
c
c
e
sse
d
:
Ja
n
.
0
1
,
2
0
2
6
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s
:
/
/
w
w
w
.
w
h
o
.
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t
/
n
e
w
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m
/
f
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c
t
-
sh
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e
t
s
/
d
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t
a
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l
/
n
o
n
c
o
mm
u
n
i
c
a
b
l
e
-
d
i
s
e
a
ses
.
[
2
]
B
a
d
a
n
K
e
b
i
j
a
k
a
n
P
e
mb
a
n
g
u
n
a
n
K
e
s
e
h
a
t
a
n
,
“
S
K
I
2
0
2
3
d
a
l
a
m
a
n
g
k
a
,
”
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e
me
n
k
e
s
B
K
P
K
.
A
c
c
e
sse
d
:
Ja
n
.
0
1
,
2
0
2
6
.
[
O
n
l
i
n
e
]
.
A
v
a
i
l
a
b
l
e
:
h
t
t
p
s:
/
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w
w
.
w
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/
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e
w
s
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/
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c
t
-
sh
e
e
t
s/
d
e
t
a
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l
/
n
o
n
c
o
mm
u
n
i
c
a
b
l
e
-
d
i
se
a
ses
.
[
3
]
W
H
O
,
“
G
l
o
b
a
l
r
e
p
o
r
t
o
n
h
y
p
e
r
t
e
n
si
o
n
:
t
h
e
r
a
c
e
a
g
a
i
n
st
a
si
l
e
n
t
k
i
l
l
e
r
,
”
W
o
r
l
d
H
e
a
l
t
h
O
r
g
a
n
i
z
a
t
i
o
n
.
A
c
c
e
ss
e
d
:
D
e
c
.
0
1
,
2
0
2
5
.
[
O
n
l
i
n
e
]
.
A
v
a
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l
a
b
l
e
:
h
t
t
p
s:
/
/
w
w
w
.
w
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o
.
i
n
t
/
p
u
b
l
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c
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t
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n
s/
i
/
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t
e
m
/
9
7
8
9
2
4
0
0
8
1
0
6
2
.
[
4
]
N
.
A
.
El
S
a
y
e
d
e
t
a
l
.
,
“
5
.
F
a
c
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l
i
t
a
t
i
n
g
p
o
s
i
t
i
v
e
h
e
a
l
t
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b
e
h
a
v
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o
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s
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n
d
w
e
l
l
-
b
e
i
n
g
t
o
i
m
p
r
o
v
e
h
e
a
l
t
h
o
u
t
c
o
m
e
s:
s
t
a
n
d
a
r
d
s
o
f
c
a
r
e
i
n
d
i
a
b
e
t
e
s
—
2
0
2
4
,
”
D
i
a
b
e
t
e
s C
a
r
e
,
v
o
l
.
4
7
,
n
o
.
S
u
p
p
l
e
me
n
t
_
1
,
p
p
.
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7
7
–
S
1
1
0
,
Jan
.
2
0
2
4
,
d
o
i
:
1
0
.
2
3
3
7
/
d
c
2
4
-
S
0
0
5
.
[
5
]
J.
B
.
R
o
t
t
e
r
,
“
G
e
n
e
r
a
l
i
z
e
d
e
x
p
e
c
t
a
n
c
i
e
s
f
o
r
i
n
t
e
r
n
a
l
v
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r
s
u
s
e
x
t
e
r
n
a
l
c
o
n
t
r
o
l
o
f
r
e
i
n
f
o
r
c
e
m
e
n
t
,
”
Psy
c
h
o
l
o
g
i
c
a
l
Mo
n
o
g
r
a
p
h
s:
G
e
n
e
r
a
l
a
n
d
A
p
p
l
i
e
d
,
v
o
l
.
8
0
,
n
o
.
1
,
p
p
.
1
–
2
8
,
1
9
6
6
,
d
o
i
:
1
0
.
1
0
3
7
/
h
0
0
9
2
9
7
6
.
[
6
]
K
.
A
.
W
a
l
l
st
o
n
,
B
.
S
t
r
u
d
l
e
r
W
a
l
l
s
t
o
n
,
a
n
d
R
.
