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n
t
s
[
4]
.
Alm
o
s
t
a
ll
c
hil
dr
e
n
s
pe
n
d
t
h
e
f
i
r
s
t
t
wo
de
c
a
de
s
o
f
t
h
e
i
r
li
f
e
i
n
s
c
h
o
o
l
,
m
a
k
i
ng
t
h
e
s
c
h
o
o
l
s
e
t
t
i
n
g
a
n
im
po
r
t
a
n
t
h
e
a
l
t
h
de
t
e
r
m
i
na
n
t
[
5]
.
T
h
e
s
c
h
o
o
l
i
s
a
n
im
po
r
t
a
n
t
a
s
pe
c
t
o
f
th
e
s
o
c
i
a
l
e
nvi
r
o
nm
e
n
t
a
n
d
a
l
s
o
pr
e
s
e
n
t
i
m
po
r
t
a
n
t
a
v
e
n
ue
s
w
i
t
hi
n
w
hi
c
h
c
hi
l
dr
e
n
pr
a
c
t
i
c
e
a
n
d
a
do
pt
h
e
a
l
t
hy
h
a
bi
t
s
[
6]
.
T
h
e
s
c
h
o
o
l
s
e
t
t
i
n
g
c
a
n
e
i
t
h
e
r
r
e
i
nf
o
r
c
e
o
r
hi
n
de
r
h
e
a
l
t
h
m
e
s
s
a
ge
s
d
e
l
i
ve
r
e
d
t
h
r
o
ugh
h
e
a
l
t
h
e
duc
a
t
i
o
n
c
ur
r
i
c
u
l
a
r
[
7]
.
C
hi
l
dr
e
n
’
s
r
e
c
e
pt
i
o
n
o
f
n
ut
r
i
t
i
o
n
e
d
uc
a
t
i
o
n
i
s
l
a
r
ge
ly
de
pe
n
d
e
d
o
n
t
h
e
c
o
n
t
e
x
t
s
i
n
w
hi
c
h
t
h
e
y
l
e
a
r
n
a
b
o
ut
n
ut
r
i
t
i
o
n
a
n
d
he
a
l
t
hy
e
a
t
i
n
g
[
8]
.
P
hy
s
i
c
a
l
a
c
t
i
vi
t
y
a
n
d
T
VV
a
r
e
im
po
r
t
a
n
t
de
t
e
r
m
in
a
n
t
s
o
f
o
v
e
r
we
i
g
h
t
a
n
d
o
b
e
s
i
t
y
i
n
c
hil
dr
e
n
[
9
]
,
[
10]
.
L
e
s
s
p
hy
s
i
c
a
l
ly
a
c
t
i
v
e
c
hil
dr
e
n
a
r
e
m
o
r
e
l
i
ke
ly
t
o
b
e
o
v
e
r
we
i
g
h
t
or
o
b
e
s
e
c
o
m
pa
r
e
d
t
o
t
h
e
i
r
p
hy
s
i
c
a
ll
y
a
c
t
i
v
e
c
o
un
t
e
r
pa
r
t
s
.
A
c
c
o
r
d
i
n
g
t
o
E
b
b
e
li
ng,
P
a
w
l
a
k,
&
L
udw
i
g
[
11]
a
li
f
e
s
t
y
l
e
c
h
a
r
a
c
t
e
r
i
z
e
d
by
l
a
c
k
o
f
phy
s
i
c
a
l
a
c
t
i
vi
t
y
a
n
d
e
x
c
e
s
s
i
ve
i
na
c
t
i
vi
t
y
(
pa
r
t
i
c
u
l
a
r
ly
t
e
l
e
vi
s
i
o
n
vi
e
w
i
ng)
mi
g
h
t
c
a
us
e
o
b
e
s
i
t
y
i
n
c
hil
dr
e
n
.
Am
o
n
g
c
hil
dr
e
n
f
r
o
m
M
e
xi
c
o
C
i
t
y
,
o
b
e
s
i
t
y
r
i
s
k
de
c
r
e
a
s
e
d
by
10%
f
o
r
e
a
c
h
h
o
ur
pe
r
da
y
o
f
m
o
de
r
a
t
e
-
to
-
vi
go
r
o
us
phy
s
i
c
a
l
a
c
t
i
vi
t
y
,
a
n
d
i
nc
r
e
a
s
e
d
by
12%
f
o
r
e
a
c
h
h
o
ur
pe
r
da
y
o
f
t
e
l
e
vi
s
i
o
n
vi
e
w
i
n
g
[
12]
.
T
o
t
h
e
b
e
s
t
o
f
o
ur
kn
o
w
l
e
dge
n
o
s
t
ud
y
h
a
s
i
n
v
e
s
t
i
g
a
t
e
d
t
h
e
to
ge
t
h
e
r
t
h
e
h
o
m
e
a
n
d
s
c
h
o
o
l
e
nvi
r
o
nm
e
n
t
s
,
phy
s
i
c
a
l
a
c
t
i
vi
t
y
l
e
v
e
l
s
,
t
e
l
e
vi
s
i
o
n
vi
e
w
i
ng
a
n
d
t
he
i
r
e
f
f
e
c
t
o
n
t
h
e
a
d
i
po
s
i
t
y
i
nd
i
c
e
s
o
f
s
c
h
o
o
l
a
ge
c
hil
dr
e
n
.
