EFFECT OF YOGA PRACTICES ON EMOTIONAL INTELLIGENCE AND HEALTHY LIFE STYLE HABITS

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1 KAAV INTERNATIONAL JOURNAL OF ARTS, HUMANITIES & SOCIAL SCIENCES EFFECT OF YOGA PRACTICES ON EMOTIONAL INTELLIGENCE AND HEALTHY LIFE STYLE HABITS ANAMIKA TIWARI Research scholar, Department of Education, University of Allahabad, Allahabad ASHISH MISHRA Junior Research Fellow, Department of Education, University of Allahabad, Allahabad ABSTRACT Present research is an effort to study the effect of yoga practices (asanas, pranayam & meditation including theories and practical) on emotional intelligence and healthy lifestyle habits. Researchers selected 100 people of Allahabad city on random basis (50 regular Yoga practitioners of Bhartiya Yoga Sansthan Allahabad centre who practiced yoga regularly under the supervision of trained experts & 50 individuals who practiced yoga rarely).self constructed questionnaires were used to measure emotional intelligence and healthy life style habits. Content validity of the tools was ascertained through expert opinion and reliability was checked through the split-half method using product moment correlation. Ex-post facto research design was used to analyse the data. Data were 68

2 analyzed by using Mean(X), Standard deviation (SD) & t-test. Results evidenced that practitioners who involved in regular yoga practices scored more on emotional intelligence as well as healthy life style habits than practitioners who were rarely practicing yoga. Age, working status and gender were not found as significant factors of emotional intelligence and healthy life style habits among regular yoga practitioners as well as among rare yoga practitioners. t-test result indicated significant differences between mean score of emotional intelligence of regular yoga practitioners and rare yoga practitioners at.01 level in favour of regular ones, similar result was witnessed in the case of comparison of mean scores of healthy life style habits. Present research recommends Yoga awareness workshop & yoga training in educational institution, work place as well as among community members. Key words: emotional intelligence, healthy lifestyle habits, yoga practices Modern or Unhealthy life style & health issues Today human beings are leading towards materialistic way of life to make life happy and successful but on the other side society is suffering from unlimited no. of diseases day by day due to adapting adherence of unhealthy lifestyle. Inappropriate lifestyle is one of the influential factors for the emergence of chronic diseases like colon cancers, hypertension, chronic obstructive pulmonary diseases, liver cirrhosis, peptic ulcers, AIDS and cardiovascular diseases. Non-contagious diseases are closely related to lifestyle (Rensburg & Surujlal, 2013). A report, jointly prepared by the World Health Organization and the World Economic Forum, says India will incur an accumulated loss of $236.6 billion by 2015 on account of unhealthy lifestyles and faulty diet. The resultant chronic diseases - heart disease, stroke, cancer, diabetes and respiratory 69

3 infections - which are ailments of long duration and slow progression, will severely affect people's earnings. The income loss to Indians because of these diseases, which was $8.7 billion in 2005, is projected to rise to $54 billion in Pakistan would face an accumulated loss of $30.7 billion with income loss increasing by $5.5 billion to $6.7 billion by China, however, will be worse off. While its accumulated loss will stand at $557.7 billion, the loss of income of the Chinese will stand at $131.8 billion, almost eight times what it was in Workplaces should make possible healthy food choices and support physical activity. Unhealthy diets and excessive energy intake, physical inactivity and tobacco use are major risk factors for non-communicable diseases, the report said. According to a survey conducted by the Associated Chamber of Commerce and Industry (ASSOCHAM), 68% of working women in the age bracket of years were found to be afflicted with lifestyle ailments such as obesity, depression, chronic backache, diabetes and hypertension. The study Preventive Healthcare and Corporate Female Workforce also said that long hours and working under strict deadlines cause up to 75% of working women to suffer from depression or general anxiety disorder, compared to women with lesser levels of psychological demand at work. Women employed in sectors that demand more time such as media, knowledge process outsourcing and touring jobs are unable to take leave when unwell, and force themselves to work mainly due to job insecurity, especially during the current financial meltdown, the report said. However, it said, factors such exposure to industrial pollutants and environmental toxins, poor quality of sleep, lack of exercise, sunlight exposure, poor nutrition, excessive intake of alcohol etc might play a confounding role and are the priority areas for further research. Highlighting the fact that women play vital and multiple roles, especially those employed, the report stressed on the need for a balance at home and workplace (Sharma & Majumdar, 2013) Stressful and unhealthy lifestyles are exposing upwardly mobile urban Indians to a host of diseases like TB, diabetes and cancers. According to WHO, India has the highest number of TB patients in the world, and is witnessing a rising number of diabetic cases as well. Deepak 70

