<![CDATA[Background: Adolescents are vulnerable to reproductive and sexual health problems due to biological, psychological, and social changes. WHO data show that around 16 million girls aged 15–19 give birth annually, mostly in developing countries. The SDKI reported that 33–34% of adolescents begin dating before age 15, and 5.6% have engaged in premarital sex, including 4.5% males and 0.7% females. This study aimed to determine the effect of reproductive and sexual health education using a proactive cognitive approach on preconception knowledge among adolescent girls. Methods: A quantitative pre-experimental study with a one-group pretest-posttest design was conducted at SMAN 2 Tebo, Jambi, from February to March 2025. The population consisted of 171 female students in Year 12, with 62 respondents selected using stratified random sampling based on Lemeshow’s formula. Data were collected using a validated questionnaire and analyzed using the Wilcoxon signed-rank test due to non-normal distribution. Results: The mean pretest knowledge score was 22.84, increasing to 30.92 in the posttest. Bivariate analysis showed a significant effect (p = 0.000; p < 0.05). Conclusion: Reproductive and sexual health education using a proactive cognitive approach significantly improves preconception knowledge among adolescent girls. This study suggests integrating reproductive and sexual health education into school curricula to enhance adolescents’ knowledge.]]>
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