D
e
V
e
l
l
i
s,
“
D
e
v
e
l
o
p
me
n
t
o
f
t
h
e
m
u
l
t
i
d
i
m
e
n
si
o
n
a
l
h
e
a
l
t
h
l
o
c
u
s
o
f
c
o
n
t
r
o
l
(
M
H
LC
)
sca
l
e
s,
”
H
e
a
l
t
h
E
d
u
c
a
t
i
o
n
Mo
n
o
g
r
a
p
h
s
,
v
o
l
.
6
,
n
o
.
1
,
p
p
.
1
6
0
–
1
7
0
,
M
a
r
.
1
9
7
8
,
d
o
i
:
1
0
.
1
1
7
7
/
1
0
9
0
1
9
8
1
7
8
0
0
6
0
0
1
0
7
.
[
7
]
H
.
Le
v
e
n
so
n
,
“
D
i
f
f
e
r
e
n
t
i
a
t
i
n
g
a
m
o
n
g
i
n
t
e
r
n
a
l
i
t
y
,
p
o
w
e
r
f
u
l
o
t
h
e
r
s,
a
n
d
c
h
a
n
c
e
,
”
i
n
R
e
se
a
rc
h
w
i
t
h
t
h
e
l
o
c
u
s
o
f
c
o
n
t
ro
l
c
o
n
st
r
u
c
t
,
H
.
M
.
Le
f
c
o
u
r
t
,
Ed
.
,
A
c
a
d
e
m
i
c
P
r
e
ss,
1
9
8
1
,
c
h
.
2
,
p
p
.
1
5
–
6
3
.
[
8
]
K
.
A
.
W
a
l
l
st
o
n
,
“
T
h
e
v
a
l
i
d
i
t
y
o
f
t
h
e
mu
l
t
i
d
i
me
n
si
o
n
a
l
h
e
a
l
t
h
l
o
c
u
s
o
f
c
o
n
t
r
o
l
sca
l
e
s
,
”
J
o
u
r
n
a
l
o
f
H
e
a
l
t
h
Psy
c
h
o
l
o
g
y
,
v
o
l
.
1
0
,
n
o
.
5
,
p
p
.
6
2
3
–
6
3
1
,
S
e
p
.
2
0
0
5
,
d
o
i
:
1
0
.
1
1
7
7
/
1
3
5
9
1
0
5
3
0
5
0
5
5
3
0
4
.
[
9
]
C
.
C
h
e
n
g
,
M
.
W
.
-
L.
C
h
e
u
n
g
,
a
n
d
B
.
C
.
Y
.
Lo
,
“
R
e
l
a
t
i
o
n
s
h
i
p
o
f
h
e
a
l
t
h
l
o
c
u
s
o
f
c
o
n
t
r
o
l
w
i
t
h
sp
e
c
i
f
i
c
h
e
a
l
t
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b
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h
a
v
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r
s
a
n
d
g
l
o
b
a
l
h
e
a
l
t
h
a
p
p
r
a
i
sal
:
a
met
a
-
a
n
a
l
y
s
i
s
a
n
d
e
f
f
e
c
t
s
o
f
m
o
d
e
r
a
t
o
r
s,
”
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e
a
l
t
h
P
syc
h
o
l
o
g
y
R
e
v
i
e
w
,
v
o
l
.
1
0
,
n
o
.
4
,
p
p
.
4
6
0
–
4
7
7
,
O
c
t
.
2
0
1
6
,
d
o
i
:
1
0
.
1
0
8
0
/
1
7
4
3
7
1
9
9
.
2
0
1
6
.
1
2
1
9
6
7
2
.
[
1
0
]
L.
M
.
W
e
st
,
R
.
B
o
r
g
Th
e
u
ma,
a
n
d
M
.
C
o
r
d
i
n
a
,
“
H
e
a
l
t
h
l
o
c
u
s
o
f
c
o
n
t
r
o
l
:
I
t
s
r
e
l
a
t
i
o
n
sh
i
p
w
i
t
h
m
e
d
i
c
a
t
i
o
n
a
d
h
e
r
e
n
c
e
a
n
d
med
i
c
a
t
i
o
n
w
a
s
t
a
g
e
,
”
Re
se
a
r
c
h
i
n
S
o
c
i
a
l
a
n
d
A
d
m
i
n
i
s
t
ra
t
i
v
e
Ph
a
rm
a
c
y
,
v
o
l
.
