<![CDATA[Background: Inadequate Menstrual Hygiene Management (MHM) among adolescents, driven by cultural stigma and limited access to accurate information, increases the risk of reproductive tract infections and social challenges, such as school absenteeism, in urban settings such as Semarang City, Indonesia. This study assessed changes in MHM knowledge and attitudes following a quiz card game intervention among 1,234 adolescents aged 9–15 years from 19 elementary and junior high schools.Methods: Using a pre-experimental, one-group, pretest–posttest design, structured questionnaires were administered before and after the intervention. The 30-minute quiz card game sessions, facilitated by trained educators, incorporated visual aids to address menstrual hygiene management (MHM) practices and cultural misconceptions.Results: The Wilcoxon Signed-Rank Test showed significant improvements in knowledge (Z = -14.874, p < 0.001; mean: 5.08 to 6.67) and attitudes (Z = -12.851, p < 0.001; mean: 29.41 to 31.64), with 63% of respondents (777 individuals) demonstrating increased knowledge scores, including 336 with initially poor knowledge.Conclusion: These findings highlight the effectiveness of quiz card games in engaging adolescents and reducing stigma. Integrating such interactive, culturally sensitive tools into school curricula can promote healthy menstrual practices, reduce health risks, and empower Semarang adolescents to adopt safe and dignified hygiene behaviors early on.]]>
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