4 Nama, respiratory diseases specialist, explained a stressful lifestyle releases adrenaline in the body. It disrupts sleep, causes fatigue and immunity is lowered. Obesity is increasing in children and adults. The reasons are improper nutrition and irregular eating habits, said Nama. (Rangarajan, 2009) It can be said that modern or better to say stressful life style emerged the needs to follow healthy life style habits as precautionary and curative tool which can enable human being to deal with stressful situation with the ability to deal with self as well as others emotion to create tension free environment through making them emotionally intelligent. Numerous studies had been conducted to fulfill the above mentioned needs and researches on yoga practices is one of the efforts made by Indian and overseas researchers. After reviewing the vast literature on benefits of yoga practices, researchers realized that there are very rare researches that evidenced the influence of yoga practices on healthy life style habits as well as emotional intelligence so researchers felt the need to throw some light on the influence of yoga practices on emotional intelligence and healthy life style habits. Yoga The term yoga and the English word yoke are derived from Samskrit root yuj which means union. Yoga is one of the six foundations of Indian philosophy and has been used for millennia to study, explain, and experience the complexities of the mind and human existence (Feuerstein, 1998). Yoga is a psycho-somatic-spiritual discipline for achieving union & harmony between our mind, body and soul and the ultimate union of our individual consciousness with the Universal consciousness (Madanmohan, 2008). Patanjali, an ancient yoga sage, in his Yoga Sutras, defined yoga as a technique used to still the mental fluctuations of the mind to reach the central reality of the true self (Iyengar, 1966). Patanjali s Yoga Sutras outline a skilful way of conducting life that fosters moderation and harmony (Becker, 2000). These guidelines, which include ethical and moral standards of living in addition to postural and breathing exercises, can be used to foster spiritual 71

5 growth and evolve one s consciousness. The yoga way of life encompasses the philosophy of Karma yoga (path of detached action), Jnana yoga (knowledge of self), Bhakti yoga (trust in the supreme order), and Raja yoga (a prescribed set of eight steps also known as Ashtanga yoga). Karma yoga is the path of focusing on the action on hand without selfishness, ego and carelessness as prescribed by Lord Krishna in the Bhagavad Gita (Swami Ranganathananda, 2000). Jnana yoga is the path of knowledge of self (atman) propagated by Adi Shankaracharya through an interpretation of the Upanishads, considered the most ancient books of Indian wisdom. Bhakti yoga is the path of total surrender to the supreme power which is based on deep rooted faith in God s justice system. Raja yoga is the path of control of mind though the practice of Ashtanga yoga or the eight fold path given by the sage Patanjali in his Yoga Sutras (Swami Satyananda Saraswati, 1976). The eight steps of Ashtanga yoga are yama, niyama, asana, pranayama, pratyahara, dharana, dhyana and samadhi (Swami Satyananda Saraswati, 1976). Chakraborty and Chakraborty (2008) see the human personality as a composite of four subtle variables: reason, will, emotion and conscience. In order to integrate the personality, these four factors must be habituated to work in harmony instead of working at cross purposes, and this requires effort. Further, the expression integrated personality is often employed to imply the same characteristics that are expected of a holistic, self-possessed personality. Yoga Practices: Precautionary and Curative Instrument for Healthy Life There is a vast repository of knowledge and accumulated experience in India on the role of yoga as a way of life in enabling individuals to lead successful and satisfied lives (Becker, 2000; Srinivas, 1994). In a study on executive stress Malhotra (1996) reported that unreasonable performance pressures and demanding life styles of an executive often causes health problems such as hypertension, migraine, high blood pressure, insomnia, ulcers and cardiovascular diseases. The author analyzed the impact of techniques such as meditation, yoga, aerobics etc for a stress free 72