1
4
,
n
o
.
1
1
,
p
p
.
1
0
1
5
–
1
0
1
9
,
N
o
v
.
2
0
1
8
,
d
o
i
:
1
0
.
1
0
1
6
/
j
.
sa
p
h
a
r
m.
2
0
1
7
.
1
2
.
0
0
3
.
[
1
1
]
R
.
W
a
n
g
e
t
a
l
.
,
“
P
a
t
i
e
n
t
e
m
p
o
w
e
r
m
e
n
t
a
n
d
se
l
f
‐
man
a
g
e
me
n
t
b
e
h
a
v
i
o
u
r
o
f
c
h
r
o
n
i
c
d
i
sea
s
e
p
a
t
i
e
n
t
s
:
A
m
o
d
e
r
a
t
e
d
med
i
a
t
i
o
n
m
o
d
e
l
o
f
s
e
l
f
‐
e
f
f
i
c
a
c
y
a
n
d
h
e
a
l
t
h
l
o
c
u
s
o
f
c
o
n
t
r
o
l
,
”
J
o
u
r
n
a
l
o
f
Ad
v
a
n
c
e
d
N
u
rs
i
n
g
,
v
o
l
.
7
8
,
n
o
.
4
,
p
p
.
1
0
5
5
–
1
0
6
5
,
A
p
r
.
2
0
2
2
,
d
o
i
:
1
0
.
1
1
1
1
/
j
a
n
.
1
5
0
7
7
.
[
1
2
]
H
.
R
.
M
a
r
k
u
s
a
n
d
S
.
K
i
t
a
y
a
ma
,
“
C
u
l
t
u
r
e
a
n
d
t
h
e
s
e
l
f
:
I
mp
l
i
c
a
t
i
o
n
s
f
o
r
c
o
g
n
i
t
i
o
n
,
e
mo
t
i
o
n
,
a
n
d
m
o
t
i
v
a
t
i
o
n
,
”
Psy
c
h
o
l
o
g
i
c
a
l
Re
v
i
e
w
,
v
o
l
.
9
8
,
n
o
.
2
,
p
p
.
2
2
4
–
2
5
3
,
A
p
r
.
1
9
9
1
,
d
o
i
:
1
0
.
1
0
3
7
/
0
0
3
3
-
2
9
5
X
.
9
8
.
2
.
2
2
4
.
[
1
3
]
H
.
C
.
Tr
i
a
n
d
i
s,
I
n
d
i
v
i
d
u
a
l
i
sm
a
n
d
c
o
l
l
e
c
t
i
v
i
sm
.
N
e
w
Y
o
r
k
:
R
o
u
t
l
e
d
g
e
,
1
9
9
5
.
d
o
i
:
1
0
.
4
3
2
4
/
9
7
8
0
4
2
9
4
9
9
8
4
5
.
[
1
4
]
G
.
H
o
f
st
e
d
e
,
“
D
i
m
e
n
si
o
n
a
l
i
z
i
n
g
c
u
l
t
u
r
e
s:
T
h
e
H
o
f
st
e
d
e
m
o
d
e
l
i
n
c
o
n
t
e
x
t
,
”
O
n
l
i
n
e
Re
a
d
i
n
g
s
i
n
Psy
c
h
o
l
o
g
y
a
n
d
C
u
l
t
u
re
,
v
o
l
.
2
,
n
o
.
1
,
D
e
c
.
2
0
1
1
,
d
o
i
:
1
0
.
9
7
0
7
/
2
3
0
7
-
0
9
1
9
.
1
0
1
4
.
[
1
5
]
H
.
S
.
K
i
m,
D
.
K
.
S
h
e
r
ma
n
,
a
n
d
S
.
E.
Ta
y
l
o
r
,
“
C
u
l
t
u
r
e
a
n
d
s
o
c
i
a
l
s
u
p
p
o
r
t
,
”
Am
e
ri
c
a
n
Psy
c
h
o
l
o
g
i
s
t
,
v
o
l
.
6
3
,
n
o
.
