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Journal : JURNAL PROMOSI KESEHATAN INDONESIA

Effect of Peer Education on Knowledge and Attitudes Toward Menstrual Hygiene Management Among Boarding School Students Berliana, Besty; Defrin, Defrin; Adrial, Adrial; Yusrawati, Yusrawati; Purna, Rozi Sastra; Asri, Ennesta
Jurnal Promosi Kesehatan Indonesia Vol 21 No 1: January 2026
Publisher : Master Program of Health Promotion Faculty of Public Health Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jpki.21.1.35-47

Abstract

Background: More than half of adolescents in low- and middle-income countries feel unprepared for menarche due to a lack of menstrual knowledge, which leads to poor menstrual hygiene practices that increase reproductive health risks. This problem worsens in boarding schools, where restrictions like bans on mobile phones, limited contact with parents, and the absence of formal health programs severely limit access to accurate menstrual health information. Peer education leverages adolescents' natural dependence on peers for sensitive issues and is especially vital in environments with limited information, such as boarding schools. This study aimed to evaluate the effectiveness of peer education in enhancing Menstrual Hygiene Management (MHM) knowledge and attitudes among female students in a boarding school and to explore their experiences with this intervention.Method: An explanatory sequential mixed-methods design was employed. The quantitative phase involved a One Group Pre-test Post-test design with 31 purposively selected students to assess changes in knowledge and attitude following the peer education intervention. Five trained peer educators conducted 120-minute sessions using standardized modules. Quantitative data were analyzed using paired t-tests and N-gain scores. The qualitative phase adopted a phenomenological approach with in-depth interviews involving six primary informants (students) and five supporting informants (peer educators) to explore the intervention experiences and the mechanisms behind observed changes. Qualitative data were analyzed thematically with source triangulation to enhance credibility.Result: Mean knowledge scores increased significantly from 30.10 to 72.04 (p<0.001, N-gain=0.612, moderate effectiveness), with the largest improvement in pad disposal knowledge (90.3 percentage points). Mean attitude scores rose from 54.41 to 80.72 (p<0.001, N-gain=0.586, moderate effectiveness). Qualitative findings showed that students gained evidence-based knowledge, corrected menstrual myths, and expressed readiness to adopt proper hygiene practices. However, deeply rooted cultural beliefs remained resistant after a single session. The findings confirmed that knowledge improvements do not automatically lead to uniform behavioral change. Boarding schools should implement multiple-session peer education programs with spaced repetition, invest in peer educator training, establish student-led health clubs, and incorporate a formal MHM curriculum before menarche. 
Co-Authors Abdur Rahman Adang Bachtiar Ade, Frihapma Semita Adrial Adrial, Adrial Afrilda, Fauziah Afriwardi Afriwardi Aisyah Herviana Rifka Amatul Firdausa Nasa Amel Yanis Andhita Nurul Khasanah Anggreiny, Nila angraini, fitri Asri, Ennesta Berliana, Besty Cikita Aidha Putri Dasman, Hardisman Defrin, Defrin Delmi Sulastri Desi Kurniati Destia Fachri Dinda Rutri Ayang Bestari MP Diny Amenike Dwi Puspasari Dwi Puspasari Egha Febrianingsih Eryandra, Alvin Fadila, Zurayya Farah Aulia, Farah Faulina Adma Fauziah Afrilda Fitri Angraini Fitri Angraini Fitri Angraini Fitri Angraini Fitri Angraini Fitri Angraini Fitria Rahmi Gita Sri Ramadhani Hany Lutfia Hardisman Hasanah, Afifah Nur Hasmiwati Haznaz Dhiya Ulhaq Z.N. Hindun Mila Hudzaifah Hudila Rifa Karmia Husna Yetti Istazro Rozyid Yurisman Izzanil Hidayati Kuwardani Susari Putri lala septiyani sembiring, lala septiyani Liliyana Sari Lubis, Basyariah M. Yasep Setiawan Mafaza Mafaza Mafaza, Mafaza Meri Susanti Mizawati, Afrina Mona, Deli Nabilah Dina Humaidah Nelia Afriyeni Nezha Hanifah Nila Anggreiny Nila Kasuma Nisa Indah Pertiwi Nur Afrainin Syah Nur Indrawaty Lipoeto Nurhalimah Juneldi Nurmina Nurmina, Nurmina Nursyirwan Effendi, Nursyirwan Nurul Afifah Puti Dewi Sartika putri, Joana Rahma Rahayu, Ana Latifa Sri Raisa Karima Rani Armalita Rania Putri Shaliha Rizal Kurniawan Rizanda Machmud Rosfita Rasyid Sartana Sartana, Sartana Septi Mayang Sari Septi Mayang Sarry Siska Oktari Syamel Muhammad Syarifah Aini Sylvia Dewiriza Tiffany Atia Aristi Tri Rahayuningsih Tri Rahayuningsih Trisnanda Marintan Tryanda Millenia Ulfa Farrah Lisa, Ulfa Farrah Ulfah Ramadhia Utami, Rahayu Hardianti Vaulline Basyir Weno Pratama Widya Utami Nasution Yantri Mapitra Yantri Maputra Yantri Miaputra Yoszya Silawati Yoszya Silawati Yulistini, Yulistini Yusrawati Yusrawati Zia, Hanim Khalida