Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
Vol
.
4,
N
o
.
4
,
D
ecem
b
er 20
1
5
, pp
. 32
6~
33
1
I
S
SN
: 225
2-8
8
0
6
3
26
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Knowl
e
d
g
e and B
e
haviou
r about
Adoles
cen
t Reproductive
Health i
n
Yogyakart
a
, Indonesi
a
Solikh
a
h,
Sitti Nur
d
jann
ah
Faculty
of Public Health
, Univ
er
sitas Ahmad Dahlan, Yog
y
akar
ta, Indon
esia
Article Info
A
B
STRAC
T
Article histo
r
y:
Received Sept 25, 2015
Rev
i
sed
O
c
t 26
, 20
15
Accepted Nov 25, 2015
Lack of knowledge about repro
ductiv
e
health in adolescent, m
a
king teens
easily
inf
l
uen
ced
b
y
misinformation and
harmful to their rep
r
oductive health
.
Health edu
catio
n play
s an impo
rtant
role in incr
easing their knowledge and
behaviour
of
y
o
ung people in o
r
der to
maintain
good reprodu
ctive health.
The purpos
e of the res
ear
ch was
to s
ee the im
pac
t
of health edu
c
a
tion on the
knowledge and
behaviour of
ad
olescen
ts
in repr
oductiv
e health.
Paired t test
analy
s
is results
indicate th
at co
uns
elling on reproductiv
e health effect on
both knowledge
about rep
r
oductive health
(mean
differen
c
e: 10.2
16, 95% CI:
6.622 to 13.809)
and at
titud
e
abo
u
t reproductive
heal
th in ado
l
escents (m
ean
differen
c
e: 65.4
17, 95% CI: 11,176 to
61.690). Knowledge of adolescents
about reprodu
ctive health would
be be
neficial
in preparing the y
o
ung
people
in good reprodu
ctiv
e health issues so
expect teenagers do not conflict with
the norms prev
ailing in
th
e
community
.
Keyword:
Adolesce
nt
Kn
o
w
l
e
d
g
e a
n
d
beha
vi
o
u
r
R
e
pr
od
uct
i
v
e
h
eal
t
h
Copyright ©
201
5 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
So
likh
a
h,
Facu
lty of Public Health
,
Uni
v
ersitas A
h
m
a
d
Da
hlan,
Jl
. Pr
of
S
o
e
p
o
m
o, Jant
ura
n
,
War
u
ng
b
o
t
o
,
Yo
gy
aka
r
t
a
,
In
do
nesi
a.
Em
a
il: so
lik
h
a
h
_
m
an
is@yaho
o
.co
m
1.
INTRODUCTION
The
Wo
rl
d H
eal
t
h
Or
gani
za
t
i
on (
W
H
O
)
i
s
est
i
m
a
t
e
d 1.3 m
i
l
l
i
on adol
escent
s
di
e
d
i
n
2
0
1
2
a
n
d
m
o
st
ly
i
t
m
a
y
be
pre
v
e
n
t
e
d
o
r
t
r
eat
ed
.
On
t
h
e ot
he
r
ha
nd
, t
h
e m
a
in cause
of
adolescent
deaths is ca
use
d
HIV,
suicide, l
o
we
r respi
r
atory i
n
fections
, and i
n
terpers
o
nal violence [1]. T
h
e pre
gna
ncy
i
s
t
h
e m
o
st
com
m
o
n
pr
o
b
l
e
m
of w
o
rl
dwi
d
e i
n
2
0
1
5
a
n
d t
h
e
r
e
i
s
f
o
u
n
d
m
o
st
l
y
bot
h l
o
w
i
n
com
e
cou
n
t
r
i
e
s an
d m
i
ddl
e i
n
com
e
co
un
tries. Th
ere h
a
s esti
m
a
te
d
4
m
i
llio
n
g
i
rls ag
ed
15
to
19
and
1
m
i
llio
n
g
i
rls und
er 15
years o
l
d
g
i
ve b
i
rt
h
ev
er
y year. Even
thou
gh
, some 3
m
i
llio
n
gir
l
s ag
ed
1
5
to 19
w
e
n
t
un
d
e
r
un
saf
e
ab
or
tio
n
s
annu
ally.