6
,
p
p
.
5
1
8
–
5
2
6
,
2
0
0
8
,
d
o
i
:
1
0
.
1
0
3
7
/
0
0
0
3
-
0
6
6
X
.
[
1
6
]
C
.
C
h
e
n
g
,
S
.
F
.
C
h
e
u
n
g
,
J
.
H
.
C
h
i
o
,
a
n
d
M
.
-
P
.
S
.
C
h
a
n
,
“
C
u
l
t
u
r
a
l
mea
n
i
n
g
o
f
p
e
r
c
e
i
v
e
d
c
o
n
t
r
o
l
:
A
me
t
a
-
a
n
a
l
y
s
i
s
o
f
l
o
c
u
s
o
f
c
o
n
t
r
o
l
a
n
d
p
s
y
c
h
o
l
o
g
i
c
a
l
sy
m
p
t
o
ms
a
c
r
o
ss
1
8
c
u
l
t
u
r
a
l
r
e
g
i
o
n
s,”
Ps
y
c
h
o
l
o
g
i
c
a
l
Bu
l
l
e
t
i
n
,
v
o
l
.
1
3
9
,
n
o
.
1
,
p
p
.
1
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c
o
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tac
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a
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:
y
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n
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p
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it
a
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u
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p
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a
c
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id
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a
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tr
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h
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p
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rtme
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t
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a
c
u
l
ty
o
f
P
sy
c
h
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n
d
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a
lt
h
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iv
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a
d
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g
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st
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u
m
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tra,
In
d
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.
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p
ro
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n
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s
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se
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e
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lt
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se
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d
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sy
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l
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l
se
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e
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rly
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re
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r
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li
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g
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n
d
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m
m
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n
it
y
m
e
n
tal
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e
a
lt
h
su
p
p
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rt.
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c
o
n
tri
b
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ted
t
o
th
e
p
re
se
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stu
d
y
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c
c
o
rd
i
n
g
t
o
th
e
ro
les
in
d
ica
ted
in
t
h
e
a
u
th
o
r
c
o
n
tri
b
u
ti
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tem
e
n
t.
He
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
a
lfi
a
n
.
y
a
n
d
a
@g
m
a
il
.
c
o
m
.
Pu
p
u
t
No
fi
a
R
a
h
m
a
is
a
ffil
iate
d
wit
h
th
e
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p
a
rtme
n
t
o
f
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sy
c
h
o
l
o
g
y
,
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a
c
u
lt
y
o
f
P
sy
c
h
o
l
o
g
y
a
n
d
He
a
lt
h
,
Un
iv
e
rs
it
a
s
Ne
g
e
ri
P
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d
a
n
g
,
P
a
d
a
n
g
,
We
st
S
u
m
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tra,
In
d
o
n
e
sia
.
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r
a
c
a
d
e
m
ic
b
a
c
k
g
ro
u
n
d
is
in
p
s
y
c
h
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l
o
g
y
with
a
fo
c
u
s
o
n
a
p
p
li
e
d
a
n
d
c
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m
m
u
n
it
y
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b
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se
d
p
sy
c
h
o
lo
g
ica
l
p
ra
c
ti
c
e
.
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r
p
r
o
f
e
ss
io
n
a
l
i
n
tere
sts
in
c
l
u
d
e
p
sy
c
h
o
lo
g
ica
l
se
rv
ice
s,
c
o
u
n
se
li
n
g
p
ra
c
ti
c
e
,
wo
rk
f
o
rc
e
a
d
ju
stm
e
n
t
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a
n
d
c
o
m
m
u
n
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y
m
e
n
tal
h
e
a
lt
h
.
S
h
e
c
o
n
tri
b
u
te
d
t
o
t
h
e
p
re
se
n
t
stu
d
y
a
c
c
o
rd
i
n
g
to
th
e
r
o
les
in
d
ica
ted
in
th
e
a
u
th
o
r
c
o
n
tri
b
u
ti
o
n
sta
tem
e
n
t.
S
h
e
c
a
n
b
e
c
o
n
tac
ted
a
t
e
m
a
il
:
p
u
p
u
tn
o
fiara
h
m
a
@g
m
a
il
.
c
o
m
.
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