W
e
t
h
u
s
e
v
a
l
ua
t
e
d
t
h
e
h
o
m
e
a
n
d
s
c
h
o
o
l
e
nvi
r
o
nm
e
n
t
s
,
phy
s
i
c
a
l
a
c
t
i
vi
t
y
l
e
v
e
l
s
,
T
VV
a
n
d
t
h
e
i
r
a
s
s
o
c
i
a
t
i
o
n
s
w
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t
h
t
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e
a
d
i
po
s
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t
y
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nd
i
c
e
s
o
f
s
c
h
o
o
l
-
a
ge
c
hil
dr
e
n
i
n
t
h
e
T
a
m
a
l
e
M
e
t
r
o
p
o
l
i
s
.
2.
RE
S
E
AR
CH
M
E
T
HO
D
2.
1.
S
t
u
d
y
d
e
s
ign
,
s
t
u
d
y
s
e
t
t
in
g
an
d
s
t
u
d
y
p
op
u
l
at
io
n
T
hi
s
C
r
o
s
s
-
s
e
c
t
i
o
na
l
s
t
ud
y
wa
s
c
o
n
duc
t
e
d
i
n
pr
i
m
a
r
y
s
c
h
o
o
l
s
l
o
c
a
t
e
d
i
n
t
he
T
a
m
a
l
e
M
e
t
r
o
p
o
l
i
s
o
f
Gh
a
n
a
.
T
a
m
a
l
e
i
s
t
h
e
c
a
p
i
t
a
l
c
i
t
y
o
f
t
h
e
No
r
t
h
e
r
n
R
e
g
i
o
n
o
f
G
h
a
n
a
.
L
yi
ng
b
e
t
we
e
n
9
°
22
'
N
a
n
d
lo
n
g
i
t
ude
0°
50
'W
a
n
d
c
o
v
e
r
i
ng
a
n
a
r
e
a
o
f
a
b
o
ut
922
km
2,
T
a
m
a
l
e
i
s
a
b
o
ut
600
km
n
o
r
t
h
o
f
A
c
c
r
a
,
Gh
a
n
a
’
s
c
a
p
i
t
a
l
c
i
t
y
.
P
a
r
t
i
c
i
pa
n
t
s
o
f
t
hi
s
s
t
ud
y
i
nc
l
ude
d
s
c
h
o
o
l
-
a
ge
d
c
hil
dr
e
n
r
e
c
r
u
i
t
e
d
f
r
o
m
10
pr
i
v
a
t
e
a
n
d
pu
bli
c
s
c
h
o
o
l
s
i
n
T
a
m
a
l
e
.
2.
2.
S
am
p
l
e
s
i
z
e
A
s
a
m
p
l
e
s
i
z
e
o
f
316
c
hil
dr
e
n
-
pa
r
e
n
t
s
pa
i
r
s
wa
s
r
e
c
r
u
i
t
e
d
f
o
r
t
h
e
s
t
ud
y
.
T
hi
s
n
u
m
be
r
wa
s
a
r
r
i
v
e
d
a
t
b
a
s
e
d
o
n
t
h
e
f
o
l
l
o
w
i
n
g
f
o
r
m
u
l
a
a
d
a
pt
e
d
f
r
o
m
t
h
e
W
HO
S
T
E
P
wi
s
e
a
ppr
o
a
c
h
f
o
r
c
h
r
o
ni
c
d
i
s
e
a
s
e
r
i
s
k
f
a
c
t
o
r
s
ur
v
e
il
l
a
n
c
e
(
S
T
E
P
S
)
(
W
o
r
l
d
H
e
a
l
t
h
Or
ga
ni
z
a
t
i
o
n
,
2008)
:
n=
Z
2
(
P
(
1
-
P
)
)
/e2,
wh
e
r
e
Z
=
l
e
v
e
l
o
f
c
o
nf
i
de
n
c
e
(
1.
96
v
a
l
u
e
f
o
r
95%
c
o
nf
i
de
n
c
e
i
n
t
e
r
v
a
l
)
,
P
=
ba
s
e
li
ne
l
e
v
e
l
o
f
t
h
e
i
nd
i
c
a
t
o
r
s
(
f
r
o
m
pr
e
vi
o
u
s
s
t
ud
i
e
s
b
a
s
e
li
ne
pr
e
v
a
l
e
n
c
e
o
f
c
hil
d
h
o
o
d
o
b
e
s
i
t
y
=
10%
)
,
e
=
m
a
r
g
i
n
o
f
e
r
r
o
r
(
f
o
r
t
h
i
s
0.
05
w
il
l
be
u
s
e
d
be
c
a
us
e
t
h
e
b
a
s
e
li
ne
l
e
v
e
l
o
f
t
h
e
i
n
d
i
c
a
t
o
r
s
i
s
n
o
t
<
0
.
10)
.
T
h
us
n
=
1
.
9620.
10(
1
-
0.
10
)
/0.
052=
200.
T
o
c
a
t
e
r
f
o
r
de
s
i
g
n
e
f
f
e
c
t
,
200
wa
s
m
u
l
t
i
p
li
e
d
by
1.
