

Top Box: “Enrollment: 260 students assessed for eligibility”. Left Branch (Excluded): Arrow pointing to a box: “Excluded (n=6): 2 Repeaters, 2 Voluntary Withdrawals, 2 Other”. Middle Branch (Allocation): Arrow pointing down to “Randomization”. Split into two paths: Left: “Allocated to Control Group (n=126)”. Right: “Allocated to Experimental Group (n=128)”. Intervention Box: Control path: “Received Traditional Instruction (n=126)”. Experimental path: “Received ANS Intervention (n=128)”. Bottom Box (Analysis): Control path: “Analyzed (n=126)”. Experimental path: “Analyzed (n=128)”.
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