Effectiveness of Peer Education Using a Novel-Styled Book to Improve Post-Menarche Adolescents’ Menstrual Knowledge and Anxiety

Abstract

Specific publications on interventions for anxiety in post-menarche adolescents are still very rare in Indonesia. This study aimed to explore the effectiveness of peer education using a novel-styled book intervention, not only on anxiety but also on menstrual knowledge in post-menarche adolescents. This quantitative study one group pre- and post-test pre-experimental design involved a population of 376 female students of SMP (Junior High School) Negeri 1 Rancaekek who had experienced menarche in the period of June–July 2017. Of the total population, 40 students were selected as sample using the proportionate stratified random sampling method. The content and design of the novel-styled book were initiated based on results of an action research using in-depth interviews and focus group discussion, respectively. Intervention was delivered twice within 1 week. A menstrual knowledge questionnaire was designed based on the results of the in-depth interviews (Cronbach’s alpha: 0.807), while the anxiety was measured using Taylor Manifest Anxiety Scale (0.708). Data were then analyzed using Wilcoxon signed-rank test with effect size (ES) calculation. Improvement in the scores was seen for both menstrual knowledge and anxiety after intervention. The median score for menstrual knowledge increased from 60 (range: 35–80) to 90 (65–100), and the median score for anxiety decreased from 46.43 (35.71–85.71) to 32.14 (14.29–71.43), with a p-value of 0.000 (p < 0.05) for both. The intervention effect was found to be large (ES ≥ 0.5), which was reflected in increased menstrual knowledge (0.873) and decreased anxiety (0.830). Peer education using a novel-styled book is effective for improving menstrual knowledge and anxiety in post-menarche adolescents.