Sev
e
r
a
l
st
udi
es ar
e re
p
r
esent
e
d ba
bi
e
s
bo
r
n
an
d wi
t
h
ad
ol
esce
nt
m
o
t
h
e
r
s ha
d t
h
e
hi
g
h
er
ri
sk c
o
m
p
li
cat
i
on t
h
a
n
t
h
ose
bo
r
n
wi
t
h
wom
e
n a
g
ed
2
0
t
o
2
4
[2]
-
[
4]
.
Adolesce
nce is a transitional peri
od
betwee
n childho
od a
n
d adulthood
who ha
ve desi
re to accent
u
ate
h
i
s id
en
tity to
search for id
entity. Th
e
p
r
e-ad
u
lt tran
sitio
n
p
e
ri
o
d
m
a
k
e
s ad
o
l
escen
t
s are
p
a
rticu
l
arly p
r
o
n
e
t
o
ri
sky
be
ha
vi
o
u
r
suc
h
as f
r
ee s
e
x, m
a
ri
jua
n
a use,
ju
ve
ni
l
e
d
e
l
i
nque
ncy
,
s
u
ch as d
r
i
n
ki
n
g
al
coh
o
l
,
an
d s
m
oki
ng
[5
],[6
]. Th
is is
d
u
e
to
cl
o
s
ely related
wit
h
the in
flu
e
n
ce
of
p
eers in
term
s o
f
i
n
terests, attitu
d
e
, app
earance and
beha
vi
o
u
r
[
7
]
,
[
8
]
.
Whi
l
e
t
h
e
m
a
t
u
ri
t
y
of t
h
e
re
pr
od
uct
i
v
e
or
ga
ns a
n
d
ad
ol
escent
psy
c
h
o
l
o
gi
cal
de
vel
opm
ent
.
The infl
ue
nce
of electronic inform
ati
o
n
such
as telev
i
sion
and
th
e in
tern
et is also a great effect on the
attitu
d
e
s and
beh
a
v
i
o
u
r
o
f
ado
l
escen
ts, in
cl
u
d
i
n
g
in
t
h
e case of sexu
al p
e
rv
ersion
[9
].
Lack
of
k
n
o
w
l
edge a
b
out
t
h
e f
u
nct
i
o
n a
n
d
st
r
u
ct
ure
o
f
ad
ol
esce
nt
r
e
pr
o
duct
i
v
e
o
r
gan
s
m
a
ke
teen
ag
ers easil
y in
flu
e
n
c
ed
by in
fo
rm
atio
n
th
at is un
tru
e
an
d harm
fu
l to
reprodu
ctiv
e h
ealth.
Knowled
g
e
ab
ou
t th
e
fun
c
t
i
o
n
an
d
st
ru
ct
ure will affect rep
r
od
u
c
tio
n
in treatin
g
ad
o
l
escen
t rep
r
od
u
c
tiv
e o
r
g
a
n
s
th
at will
affect
their reproductive health [10].
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
K
now
l
e
d
g
e
a
n
d
Be
h
a
vi
o
u
r A
b
o
u
t
A
d
ol
scent
Repr
o
duct
i
ve
Heal
t
h
i
n
Yo
gy
aka
r
t
a
,
I
n
d
o
n
e
s
i
a
(
S
ol
i
k
ha
h)
32
7
BK
K
B
N
(
T
h
e
su
rv
ey r
e
su
lts o
f
Th
e N
a
tio
nal
Fam
i
ly
Plan
n
i
ng
C
o
ord
i
n
a
t
i
o
n
Bo
ar
d)
r
e
po
r
t
ed
2
880
respon
d
e
n
t
s aged
1
5
-24
years in
six
cities in
West Jav
a
(May 2
002
) i
n
d
i
cat
ed
th
at
3
9
,6
5
%
o
f
respo
n
d
e
n
t
s h
a
d
prem
ari
t
a
l
sex [1
1]
. B
K
KB
N
sur
v
ey
res
u
l
t
s
of
20
1
0
, ar
o
u
nd 51% of teena
g
ers i
n
the area
of Ja
bodetabe
k wa
s
not
a vi
r
g
i
n
. A
t
o
t
a
l
of 4% of
resp
on
de
nt
s w
ho a
d
m
i
t
t
e
d t
o
havi
n
g
sex
u
al
i
n
t
e
rcou
rse si
nce t
h
e age o
f
16
-
1
8
years, 16% do at age 13-15 years.
The i
n
ci
dence o
f
p
r
e
m
ari
t
a
l
sex i
n
Sura
bay
a
rea
c
hed
47%
, w
h
i
l
e
in
B
a
nd
u
ng a
nd
M
e
dan
52
%.