5
=
300.
A
de
s
i
g
n
e
f
f
e
c
t
o
f
1.
5
i
s
r
e
c
o
m
m
e
n
de
d
f
o
r
m
o
s
t
s
ur
v
e
y
s
u
s
i
ng
c
o
m
p
l
e
x
de
s
i
g
n
s
o
t
h
e
r
t
h
a
n
s
im
p
l
e
r
a
n
do
m
s
a
m
p
l
i
ng
(
W
o
r
l
d
He
a
l
t
h
Or
ga
ni
z
a
t
i
o
n
,
2008)
.
T
a
ki
n
g
c
o
gni
z
a
n
c
e
o
f
a
n
o
n
-
r
e
s
po
n
s
e
o
f
5%
f
r
o
m
pr
e
vi
o
us
s
t
ud
i
e
s
,
t
h
e
f
in
a
l
s
a
m
p
l
e
s
i
z
e
wa
s
300/0.
95=
316.
P
r
o
p
or
t
i
o
n
a
l
a
ll
o
c
a
t
i
o
n
wa
s
us
e
d
t
o
de
t
e
r
m
i
ne
t
h
e
s
a
m
p
l
e
s
i
z
e
f
o
r
e
a
c
h
o
f
t
h
e
s
c
h
o
o
l
s
.
T
h
u
s
s
c
h
o
o
l
s
w
i
t
h
l
a
r
ge
r
pup
i
l
s
h
a
d
t
he
l
a
r
ge
s
t
s
a
m
p
l
e
s
i
z
e
.
2.
3.
I
n
c
l
u
s
ion
c
r
it
e
r
ia
All
c
hil
dr
e
n
a
ge
d
6
-
12
y
e
a
r
s
a
n
d
we
r
e
i
n
a
ny
o
f
t
h
e
c
l
a
s
s
e
s
(
i
.
e
.
pr
i
m
a
r
y
1
t
o
6)
we
r
e
e
l
i
g
i
bl
e
t
o
pa
r
t
i
c
i
pa
t
e
.
2.
4.
E
xc
l
u
s
i
on
c
r
it
e
r
ia
T
h
o
s
e
y
o
un
ge
r
t
h
a
n
6
y
e
a
r
s
a
n
d
we
r
e
n
o
t
i
n
pr
i
m
a
r
y
s
c
h
o
o
l
we
r
e
n
o
t
e
l
i
g
i
bl
e
t
o
pa
r
t
i
c
i
pa
t
e
.
2.
5.
S
am
p
l
in
g
t
e
c
h
n
iq
u
e
an
d
p
ar
t
icip
an
t
r
e
c
r
u
it
m
e
n
t
F
r
o
m
a
li
s
t
o
f
s
c
h
o
o
l
s
w
i
t
hi
n
T
a
m
a
l
e
,
7
pu
bli
c
a
nd
3
pr
i
v
a
t
e
s
c
h
o
o
l
s
w
e
r
e
s
e
l
e
c
t
e
d
us
i
ng
s
y
s
t
e
m
a
t
i
c
r
a
n
do
m
s
a
m
p
li
ng
t
e
c
hni
qu
e
s
i
n
w
hi
c
h
e
v
e
r
y
11t
h
s
c
h
o
o
l
wa
s
s
e
l
e
c
t
e
d.
L
e
t
t
e
r
s
o
f
pe
r
m
i
s
s
i
o
n
we
r
e
w
r
i
tt
e
n
to
t
h
e
h
e
a
d
s
o
f
t
h
e
s
e
l
e
c
t
e
d
s
c
h
o
o
l
s
to
o
b
t
a
i
n
a
c
c
e
s
s
t
o
t
h
e
s
c
h
o
o
l
.
P
upi
l
s
f
r
o
m
a
l
l
t
h
e
c
l
a
s
s
e
s
(
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o
f
t
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r
e
I
B
M
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P
S
S
ve
r
s
i
o
n
20.
0.
Da
t
a
a
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ly
s
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we
r
e
do
n
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us
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I
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l
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a
p
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r
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0
wa
s
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d
to
dr
a
w
gr
a
ph
s
.
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s
c
r
i
pt
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t
a
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s
s
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a
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m
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da
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d
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a
t
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o
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we
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s
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d
t
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s
c
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t
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us
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s
.
As
s
o
c
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t
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ns
a
m
o
n
g
c
o
n
t
i
n
uo
us
va
r
i
a
bl
e
s
we
r
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d
e
t
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r
m
i
ne
d
us
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P
e
a
r
s
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n
c
o
r
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l
a
t
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ly
s
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.
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l
t
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a
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ne
a
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d
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d
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n
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f
a
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t
o
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c
i
a
t
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d
w
i
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h
t
h
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f
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ve
a
d
i
po
s
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y
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d
%
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.
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b
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f
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pe
n
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v
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ll
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t
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ly
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s
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f
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n
t
.
3.
RE
S
UL
T
S
3.
1.
