Peer-reviewed article

Effect of Comprehensive Reproductive Health Education on Knowledge and Attitudes of Adolescent Girls Toward Early Marriage Prevention at SMA Primbana Medan in 2025

Leni Agustina, Lenny Sepriani Br. Silalahi · 25 Feb 2026

Abstract

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.