Ethics approval and consent to participate
Ethical clearance was obtained from Institute Ethics Committee (IEC), AIIMS Bhubaneswar, with reference number IEC/AIIMS BBSR/PG Thesis/2020-21/51. Permission was obtained from the District Education Officer (DEO), Khordha, for the conduct of the study. Informed verbal consent was taken from the principal and school teachers. Assent from the students and written informed consent from their parents were taken.