Gene
r
a
l
c
h
ar
ac
t
e
r
i
s
t
ics
of
t
h
e
s
c
h
ool
-
age
c
h
il
d
r
e
n
T
h
r
e
e
h
u
n
dr
e
d
a
n
d
s
i
x
t
e
e
n
(
316)
c
hi
l
dr
e
n
c
o
m
p
l
e
t
e
d
t
h
e
c
hil
d
que
s
t
i
o
nna
i
r
e
f
r
o
m
w
hi
c
h
299
we
r
e
c
o
m
p
l
e
t
e
f
o
r
a
n
a
ly
s
i
s
(
R
e
s
po
n
s
e
r
a
t
e
=
95%
)
.
T
wo
h
u
n
dr
e
d
a
n
d
s
i
x
t
y
f
o
ur
pa
r
e
n
t
s
/ca
r
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g
i
v
e
r
s
c
o
m
p
let
e
d
t
h
e
f
a
mi
ly
a
n
d
h
o
m
e
e
nvi
r
o
nm
e
n
t
que
s
t
i
o
nn
a
i
r
e
w
it
h
R
e
s
po
n
s
e
r
a
t
e
o
f
84%
.
T
a
bl
e
1
pr
e
s
e
n
t
s
t
h
e
ge
n
e
r
a
l
c
h
a
r
a
c
t
e
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s
t
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c
s
o
f
t
h
e
s
c
h
o
o
l
-
a
ge
d
c
hi
l
dr
e
n
a
s
we
l
l
a
s
t
h
e
pa
r
e
n
t
s
/ca
r
e
g
i
ve
r
s
.
T
h
e
c
hil
dr
e
n
we
r
e
pr
e
domi
na
n
t
ly
f
e
m
a
l
e
a
n
d
m
o
r
e
t
h
a
n
60%
o
f
t
h
e
m
ha
d
b
o
t
h
pa
r
e
n
t
s
a
t
t
a
i
ni
ng
S
HS/
T
e
r
t
i
a
r
y
l
e
v
e
l
o
f
e
duc
a
t
i
o
n
.
W
i
t
h
a
m
e
a
n
(
S
D)
a
ge
o
f
9.
30
y
e
a
r
s
(
S
D
2.
14
y
e
a
r
s
)
,
61.
0%
o
f
t
h
e
c
hil
dr
e
n
we
r
e
a
ge
d
9
-
12
y
e
a
r
s
o
f
a
g
e
.
M
e
a
n
nu
m
b
e
r
o
f
c
hil
dr
e
n
a
n
d
a
du
l
t
s
l
i
v
i
ng
w
i
t
h
a
s
c
h
o
o
l
-
a
ge
d
c
hil
d
we
r
e
4.
71
(
S
D
3.
98
)
a
n
d
4.
92
(
S
D
3
.
62)
r
e
s
pe
c
t
i
ve
l
y
.
T
a
bl
e
1.
Ge
n
e
r
a
l
c
h
a
r
a
c
t
e
r
i
s
t
i
c
s
o
f
t
h
e
c
hil
dr
e
n
V
a
r
ia
bl
e
F
r
e
qu
e
n
c
y
(
%
)
G
e
nde
r
F
e
ma
l
e
165 (
55.0%
)
M
e
a
n (
S
D
)
A
ge
9.30 (
2.14)
y
e
a
r
s
A
ge
c
a
t
e
g
o
r
i
e
s
6y
-
8y
117(
39.0%
)
9y
-
12
y
183(
61.0%
)
M
e
a
n (
S
D
)
numb
e
r
of
c
hi
ld
r
e
n
li
v
in
g w
it
h
c
hi
ld
4.71(
3.98)
M
e
a
n (
S
D
)
numb
e
r
of
a
dul
ts
l
i
v
in
g w
it
h
c
hi
ld
4.92(
3.62)
*
C
la
s
s
of
c
hi
ld
(
n=
286)
L
o
w
e
r
p
r
im
a
r
y
(
G
r
a
de
1
-
3)
143(
50%
)
U
ppe
r
pr
i
ma
r
y
(
G
r
a
d
e
4
-
6)
143(
50%
*
M
o
th
e
r
'
s
l
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ve
l
of
e
du
c
a
ti
o
n (
n=
293)
N
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f
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ma
l
e
du
c
a
ti
o
n
43(
14.7%
)
P
r
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a
r
y
/J
H
S
58(
19.8%
)
S
H
S
/
T
e
r
ti
a
r
y
192(
65.5%
)
*
F
a
th
e
r
'
s
l
e
ve
l
of
e
du
c
a
ti
o
n
N
o
f
or
ma
l
e
du
c
a
ti
o
n
34(
11.6%
)
P
r
im
a
r
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H
S
56(
19.1%
)
S
H
S
/
T
e
r
ti
a
r
y
203(
69.3%
)
*
F
r
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qu
e
n
c
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s
do
n
o
t
a
dd up t
o
299 du
e
t
o
mi
s
s
in
g r
e
s
po
ns
e
s
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86
3.
2
.
C
h
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d
r
e
n
’
s
h
om
e
e
n
vi
r
on
m
e
n
t
s
P
a
r
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n
t
s
o
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c
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ly
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n
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s
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a
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d
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d
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a
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h
o
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dr
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d
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c
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t
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t
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s
a
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d
58.
9%
h
a
d
a
ga
r
de
n
o
r
o
u
t
d
oor
s
pa
c
e
f
o
r
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d
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.