Free se
x be
ha
vi
o
u
r am
on
g t
eenage
r
s
have
an i
m
pact
on cases of i
n
fe
ct
i
on
o
f
HIV/AIDS tha
t
tend to
de
velop i
n
Indonesi
a, while the
fa
vourite place for se
xual intercourse is at
home as
m
u
ch as 40%,
in the
boarding hous
e
30%
, a
n
d i
n
t
h
e
h
o
t
e
l
s
30
% [
1
2]
.
Meanwhile,
t
h
e data from
PIL
A
R (the
survey
r
e
su
lts Cen
t
er
fo
r In
fo
r
m
atio
n
an
d Ser
v
ices
Ad
ol
esce
nt
s and P
K
B
I
(
I
n
d
one
si
an Fam
i
ly
Pl
anni
n
g
As
soci
at
i
o
n
)
i
n
C
e
nt
ral
Java a
b
o
u
t
prem
ari
t
a
l
sexual
beha
vi
o
u
r
i
n
t
h
e st
ude
nt
s i
n
S
e
m
a
rang i
n
Se
pt
em
ber 20
0
2
agai
nst
10
0
0
re
spo
n
d
e
n
t
s
i
.
e.
50
0 r
e
sp
o
nde
nt
s fr
om
v
a
ri
o
u
s
co
lleg
e
s in
Se
m
a
ran
g
rev
ealed
th
at activ
ities p
e
rformed
wh
ile co
urtin
g
n
o
t
ju
st ch
attin
g
,
h
ugg
ing
and
ki
ssi
n
g
t
h
e l
i
p
s
but
ha
d f
u
rt
he
red i
.
e.
d
o
pet
t
i
ng
25%
, eve
n
7.
6% o
f
t
h
em
have m
a
de sex
u
al
i
n
t
e
rc
ou
rse
[1
3]
.
The
dat
a
f
r
o
m
PKB
I
i
n
Pal
e
m
b
an
g,
K
u
pan
g
,
Tasi
k M
a
l
a
y
a
,
C
i
reb
o
n
,
Si
ng
kawa
n
g
20
0
5
m
e
nt
i
oned
t
h
at
9.
1
%
of
t
eena
g
ers
h
a
ve se
x
an
d
8
5
%
o
f
t
h
em
doi
ng
t
h
ei
r
fi
rs
t sex
u
a
l
in
tercou
rse at th
e ag
e of
1
3
-
15 year
s i
n
their
h
o
m
e w
ith
a
g
i
r
l
fr
iend
[14
]
. An
o
t
h
e
r study f
oun
d 42
.3% of
st
u
d
e
n
t
s of
Ju
n
i
o
r
H
i
gh
an
d H
i
g
h
Sch
o
o
l
in
C
i
anj
u
r ha
d se
xual
i
n
t
e
rc
o
u
rs
e. Acco
r
d
i
n
g t
o
t
h
ei
r co
nfe
s
s
i
ons
, sex was
per
f
o
r
m
e
d con
s
ens
u
al
, an
d som
e
h
a
v
e
m
u
ltip
le p
a
rt
n
e
rs and
on
ly 9
%
economic reaso
n
s [15
]
.
Knowledg
e is p
o
wer factor fo
r th
e o
c
curren
ce o
f
a
ch
ange in
atti
tu
d
e
. Kn
owledg
e and
attitu
d
e
will
b
e
a co
rn
erst
on
e toward
th
e
estab
lish
m
en
t o
f
m
o
ral teen
so
th
at
with
in
an
id
eally th
ere is h
a
rm
o
n
y
between
k
now
ledg
e and
attitu
d
e
s, where attitu
d
e
s are form
ed
after a p
r
o
cess know
n
b
e
forehand. A
st
u
d
y
in Nig
e
ria
en
titled
k
nowled
g
e
abo
u
t
teen
pregn
a
n
c
y, teen
sexu
ality
an
d
co
n
t
racep
tio
n
g
e
ts resu
lts th
at al
mo
st the
en
tirety o
f
th
e teen
ag
er
who research
ed
(85
%
)
h
a
d
a
n
e
g
a
tiv
e attitu
d
e
ab
ou
t repro
ductiv
e h
ealth
. Lack
of
kn
o
w
l
e
d
g
e ab
out
re
p
r
o
d
u
ct
i
v
e heal
t
h
, ad
ol
escent
p
r
eg
na
n
c
y
and c
ont
r
a
c
e
pt
i
on ca
use
d
num
ero
u
s p
r
e
g
nancy
o
ccur
r
i
n
g
in
teen
ag
er
[1
6
]
.
