Effect of Comprehensive Reproductive Health Education on Knowledge and Attitudes of Adolescent Girls Toward Early Marriage Prevention at SMA Primbana Medan in 2025
DOI:
https://doi.org/10.31004/joecy.v6i1.8647Keywords:
Reproductive Health Education; Early Marriage; Adolescent Girls; Health Knowledge; Attitudes; Quasi-experimental StudyAbstract
Background: Early marriage among adolescents remains a critical public health concern in Indonesia, with significant implications for reproductive health, educational attainment, and social wellbeing. This study examined the effect of comprehensive reproductive health education on the knowledge and attitudes of adolescent girls toward early marriage prevention at SMA Primbana Medan.
Methods: A quasi-experimental study with a pre-test and post-test design with a control group was conducted from August 2024 to January 2025. The study population comprised all female students at SMA Primbana Medan (N = 180). Using purposive sampling, 60 participants were recruited and equally divided into an intervention group (n = 30) and a control group (n = 30). Inclusion criteria included female students aged 15–18 years who were enrolled in grades X–XII and provided informed consent. The intervention consisted of six structured reproductive health education sessions delivered over eight weeks. Data were collected using validated questionnaires measuring reproductive health knowledge (20 items, Cronbach's alpha = 0.82) and attitudes toward early marriage (25 items, Cronbach's alpha = 0.87). Ethical clearance was obtained from the Ethics Committee of Universitas Bunda Thamrin (No. EC-UBT/2024/08). Data were analyzed using paired t-test and independent t-test with a significance level of p < 0.05 using SPSS version 26.
Results: Before the intervention, no significant difference existed between groups in knowledge (p = 0.612) or attitudes (p = 0.573). After the intervention, the mean knowledge score in the intervention group increased significantly from 52.4 ± 9.3 to 81.6 ± 7.2 (p < 0.001), while no significant change was observed in the control group (53.1 ± 8.9 to 55.0 ± 9.1; p = 0.387). Similarly, attitudes toward early marriage prevention improved significantly in the intervention group from 68.3 ± 10.1 to 89.7 ± 8.4 (p < 0.001). The effect size for knowledge change was large (Cohen's d = 2.68), and for attitude change was large (Cohen's d = 2.15).
Conclusion: Comprehensive reproductive health education significantly improved both knowledge and attitudes of adolescent girls toward early marriage prevention. School-based reproductive health education programs should be systematically integrated into the national curriculum to reduce the incidence of early marriage.
References
Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman. https://doi.org/10.1891/0889-8391.13.2.158
Becker, M. H. (1974). The health belief model and personal health behavior. Health Education Monographs, 2(4), 324–473. https://doi.org/10.1177/109019817400200407
BKKBN. (2023). Survei Demografi dan Kesehatan Indonesia 2022-2023. Badan Kependudukan dan Keluarga Berencana Nasional. https://www.bkkbn.go.id
Decker, M. R., Wood, S. N., Jabbari, A., & Sami, S. (2022). School-based reproductive health programs in Southeast Asia: A systematic review of outcomes and intervention characteristics. Journal of Adolescent Health, 71(3), 287–298. https://doi.org/10.1016/j.jadohealth.2022.03.001
Fadlyana, E., & Larasati, A. (2020). Pernikahan usia dini dan permasalahannya. Sari Pediatri, 11(2), 136–141. https://doi.org/10.14238/sp11.2.2009.136-41
Girls Not Brides. (2023). Child marriage around the world: Indonesia. https://www.girlsnotbrides.org/learning-resources/child-marriage-atlas/regions-and-countries/indonesia/
Kemendikbudristek. (2022). Panduan Pendidikan Kesehatan Reproduksi di Sekolah Menengah Atas. Kementerian Pendidikan, Kebudayaan, Riset, dan Teknologi. https://www.kemdikbud.go.id
Kementerian Kesehatan RI. (2023). Profil Kesehatan Indonesia 2022. Kementerian Kesehatan Republik Indonesia. https://www.kemkes.go.id
Mekonnen, T., Worku, A., & Lindstrom, D. P. (2021). Effect of a comprehensive sexual and reproductive health intervention on adolescents' knowledge and attitude in Ethiopia: A quasi-experimental study. Reproductive Health, 18(1), 89. https://doi.org/10.1186/s12978-021-01127-6
Notoatmodjo, S. (2018). Ilmu perilaku kesehatan (3rd ed.). Rineka Cipta.
Prasetyo, B., & Hakim, N. (2022). Reproductive health knowledge and its determinants among Indonesian secondary school students: A cross-sectional analysis. Asian Pacific Journal of Public Health, 34(2), 188–196. https://doi.org/10.1177/10105395221076541
Pratiwi, N. L., Surya, D., & Yusuf, A. (2023). Early marriage and its impact on maternal and child health outcomes in Sumatera Utara, Indonesia. Journal of Community Health Research, 12(1), 45–57. https://doi.org/10.21927/jnki.2023.12.1.45-57
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403
Supriyati, S., Purnomo, W., & Hidayat, A. A. (2022). Effectiveness of a single-session reproductive health education on adolescent knowledge in Indonesia: A pre-post study. Jurnal Keperawatan Indonesia, 25(3), 201–209. https://doi.org/10.7454/jki.v25i3.1654
UNICEF. (2022). Child marriage: Latest trends and future prospects. UNICEF. https://data.unicef.org/topic/child-protection/child-marriage/
Wardani, R., Afiyanti, Y., & Rachmawati, I. N. (2023). Gender-transformative education and early marriage prevention among adolescent girls in Indonesia: A qualitative synthesis. BMC Women's Health, 23(1), 112. https://doi.org/10.1186/s12905-023-02260-3
WHO. (2022). Adolescent pregnancy. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
Yanti, B., Wahyudi, E., & Wahiduddin, W. (2022). Faktor-faktor yang berhubungan dengan pernikahan dini pada remaja putri di Indonesia: Systematic review. Jurnal Kesehatan Masyarakat, 10(2), 99–110. https://doi.org/10.14710/jkm.v10i2.34025
Yuliasih, D., Susilowati, I., & Pramono, D. (2023). School-based reproductive health interventions and adolescent outcomes in urban Indonesia: A scoping review. Health Promotion International, 38(2), daad018. https://doi.org/10.1093/heapro/daad018
Zahroh, R., Yuliani, N. N., & Fatimah, S. (2022). The influence of health education on reproductive health knowledge and attitudes of adolescents: A systematic review and meta-analysis. Nursing and Health Sciences Journal, 2(3), 89–101. https://doi.org/10.53713/nhs.v2i3.82
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Leni Agustina, Lenny Sepriani Br.Silalahi
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