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o
ut
50%
o
f
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pa
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n
t
s
s
a
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t
h
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r
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dr
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s
a
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y
h
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d
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r
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o
r
o
u
t
d
oo
r
s
pa
c
e
f
o
r
c
hil
d
to
pl
a
y
a
n
d
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nly
16%
s
a
i
d
t
h
e
y
h
a
d
a
us
a
bl
e
p
l
a
y
e
qu
i
p
m
e
n
t
f
o
r
t
h
e
c
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d
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o
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a
y
w
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h
a
t
h
o
m
e
.
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e
a
n
(
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s
i
c
a
l
a
c
t
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vi
t
y
m
o
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ll
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ng
c
o
m
po
s
i
t
e
s
c
o
r
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o
f
2.
91(
0.
84
)
wa
s
r
e
c
o
r
de
d
o
u
t
o
f
a
s
c
o
r
e
m
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xi
m
u
m
s
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o
r
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o
f
5.
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e
a
n
(
S
D)
n
e
i
g
hb
o
ur
h
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d
s
a
f
e
t
y
s
c
o
r
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o
f
3.
92(
0.
98
)
wa
s
r
e
c
o
r
de
d
.
T
a
bl
e
2.
A
s
s
e
s
s
m
e
n
t
o
f
t
h
e
phy
s
i
c
a
l
a
c
t
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vi
t
y
e
nvi
r
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nm
e
n
t
o
f
t
h
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c
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d
’
s
h
o
m
e
V
a
r
ia
bl
e
F
r
e
qu
e
n
c
y
(
%
)
P
r
e
s
e
nc
e
of
pa
r
ks
o
r
o
u
td
oo
r
r
e
c
r
e
a
ti
o
n
c
e
nt
e
r
s
w
it
hi
n w
a
lk
in
g
di
s
ta
nc
e
o
r
s
h
o
r
t
d
r
i
ve
f
r
o
m h
o
m
e
(
n=
261)
Y
e
s
118(
45.2%
)
No
124(
46.7%
)
D
o
n'
t
kn
o
w
19(
7.3%
)
A
v
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il
a
bi
li
t
y
of
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d
oo
r
r
e
c
r
e
a
ti
o
n
c
e
nt
e
r
s
(
e
.g. g
y
m, i
nd
oor
s
of
t
pl
a
y
)
th
a
t
a
r
e
w
it
hi
n a
w
a
lk
in
g
di
s
ta
nc
e
o
r
s
h
o
r
t
dr
i
ve
(
n=
259)
Y
e
s
68 (
26.3%
)
No
164(
63.3%
)
D
o
n'
t
kn
o
w
27(
10.4%
)
H
a
s
a
ga
r
de
n
o
r
o
ut
d
oor
s
pa
c
e
f
or
c
hi
ld
t
o
pl
a
y
(
n=
263)
Y
e
s
155(
58.9%
)
No
108(
41.1%
)
H
a
s
us
a
bl
e
pl
a
y
e
qui
pm
e
nt
(
e
.g. s
w
in
gs
, s
li
de
s
, c
li
mbi
ng
f
r
a
m
e
s
, t
r
a
mpo
li
n
e
s
)
in
y
our
ga
r
d
e
n (
n=
262)
Y
e
s
41(
15.6%
)
No
221(
84.4%
)
C
hi
ld
ha
s
us
a
bl
e
bi
c
y
c
l
e
, t
r
i
c
y
c
l
e
, s
c
oo
t
e
r
or
w
he
e
l
e
d t
oy
(
n=
24
8)
Y
e
s
123(
49.6%
)
No
125(
50.4%
)
P
a
r
e
nt
a
l
m
o
d
e
li
ng
of
a
c
ti
v
it
y
I
te
m
M
e
a
n (
S
D
)
E
nc
o
u
r
a
ge
s
c
hi
ld
t
o
d
o
ph
y
s
i
c
a
l
a
c
ti
v
it
y
(
n=
263)
2.94
(
1.22)
F
r
e
qu
e
nt
l
y
pl
a
y
s
ph
y
s
i
c
a
l
a
c
ti
v
it
y
o
r
pl
a
y
s
p
o
r
ts
w
it
h
c
hi
ld
(
n=
264)
2.67
(
1.22)
F
r
e
qu
e
nt
l
y
t
r
a
ns
po
r
t
c
hi
ld
t
o
pl
a
c
e
f
or
c
hi
ld
t
o
d
o
ph
y
s
i
c
a
l
a
c
ti
vi
t
y
(
n=
263)
2.49
(
1.27)
P
a
r
ti
c
ip
a
t
e
s
i
n ph
y
s
i
c
a
l
a
c
ti
v
it
y
w
it
h
c
hi
ld
(
n=
257)
2.90
(
1.24)
T
e
ll
s
c
hi
ld
a
b
o
ut
t
h
e
be
n
e
f
it
s
of
be
in
g ph
y
s
i
c
a
l
f
it
(
n=
254)
3.40
(
1.28)
B
e
in
g ph
y
s
i
c
a
ll
y
a
c
ti
v
e
in
f
r
o
nt
of
c
h
il
d (
n=
252)
3.12
(
1.30)
P
a
r
e
nt
a
l
m
o
d
e
li
ng
of
a
c
ti
v
it
y
t
o
ta
l
s
c
o
r
e
(
n=
264)
2.91
(
0.84)
P
a
r
e
nt
s
/
c
a
r
e
g
i
v
e
r
s
’
pe
r
c
e
pt
i
o
n
of
t
h
e
h
o
us
e
a
nd ne
ig
hb
o
u
r
h
oo
d
s
a
f
e
t
y
f
o
r
t
h
e
p
e
r
f
or
ma
nc
e
of
ph
y
s
i
c
a
l
a
c
ti
vi
t
y
M
e
a
n (
S
D
)
S
a
ti
s
f
i
e
d w
it
h t
h
e
s
a
f
e
t
y
of
y
our
n
e
ig
hb
o
r
h
oo
d
(
n=
255)
3.79 (
1.26)
E
a
s
e
of
w
a
lk
in
g i
n t
h
e
ne
ig
hb
o
r
h
oo
d
(
n=
259)
4.20
(
1.24)
E
a
s
e
of
bi
c
y
c
li
ng i
n t
h
e
ne
ig
hb
o
r
h
oo
d
(
n=
259)
3.99 (
1.41)
T
ot
a
l
ne
ig
hb
or
h
oo
d
s
a
f
e
t
y
s
c
or
e
(
n=
260)
3.92
(
0.98)
3.