A
stud
y co
nducted
in
20
06
co
n
c
l
u
d
e
d
t
h
at th
e lack of
k
now
ledg
e an
d guid
a
n
ce
on
re
pr
o
duct
i
v
e heal
t
h
f
o
r
a
dol
esce
nt
s
has
cause
d
u
n
wa
nt
ed
p
r
eg
na
nc
y
72
,9
%,
9
4
.
8
% o
f
un
safe a
b
o
r
t
i
o
n,
5
.
2
%
of abo
r
tio
n
s
in
facilitie
s o
r
h
ealth
work
ers, 32
.2
% o
f
sex
u
a
lly tran
smit
ted
d
i
seases (STDs), 54
.3% were
in
f
ected
w
ith
H
I
V
and
AI
DS th
an
200
thou
san
d
p
e
op
le in
In
don
esia, as w
e
ll as d
r
ug u
s
e 78
.8
% of
th
e 3
.
2
m
i
ll
i
on d
r
ug
us
ers i
n
I
n
do
nesi
a [
17]
.
In a
d
di
t
i
on,
a s
t
udy
al
so
sh
o
w
ed t
h
at
t
h
e
r
e a
r
e t
h
ree
vari
a
b
l
e
s rel
a
t
e
d t
o
p
r
em
ari
t
a
l
sexual
be
havi
ou
r
of st
u
d
e
n
t
s
, na
m
e
l
y
t
h
e st
at
us of resi
de
nce (
p
= 0,
04
0)
, ex
pos
u
r
e t
o
p
o
r
n
og
ra
phy
(
p
= 0
,
0
1
9
)
, an
d t
h
e
rol
e
o
f
peers
(
p
=
0.
00
1)
[
18]
,
[
1
9
]
.
A
st
u
d
y
i
n
hi
gh
sch
ool
i
ndi
cat
e
d
t
h
at
st
u
d
e
n
t
s
were
l
e
ss c
o
r
r
e
c
t
i
n
descri
bi
n
g
t
h
e
mean
in
g
of sex
u
a
lity. Ado
l
escen
ts tend to
u
n
d
e
rstand
th
at sexu
ality is sex
u
a
l i
n
terco
u
rse b
e
t
w
een m
e
n
an
d
wom
e
n. S
o
m
e
t
eenage
sex
u
al
be
havi
ou
r c
o
n
duct
e
d am
on
g
t
h
em
hol
di
n
g
han
d
s
,
hu
gs,
k
i
sses o
n
t
h
e c
h
eeks,
k
i
ssing
lip
s, h
i
ck
ey, ev
en
"g
rep
e
" (oral sex). Th
e lack
o
f
i
n
fo
rm
atio
n
o
n
sex
u
a
lity an
d rep
r
od
u
c
tiv
e
h
ealth
am
ong
ad
ol
esc
e
nt
s
br
ou
g
h
t
t
h
e t
eens t
o
ri
s
k
y
be
havi
ou
r
[2
0
]
.
In add
itio
n,
research in cen
tral Jav
a
ind
i
cated
t
h
e
g
e
n
e
ral
pattern
s
o
f
risk
s to
sexu
al an
d rep
r
od
u
c
tiv
e
h
ealth
of ado
l
escen
ts is relativ
ely lo
w co
m
p
ared
with
o
t
h
e
r co
un
tries.
It was p
a
rtly related
to
th
e ch
aracter o
f
cu
ltu
re in
cen
t
ral Jav
a
were
p
o
s
itiv
e and
co
nfid
en
ce. Con
f
i
d
en
ce is th
e m
o
st p
o
werful factor
o
f
i
n
fl
u
e
n
ce
on
ad
o
l
escen
t
sexu
al b
e
h
a
v
i
our [2
1
]
. Based
o
n
t
h
is, ado
l
escen
t
s
o
r
stud
en
ts sh
ou
ld
b
e
g
i
v
e
n a p
o
s
itiv
e acti
v
ity to
avoi
d t
h
e
dev
i
ant
be
ha
vi
o
u
r
.
It
i
s
rec
o
m
m
e
nded
t
o
t
h
e sch
o
o
l
t
o
c
o
n
d
u
ct
rel
i
g
i
o
us l
ect
u
r
es
rel
a
t
e
d t
o
reprodu
ctiv
e
health
p
e
riod
ically an
d
im
p
r
ove relig
iou
s
and
ex
tracu
r
ricu
lar
activ
ities.