6 culture. Several studies have been conducted by the researchers on relaxation practices from time to time. Yoga seems to have potentiality to influence health practices. Yoga practices were studied by Sachdeva (1994) and Rao (1995). Findings from these studies on Yoga revealed that long term practitioners of Yoga had acquired remarkable voluntary control over their autonomic processes which helped them in coping with psychological stress. Shekhawat & Mishra, (2008) demonstrated the effects of Preksha Meditation on various psychophysiological components of healthy human subjects, a significant decline was observed in Heart Rate, Systolic pressure, Diastolic pressure, Mean pressure, Rate pulse pressure, Anxiety level, Fear level and Frustration levels (Aggression, Reservation, Fixation and Regression). On the basis of results obtained it was inferred that practice of Preksha Meditation has brought down the level of these components by modulating the functions of Autonomic and Central nervous system. Harinath et al (2004) have studied the Effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychological profile, and melanin secretion. They found that Yogic practices for 3 months resulted in an improvement in cardiorespiratory performance and psychological profile. The systolic blood pressure, diastolic blood pressure, mean arterial pressure, and orthostatic tolerance did not show any significant correlation with plasma melanin. However, the maximum night time melanin levels in yoga group showed a significant correlation (r = 0.71, p < 0.05) with well-being score. They conclude that yogic practices can be used as psychophysiology stimuli to increase endogenous secretion of melanin, which, in turn, might be responsible for improved sense of well-being. Madanmohan et al (2002) stated that the shavasan is known to enhance one s ability to combat stressful situations. They planned to determine if shavasan could modulate the physiological response to stress induced by cold pressor test (CPT) and the possible mechanisms involved. Ten normal adults were taught shavasan and practiced the same for a total duration of seven days. RR interval variation (RRIV), deep breathing difference (DBD), and heart rate, blood pressure and ratepressure-product (RPP) response to CPT were measured before and immediately after shavasan. 73

7 Shavasan produced a significant increase in DBD and an appreciable but statistically insignificant increase in RRIV suggesting an enhanced parasympathetic activity. Significant blunting of cold pressure induced increase in heart rate, blood pressure and RPP by shavasan was seen during and even five minutes after CPT suggesting that shavasan reduces the load on the heart by blunting the sympathetic response. It is concluded that shavasan can enhance one s ability to withstand stress induced by CPT and this ability can be achieved even with seven days of shavasan training. Damodaran et al (2002) observed twenty patients with mild to moderate essential hypertension underwent yogic practices daily for one hour for three months. Results showed decreased blood pressure, blood glucose, cholesterol and triglycerides and improved subjective well-being and quality of life. Bhargava et al (1988) have shown that base line heart rate and blood pressure (Systolic and Diastolic) showed a tendency to decrease and both these autonomic parameters were significantly decreased at breaking point after pranayamic breathing. Although the GSR was recorded in all subjects the observations made were not conclusive. Thus Pranayama breathing exercises appear to alter autonomic responses to breathe holding probably by increasing vagal tone and decreasing sympathetic discharges. Emotional Intelligence One can argue that for people to take maximum advantage of their cognitive intelligence (things such as their intelligence quotient [IQ]), they first need EI. If people turn others off with abrasive behavior, remain unaware of how they present themselves, or struggle under minimal stress,no one will notice their high IQs. The stronger the EI abilities, the greater the chances for success.3 Emotional intelligence is the ability to recognize emotions in self and others and the capacity to use those emotions to enhance emotional and intellectual growth and decision-making. However EI may be defined, writers such as Goleman(p317) view EI as separate from cognitive intelligence 74

8 (measured by IQ tests) and complementary to academic intelligence (measured by academic performance). Researchers have noted that EI represents a set of core competencies for identifying, processing, and managing emotions that enable nurses to cope with daily demands in a knowledgeable, approachable, and supportive manner. An underlying assumption in EI theories is that using emotions in thinking and decision making can be a form of intelligence. This view assumes that joining emotions and cognition, when done well, facilitates decisions, manages emotions, improves relationships, and ultimately results in more intelligent decisions.12 Emotional intelligence involves the accurate processing of emotionally relevant information and the ability to use emotions in reasoning to solve problems. Emotional Intelligence in the present study refers to the total score of self awareness, self management, social awareness and relationship management obtained by subjects (based on emotional intelligence model of Goleman, 2000) Yoga and Emotional Intelligence What differences in emotional intelligence are caused by yoga practice? Adhia, Nagendra & Mahadevan(2010) studied the impact of the yoga way of life on EI using data collected from 60 managers in a business enterprise and reports enhanced EI as a result of the practice of yoga. The results indicate the importance of yoga as an integral element in improving managerial performance in organizations and the need to further explore this construct in greater detail. Sindhu & AV* conducted a study to assess the effect of the Integrated Yoga module on emotional dimensions of the participants. The study includes 30 subjects between 20-60years of age who came to Prasanti Kutiram for yoga practice and 30 age matched controls. In this study the EQ test 75