3
.
F
ood
,
n
u
t
r
it
ion
an
d
p
h
ys
ical
ac
t
ivi
t
y
e
n
vir
o
n
m
e
n
t
of
c
h
il
d
r
e
n
’
s
s
c
h
oo
l
s
Only
26.
7%
o
f
t
h
e
s
c
h
o
o
l
s
h
a
d
a
n
ut
r
i
t
i
o
n
/
f
o
o
d
po
l
i
c
y
,
f
r
o
m
w
hi
c
h
a
ll
o
f
t
h
e
m
s
a
i
d
s
uc
h
a
po
l
i
c
y
wa
s
m
o
de
r
a
t
e
l
y
e
f
f
e
c
t
i
v
e
i
n
pr
o
m
ot
i
n
g
h
e
a
l
t
hy
e
a
t
i
n
g
a
n
d
i
nc
r
e
a
s
i
ng
c
hi
l
dr
e
n's
pa
r
t
i
c
i
p
a
t
i
o
n
i
n
phy
s
i
c
a
l
a
c
t
i
vi
t
y
a
s
S
h
o
wn
i
n
T
a
bl
e
3.
No
n
e
o
f
t
h
e
s
c
h
o
o
l
s
h
a
d
a
g
ym
na
s
i
u
m
o
r
h
a
l
l
f
o
r
p
hy
s
i
c
a
l
a
c
t
i
vi
t
y
but
m
o
r
e
t
h
a
n
70%
o
f
t
h
e
s
c
h
o
o
l
s
h
a
d
m
o
r
e
t
h
a
n
1
f
i
e
l
d.
S
we
e
t
s
we
r
e
s
o
l
d
i
n
t
h
e
m
a
j
o
r
i
t
y
o
f
t
h
e
s
c
h
o
o
l
s
,
56.
0%
h
a
d
c
o
n
t
r
a
c
to
r
s
r
un
f
o
r
pr
o
f
i
t
f
o
o
d
s
e
r
vi
c
e
a
n
d
n
o
ne
o
f
t
h
e
s
c
h
o
o
l
s
u
s
e
d
f
o
o
d
a
s
m
e
a
ns
o
f
f
u
n
dr
a
i
s
i
ng.
I
n
or
de
r
o
f
f
r
e
qu
e
n
c
y
,
c
o
-
c
ur
r
i
c
u
l
a
r
a
c
t
i
vi
t
i
e
s
c
a
r
r
i
e
d
o
ut
by
t
h
e
s
c
h
o
o
l
s
i
nc
l
ude
d
f
o
ot
b
a
l
l
(
100%
)
,
a
t
h
l
e
t
i
c
s
(
79.
0%
)
,
da
n
c
i
ng
(
56.
0%
)
,
b
a
s
ke
t
b
a
ll
(
33.
7%
)
,
c
y
c
l
i
ng
(
17.
7%
)
,
a
e
r
o
bi
c
s
(
14.
3%
)
,
t
e
n
ni
s
(
14.
0%
)
,
s
wi
mm
i
ng
(
11.
35
)
a
n
d
n
e
t
b
a
ll
(
9.
3%
)
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
.
J
.
P
ubl
i
c
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a
l
t
h
S
c
i
.
I
S
S
N:
2252
-
8806
T
he
home
and
s
c
hool
e
nv
ir
onme
nts
,
phy
s
ical
ac
ti
v
i
ty
lev
e
ls
,
and
adipos
it
y
indi
c
e
s
o
f
…
(
P
ati
e
nc
e
K
.
G
aa
)
87
T
a
bl
e
3.