Ado
l
escen
t
rep
r
od
u
c
tiv
e
h
e
alth
co
nd
itio
ns are v
e
ry im
p
o
r
tan
t
to
en
courag
e th
e Ind
o
n
e
sian
go
ve
rnm
e
nt
est
a
bl
i
s
h ad
ol
esc
e
nt
rep
r
od
uct
i
v
e heal
t
h
i
n
f
o
r
m
at
i
on cent
r
e
(PI
K
-R
) i
n
t
o
a
nat
i
onal
p
r
og
r
a
m
i
n
2
000
.
In add
itio
n, th
e scop
e
b
r
o
a
d
Pu
sk
esmas, i.e 30
000 in
h
a
b
itan
t
s
d
u
ty to
en
su
re t
h
e h
ealth
stat
u
s
o
f
th
e
lo
cal co
mm
u
n
i
ty are in
th
e o
p
ti
m
a
l lev
e
l. W
i
rob
r
aj
an
sub
-
d
i
strict was in
o
n
e
of th
e m
a
j
o
r cities in
In
don
esia,
Yo
gy
aka
r
t
a
. T
h
e
num
ber
of
t
eenage
r
s i
n
t
h
e
W
i
r
o
b
r
a
j
an
ar
ou
n
d
42
3
7
peo
p
l
e
, a
n
d
pe
rce
n
t
a
ge
o
f
ad
ol
e
s
cent
s
i
n
sc
ho
ol
a
p
p
r
oxi
m
a
t
e
l
y
99.0
7
% a
n
d a
p
p
r
o
x
i
m
a
t
e
ly
0.9
3
%
di
d
n
o
t
at
t
e
n
d
s
c
ho
ol
.
2.
R
E
SEARC
H M
ETHOD
The type of res
earch
was quas
i experim
e
nt. The po
p
u
l
ation in
th
is stu
d
y
was all ad
o
l
escen
t
s ag
ed
9-
18 years in the W
i
robra
j
a
n
sub
dist
rict. Sam
p
ling techni
que use
d
accide
ntal sa
m
p
ling and
obtaine
d a
large
sam
p
l
e
of
37
adol
esce
nt
s.
T
o
see
t
h
e
i
n
fl
u
e
nce
of
co
u
n
s
e
l
l
i
ng a
b
o
u
t
re
pr
o
duct
i
v
e
hea
l
t
h
ad
ol
escent
s
t
h
en
teenage
r
were
given a ques
tionnai
r
e before and a
f
ter the counselling about re
productive health. Tim
e
m
easurem
ent
of t
h
e e
ffect
of
educat
i
o
n
o
n
r
e
pr
o
duct
i
v
e
he
al
t
h
, i
s
cal
cul
a
t
e
d aft
e
r a t
w
o-
m
ont
h ext
e
nsi
on
w
a
s
g
i
v
e
n
.
Variab
les research
were th
e
k
nowledg
e and
a
ttitu
d
e
o
f
ad
o
l
escen
t
s o
n
repro
d
u
c
tiv
e h
ealth. After th
e
data is c
o
llected, t
h
en analyse
d
by pai
r
ed
t
t
e
st
usi
n
g
St
at
a s
o
ft
ware
ve
rsi
o
n
13
.1
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJPHS Vol. 4, No. 4, D
ecem
ber 2015
:
326 – 331
32
8
3.
R
E
SU
LTS AN
D ANA
LY
SIS
W
i
robraja
n
is
one
of the
districts in the c
i
t
y
of Yo
gy
aka
r
t
a
, Y
o
g
y
a
kart
a Speci
al
R
e
gi
on
.
Geograph
i
cally th
e District
W
i
ro
braj
an
lo
cated
in
th
e
center of Yogyakarta precise
ly in
th
e no
rt
h
b
o
rd
ering
the District of Tegalrejo, ea
st by
three Districts of the District Gedo
ng
teng
en, D
i
str
i
ct Man
t
r
i
j
e
ro
n, an
d
Di
st
ri
ct
Ngam
pi
l
a
n, s
out
h b
y
Kasi
han B
a
nt
ul
, a
nd t
h
e
west
b
o
r
d
eri
n
g t
h
e t
w
o di
st
ri
ct
s nam
e
ly
Kasi
ha
n
B
a
nt
ul
Di
st
ri
c
t
and Tegal
r
e
j
o
.