9 developed by Prof N. K. Chadha which was standardized and validated with reliability of 0.94 and validity of 0.92 was given to all the subjects on admission to SVYASA which measure emotional dimensions of emotional competency, emotional maturity and emotional sensitivity. All the subjects of this study participated in asanas, pranayama, cyclic meditation, notional correction, devotional sessions, supervised practice sessions (by trained experts) for one hour daily. After one week of integrated yoga therapy, same questionnaire was given to subjects. Same questionnaire was also given to control group after one week without any intervention. EQ analysis (n=30) showed significant increase (P<0.001) in maturity and competency (r=0.233, respectively) and decrease in sensitivity after intervention as compared with pre intervention among the participants, whereas no difference was found in any emotional aspects among the controls before and after the test was performed. Significant increase in EQ in the present study suggests that participants may strike a balance between emotion and reason, are aware of their own feelings, show empathy and compassion for others, and have high self-esteem. Yoga enhances the EQ of the participants which helps them balance emotion and reason. A study was conducted aiming at evaluating the effect of the SMET Yoga module on emotional dynamics on a sample of 139 executives. New Delhi Salora Company by administering three different tests, were administered. Pre and Post data were collected before and after one month of yoga-based intervention called SMET. The study s chief finding is unique: levels of emotional intelligence and competence were greatly improved by SMET intervention in the Yoga group compared to Control. There were no correlations between E.Q., EC and Personality Inventory. He concluded by saying that the yoga-based intervention called SMET has a profound impact in improving the level of emotional well being among Indian managers. 76

10 HEALTHY LIFE STYLE HABITS Just as unhealthy lifestyles are the principal causes of modern-day illnesses such as heart disease, cancer, and diabetes, healthy lifestyles can result in an improved feeling of wellness that is critical to optimal health. In recognizing the importance of years of healthy life, the Public Health Service also recognizes what it calls measures of well-being. This well-being or wellness is associated with social, mental, spiritual, and physical functioning. Being physically active and eating well are two examples of healthy lifestyles that can improve well-being and add years of quality living. Health is defined using some positive qualities recommended by World Health Organization. Health is the fulfilment of human potential, maintenance of balance and goal orientation in the environment (Tol, Tavassoli, Shariferad & Shojaeezadeh, 2013). This definition covers mental, physical as well as social aspect of an individual s health. These three when put together give us the true picture of an individual in a society. On the basis of above mentioned definition of health, Healthy life style habits are defined as habits that helps individual to fulfill of his/her potential, maintenance of balance and goal orientation in the environment. What differences in healthy life style habits are caused by yoga practice? Healthy life can be considered as a by-product of practicing yogic techniques since it has been observed that yoga practitioners are physically and mentally healthier and have better coping skills to stressors than the normal population. Yoga is widely practiced and globally accepted. Hence, it can be very well integrated as a health promoting tool in our society. Documented scientific evidence strongly indicates that yoga has promotive, preventive as well as curative potential. As a non-pharmaco therapeutic and safe modality, it can be used as an effective lifestyle adjunct to medical treatment to reduce drug dosage and improve quality of life of the patients. It is to be 77