A
s
s
e
s
s
m
e
n
t
o
f
t
h
e
f
o
o
d,
n
ut
r
i
t
i
o
n
a
n
d
p
hys
i
c
a
l
a
c
t
i
vi
t
y
e
nvi
r
o
nm
e
n
t
o
f
c
hil
dr
e
n
’
s
s
c
h
o
o
l
s
V
a
r
ia
bl
e
F
r
e
qu
e
n
c
y
(
%
)
S
c
h
oo
l
ha
s
a
nut
r
it
i
o
n/
f
oo
d p
ol
ic
y
Y
e
s
80(
26.7%
)
No
220(
73.3%
)
N
umbe
r
of
f
i
e
ld
s
i
n s
c
h
oo
l
N
o
n
e
43(
14.3%
)
1 f
i
e
ld
218(
72.7%
)
2 f
i
e
ld
s
39(
13.0%
)
S
c
h
oo
l
ha
s
a
da
il
y
f
it
ne
s
s
pr
o
gr
a
mm
e
(
n=
276)
Y
e
s
118(
42.8%
)
No
158(
57.2%
)
T
y
p
e
of
f
oo
d s
e
r
vi
c
e
/
c
a
nt
e
e
n l
un
c
h
or
de
r
pr
ov
id
e
d b
y
s
c
h
oo
l
S
c
h
oo
l
r
un
f
or
pr
of
it
c
a
nt
e
e
n
71(
23.7%
)
C
o
nt
r
a
c
t
o
r
s
r
un
f
or
pr
of
it
(
th
is
i
nc
lu
de
s
f
oo
d
ve
nd
o
r
s
)
168(
56.0%
)
N
o
f
oo
d s
e
r
v
i
c
e
61(
20.3%
)
S
a
le
of
s
w
e
e
ts
i
n t
h
e
s
c
h
oo
l
Y
e
s
161(
62.9%
)
No
95(
37.1%
)
3.
4
.
As
s
e
s
s
m
e
n
t
of
t
h
e
p
h
ys
ical
ac
t
ivi
t
y
l
e
ve
ls
of
t
h
e
c
h
il
d
r
e
n
M
e
a
n
(
S
D)
a
n
d
m
e
d
i
a
n
p
hy
s
i
c
a
l
a
c
t
i
vi
t
y
s
c
o
r
e
s
f
o
r
t
h
e
c
hi
l
dr
e
n
we
r
e
2.
51(
0.
48)
a
n
d
2.
52(
1.
45
-
3.
76
)
r
e
s
pe
c
t
i
ve
ly
.
T
h
e
m
o
s
t
c
o
m
m
o
nly
r
e
po
r
t
e
d
s
po
r
t
s
a
n
d
a
c
t
i
vi
t
i
e
s
(
i
.
e
.
f
o
r
i
t
e
m
1
o
f
t
h
e
P
A
Q
-
C
)
i
n
o
r
de
r
o
f
f
r
e
qu
e
n
c
y
we
r
e
wa
l
k
i
ng
(
2.
70)
,
b
i
c
y
c
li
ng
(
2.
2
4)
,
f
oot
b
a
l
l
(
2.
16)
,
“
ampe
”
(
2
.
01)
,
j
o
gg
i
n
g
(
1.
83)
a
n
d
da
n
c
e
(
1.
81)
.
P
A
Q
s
c
o
r
e
s
s
i
g
ni
f
i
c
a
n
t
l
y
d
if
f
e
r
e
d
by
l
e
ve
l
o
f
m
o
t
h
e
r
’
s
e
duc
a
t
i
o
n
i
n
t
h
a
t
c
hil
dr
e
n’
s
w
h
o
s
e
m
o
t
h
e
r
s
h
a
d
l
o
w
l
e
v
e
l
o
f
e
duc
a
t
i
o
n
r
e
po
r
t
e
d
hi
g
h
e
r
l
e
v
e
l
s
o
f
p
hy
s
i
c
a
l
a
c
t
i
vi
t
y
c
o
m
pa
r
e
d
t
o
t
h
e
i
r
c
o
un
t
e
r
pa
r
t
s
wh
o
s
e
m
o
t
h
e
r
s
h
a
d
hi
g
h
l
e
v
e
l
o
f
e
duc
a
t
i
o
n
(
1.
57(
0.
23)
v
e
r
s
u
s
1.
49(
0.
30)
;
F
=
5.
08,
p=
0.
025)
.
P
A
Q
s
c
o
r
e
s
a
l
s
o
d
i
f
f
e
r
e
d
s
i
g
nif
i
c
a
n
t
l
y
by
ge
n
de
r
w
i
t
h
b
o
y
s
b
e
i
ng
m
o
r
e
phy
s
i
c
a
l
a
c
t
i
v
e
t
h
a
n
g
i
r
l
s
(
g
i
r
l
s
=
1.
4
8(
0.
27)
,
b
o
y
s
=
1.
58(
0.
29)
,
F
=
11.
23,
p=
0.
001
)
.
T
h
e
r
e
we
r
e
no
s
i
g
nif
i
c
a
n
t
d
i
f
f
e
r
e
n
c
e
s
w
h
e
n
P
AQ
s
c
o
r
e
s
we
r
e
c
o
m
pa
r
e
d
w
i
t
h
c
hi
l
d
’
s
c
l
a
s
s
,
f
a
t
h
e
r
’
s
l
e
ve
l
o
f
e
duc
a
t
i
o
n
,
a
ge
a
n
d
t
y
pe
o
f
s
c
h
o
o
l
.
3.
5
.