11 emphasized that yoga is very effective for prevention as well as management of all-pervading stress and stress-related disorders. Modern medicine is very effective in controlling infections, performing surgeries and managing diseases. However, it has limited role in stress-based, chronic degenerative, old age and lifestyle related disorders which are the bane of modern society. Yoga has been found to be very effective in these conditions. Our public health delivery system is under-staffed, fundstarved and reeling under severe economic burden. Knowledge of inexpensive, effective and easily administrable yogic techniques by health professionals will go a long way in helping us achieve the WHO goal of providing physical, mental, spiritual and social health to the society. I ve known about the many health benefits of yoga for years now, as I practice every week. In my book, When Cancer Hits, I wrote about how yoga can help soothe side effects like insomnia, mood swings, constipation, brain fog, and aches and pains. Now, we re learning that yoga can actually help us to change stressful habits. Because of the unique connection between brain and body and how yoga helps us to calm and soothe that connection over time, we learn to enjoy a calmer outlook overall. If you re trying to lose weight, relax your tense body, slow down your hurried life, or otherwise make any sort of change, you may find that yoga helps you do just that. (Britta Aragon, 2013) Learning to Stay Calm While Under Stress Aragon writes that he first read about this ability of yoga to change habits in Psychology Today, in an article written by Alex Korb, Ph.D. Korb writes as a neuroscientist, he realized that yoga works not because the poses are relaxing, but because they are stressful. Facing this stress in your body while working to calm the mind teaches students to produce a calmer reaction to all sorts of stress, in and out of the exercise room. 78

12 It is your attempts to remain calm during this stress that create yoga s greatest neurological benefit, Korb writes. Making Better Decisions Off the Mat Dr. Timothy McCall, author of Yoga as Medicine and medical editor at Yoga Journal told thehuffington Post that habits are stubborn, and though people may know they need to change their diets and start exercising, for instance, it s difficult to actually succeed. Yoga helps rewire the brain, he says, to help replace negative patterns with positive ones. What we do with yoga is we start a practice, McCall says, and we repeat it, ideally every day.the more we repeat this positive pattern, the deeper those new neural networks become and the more they can eventually out-compete some of our older habits, habits that can tax our health and lead to stress, disease, and dysfunction. The funny thing about yoga and I have experienced this is that the more you are on the mat, the easier healthy decisions become when you re off the mat. Suddenly I found myself craving healthier foods, and I became more sensitive to negative energy around me. McCall says that s all a result of yoga s rewiring. When yoga is practiced with sensitivity and attention, he says, it gradually increases awareness. It awakens your body to feel what s happening in your body, heart, and mind. When you become more aware of your body, more aware of your mind, more aware of your breath, you start to notice the consequences of your behavior. It comes from the inside, McCall says. What a doctor tells you is one thing. But when you notice the consequences of your actions, it s a very different and much more effective motivator. A 2009 study demonstrated yoga s magic at work. Researchers compared 159 high-stress adolescent students and 142 low-stress students. One group went through a regular yoga program for 7 weeks, 79

13 while the other did not. The students who practiced yoga performed better on academic tests. There are hundreds of other studies showing yoga s ability to affect all kinds of body systems, easing depression, and lowering blood sugar, improve immunity, and much more. Based on a review of the literature, we can formulate following hypotheses H1: Regular yoga practicing individuals demonstrate more emotional intelligence than individuals practicing yoga rarely in the context of age, working status and gender. Null hypotheses: H0: young and old individuals do not differ significantly from each other in demonstrating healthy life style habits. H0: male and female individuals do not differ significantly from each other in demonstrating healthy life style habits H0: working and non working individuals do not differ significantly from each other in demonstrating healthy life style habits H2: Regular yoga practicing individuals demonstrate healthier life style habits than individuals practicing yoga rarely in the context of age, working status and gender. Null hypotheses: H0: young and old individuals do not differ significantly from each other in demonstrating emotional intelligence. H0: working and non working individuals do not differ significantly from each other in demonstrating emotional intelligence. 80

14 H0: male and female individuals do not differ significantly from each other in demonstrating emotional intelligence. Sample: To conduct the present study researchers randomly selected 100 people of Allahabad city (50 regular Yoga practitioners of Bhartiya Yoga Sansthan Allahabad centre & 50 individuals who practice yoga rarely). Both types of individuals practice their exercises at the same place, yoga practitioners were contacted between 5:30 AM to 6:45 AM at the time of their practices whereas non yoga practitioners contacted between 5:00 AM to 8:00 AM due to their different practices time. In the present study yoga practices included practical session for asanas, pranayam & meditation with short duration per day lectures, 1 hr 15 minutes allotted jointly for both the sessions. Research design: Ex-post facto research design was used to conduct the present study. Statistics: Data were analyzed by using Mean(X) of score obtained on emotional intelligence scale as well as healthy life style habits scale by regular and rare yoga practitioners. t-test was used to check the significance of difference between values of yoga and non yoga practitioners, it is also used to test the (1)significance of difference between male and female regular yoga practitioners on emotional intelligence score as well as healthy life style score (2)significance of difference between young and old regular yoga practitioners on emotional intelligence score as well as healthy life style score (3)significance of difference between working and non working regular yoga practitioners on emotional intelligence score as well as healthy life style score. Above mentioned (1), (2) & (3) was also applied to rare yoga practitioners. Research Instruments: Self constructed Likert type 5 point rating scales (Emotional Intelligence Scale & Healthy Life Style Habits Scale) respectively were used to measure emotional intelligence and healthy life style habits. Reliability & Validity of research instruments: Content validity of 81

15 the tools were ascertained through expert opinion and the reliability were calculated through the split-half method using product moment correlation(r=0.8) Results: Mean scores on emotional intelligence of regular yoga practitioners and rarely yoga practitioners were found 4.42 and 4.0 respectively and mean scores on healthy life style habits of regular yoga practitioners and rarely yoga practitioners were found 4.14 and 3.7 respectively. T-ratio was calculated to compute the significance of the differences between two mean of emotional intelligence as well as healthy life style habits, t-value of 3.12 and 2.95 respectively proved statistically significant difference at.01 level of significance. Table-1: Emotional Intelligence of Regular and Rare yoga practitioners M SD t Significance level Regular yoga practitioner Rare yoga practitioner Table-2: Healthy lifestyle habits of Regular and Rare yoga practitioners M SD t Significance level Regular yoga practitioner Rare yoga practitioner

16 Graphical representation of mean score of regular and rare yoga practitioners on emotional intelligence and healthy life style habits Regular yoga practitioner Rare yoga practitioner Figure: 1 Results evidenced that individuals involved in regular yoga practices scored more on emotional intelligence as well as healthy life style habits than professionals who were rarely practicing yoga and involved in other physical exercises. Age, working status and gender were not found as significant factors of emotional intelligence and healthy life style habits among regular yoga practitioners as well as among rare yoga practitioners Findings & Recommendations On the basis of present result it can be concluded that emotional intelligence can be enhanced through regular yoga practices as well as it also promotes healthy life style habits. Present study results suggest following recommendations: 1. Yoga training awareness workshops must be included in govt. and private firms training to motivate employees for regular yoga practice so that they can deal with workplace problems 83

17 easily as well as enable them to develop healthy life style habits for healthy and happy life forever. 2. Yoga practice awareness programmes must be conducted by govt. through social welfare scheme to make every person aware of the yoga practices to make a happy and healthy society where everyone follows healthy lifestyle habits as well as capable to handle day to day stressful situation easily and contribute to make a healthy and developed nation. REFERENCES Effect Of Yogic Practices On Different Systems Of Human Body retrieved from Dated 10 july 2015 Emotional Intelligence: retrieved from Dated 7 sep 2015 Hasmukh, A., Nagendra, H.R., & Mahadevan, B. (2010). Impact of Adoption of Yoga Way of Life on the Emotional Intelligence of Managers. IIMB Management Review, 22, 32e41. Retrieved from Dated Oct 10, Kauts, A. and Sharma, N. (2009). Effect of Yoga on Academic Performance In Relation To Stress. International Journal of Yoga. Jan-Jun; 2(1): Posted in: Alternative Therapies and Lifestyle, Britta's Recommendations, Surviving Cancer. Rangarajan, R. (2009): retrieved from dated Oct 6,

18 Rensburg, C.J. and Surujlal, J. (2013). Gender differences related to the health and lifestyle patterns of university students. Health SA Gesondheid., 18(1): , (2013) retrieved from dated 15 sep 2015 Sharma, M. & Majumdar, K. P. (2009). Retrieved from Indian J Occup Environ Med Dec; 13(3): dated Nov 15, Sindhu, R. Vinay, A.V. (2015). Evaluation of Emotional Dimensions of the Subjects Practicing Integrated Yoga. Research Journal of Pharmaceutical, Biological and Chemical Sciences, Department of Physiology, PES Institute of Medical Science and Research, Kuppam, Andhra Pradesh, India, Tol, A., Tavassoli, E., et al. (2013). Health-Promoting Lifestyle and Quality Of Life among Undergraduate Students at School Of Health. Journal of Education and Health Promotion. 2(1), 11, retrieved from Dated 15 sep