As
s
e
s
s
m
e
n
t
of
c
h
il
d
r
e
n
’
s
m
e
d
ia
u
s
e
an
d
t
e
l
e
vis
ion
view
in
g
S
h
o
wn
i
n
T
a
bl
e
4,
m
e
a
n
(
S
D)
n
u
m
be
r
o
f
wo
r
ki
ng
T
Vs
,
DV
D/VC
R
p
l
a
y
e
r
s
,
a
n
d
c
o
m
put
e
r
s
we
r
e
2.
31(
2.
23
)
,
1.
57
(
1.
72
)
a
n
d
1.
34(
1.
29)
r
e
s
pe
c
t
i
ve
ly
.
S
i
x
t
y
-
ni
ne
pe
r
c
e
n
t
o
f
t
h
e
pa
r
e
n
t
s
r
e
po
r
t
e
d
t
h
e
pr
e
s
e
n
c
e
o
f
c
a
bl
e
/
s
a
t
e
l
li
t
e
T
V
a
t
h
o
m
e
,
27.
6%
s
a
i
d
t
h
e
c
hi
l
d
h
a
d
a
wo
r
ki
n
g
T
V
i
n
hi
s
/
h
e
r
b
e
dr
o
o
m
a
n
d
m
o
r
e
t
h
a
n
70%
h
a
d
r
u
l
e
s
a
r
o
un
d
T
VV
.
T
hi
r
t
y
-
t
h
r
e
e
pe
r
c
e
n
t
s
a
i
d
th
e
y
r
e
wa
r
de
d
c
hil
d
’
s
go
o
d
b
e
h
a
v
i
o
ur
w
i
t
h
i
nc
r
e
a
s
e
d
T
VV
t
i
m
e
a
n
d
71%
r
e
duc
e
d
T
VV
o
r
c
o
m
put
e
r
us
e
t
i
m
e
wh
e
n
c
hil
d
i
s
n
a
ug
h
t
y
.
T
a
bl
e
4.
C
hi
l
dr
e
n’
s
m
e
d
i
a
us
e
a
n
d
T
V
v
i
e
w
i
ng
V
a
r
ia
bl
e
M
e
a
n (
S
D
)
N
umbe
r
of
h
o
u
r
s
s
pe
nt
w
a
tc
hi
ng
T
V
o
r
w
a
tc
h
in
g
v
id
e
o
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m
e
s
(
n=
186)
1.72(
1.60)
N
umbe
r
of
w
or
ki
ng
T
V
s
(
n=
226)
2.31(
2.23)
N
umbe
r
of
D
V
D
o
r
V
C
R
pl
a
y
e
r
s
(
n=
200)
1.57(
1.72)
N
umbe
r
of
c
o
mput
e
r
s
/l
a
pt
o
ps
(
n=
236)
1.34(
1.29)
N
umbe
r
of
w
or
ki
ng ga
me
s
c
o
ns
o
l
e
s
(
e
.g. P
la
y
S
ta
ti
o
n,
e
t
c
)
(
n=
231)
0.71(
1.53)
T
y
p
e
of
me
di
a
F
r
e
qu
e
n
c
y
(
%
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C
hi
ld
ha
s
c
a
bl
e
o
r
s
a
te
ll
i
te
(
n=
241)
Y
e
s
165(
68.5%
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No
76(
31.5%
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C
hi
ld
ha
s
a
w
o
r
ki
ng
T
V
i
n hi
s
/h
e
r
be
d
r
oo
m (
n=
254)
Y
e
s
70(
27.6%
)
No
184(
72.4%
)
C
hi
ld
ha
s
a
l
a
pt
o
p/
c
o
mput
e
r
i
n hi
s
/h
e
r
b
e
dr
oo
m
(
n=
156)
Y
e
s
65(
41.7%
)
No
91(
58.3%
)
C
hi
ld
ha
s
a
ga
me
s
c
o
ns
ol
e
i
n h
is
/h
e
r
b
e
dr
oom (
n=
84)
Y
e
s
32(
38.1%
)
No
52(
61.9%
)
H
a
s
r
ul
e
s
a
r
o
und
T
V
w
a
t
c
hi
ng
o
r
c
o
mput
e
r
us
e
(
n=
250)
Y
e
s
193(
77.2%
)
No
57(
22.8%
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R
e
w
a
r
ds
c
hi
ld
'
s
g
oo
d
be
ha
v
i
or
w
it
h
e
x
tr
a
T
V
o
r
c
o
mput
e
r
ti
m
e
(
n=
252)
Y
e
s
84(
33.3%
)
No
168(
66.7%
)
R
e
duc
e
s
T
V
o
r
c
o
mput
e
r
ti
me
i
f
c
h
il
d i
s
na
ught
y
(
n=
252)
Y
e
s
179(
71.0%
)
No
73(
29.0%
)
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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4.
DI
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CU
S
S
I
ON
4.
1.
T
h
e
f
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d
h
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An
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[
19]
.
As
s
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mi
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ly
,
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[
20]
s
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m
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[
21
-
22]
.
Va
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[4
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G
o
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M.
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Par
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as
ag
en
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[5
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l
an
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k
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au
B
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n
v
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p
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[6
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Parce
l
G
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Si
mo
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Mo
rt
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[8
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[9
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