The
num
ber of t
eena
g
e
r
s i
n
t
h
e
W
i
ro
bra
j
a
n
aro
u
n
d
42
37
peo
p
l
e
,
an
d
perce
n
t
a
ge
o
f
a
dol
esce
nt
s i
n
s
c
ho
ol
a
p
p
r
oxi
m
a
t
e
ly
99.
0
7
%
an
d a
p
p
r
oxi
m
a
t
e
l
y
0.9
3
%
di
d
not
at
t
e
n
d
sc
ho
ol
Besid
e
s h
a
v
i
ng p
o
t
en
tial as a
cen
tral po
in
t of cu
ltu
ral
arts
devel
opm
ent, in
W
i
robra
j
an
there we
re a
gr
o
up
o
f
ad
ol
e
s
cent
re
pr
o
d
u
c
t
i
v
e heal
t
h
ca
r
e
, nam
e
l
y
PI
K
R an
d Po
syandu
,
bu
t is no
t sup
por
ted
b
y
su
ff
icien
t
funding s
o
that
its activity shoul
d see
k
thei
r own i
nde
pe
ndently. Supervis
ion a
n
d
ove
rsi
ght
was still lacking,
whe
r
eas t
h
e
behavi
our
of teenage
r
s
with t
h
e m
a
ny adva
n
ces
o
f
informatio
n
tech
no
log
y
allo
ws ad
o
l
escen
ts
w
r
o
ng in
cho
o
sin
g
fr
iend
s.
W
r
on
g in
tak
i
n
g
d
ecisi
o
n
s t
h
at wou
l
d r
e
sult in
r
i
sk
y b
e
hav
i
ou
r
s
, su
ch
as sexu
al
beha
vi
o
u
r
bef
o
re
m
a
rri
age,
ea
rl
y
pre
g
nancy
,
abo
r
t
i
o
n, dri
n
k
i
ng,
an
d d
r
u
g
u
s
ers.
Table
1. T
h
e
c
h
aracteristics
of re
ponde
n
ts
Factor
N
Percentage
(%)
L
e
vel of education
a.
Junior
high sch
ool
b.
Senior
high school
18
19
48.
6
51.
4
Ag
e
M
ean : 16.
70; Stan
dar
d
Deviation : 3.936
Health inform
ation resources
a.
Print m
e
dia
b.
Electronic m
e
dia
c.
In
tern
et
d.
M
obile phone
e.
Health Extension Worker
f.
Teacher
g.
Fa
m
i
l
y
17
19
26
6
14
24
19
45.
9
51.
3
70.
2
16.
2
37.
8
64.
8
51.
3
I
n
form
ation is
ever obtained
a.
HIV
b.
Repr
oduction healt
h
c.
Contraception
d.
Dr
ugs
e.
Beauty
f.
Internal disease
3
20
3
5
3
3
8.
1
54.
1
8.
1
13.
5
8.
1
8.
1
Status of close fr
iends (
boy
fr
iend / or
gir
l
fr
iend)
a.
Yes
b.
No
28
9
75.
7
24.
3
Age when dating
a.
never
dating
b.
9 y
ear
s
old
c.
10 y
ear
s old
d.
11 y
ear
s old
e.
12 y
ear
s old
f.
13 y
ear
s old
g.
14 y
ear
s old
h.
15 y
ear
s old
i.
16 y
ear
s old
j.
17 y
ear
s old
k.
18 y
ear
s old
M
ean,
SD: 10,
70 + 6,
078
8
1
2
1
5
9
1
1
4
4
1
21.
6
2.
7
5.
4
2.
7
13.
5
24.
3
2.
7
2.
7
10.
8
10.
8
2.
7
Par
e
nt I
nvolvem
e
n
t
in Decision M
a
king to Have Fr
iends
Close
a.
Yes
b.
No
23
14
62.
2
37.
8
Repr
oductive Health Knowledge
a.
Bef
o
re Ed
u
catio
n
Me
an
, SD :
3
2
.
6
5
+ 1
6
.
2
9
5
b.
After
E
ducation
M
ean,
SD : 42.
86 + 17.
330
Reproductive Health Attitudes
a.
Attitude Before Treat
m
e
nt
Me
dian : 6.00,
m
a
x: 7
5
;
m
i
n: 28
b.
Attitude After T
r
e
a
t
m
ent
Me
dian : 72.00,
m
a
x:75,
m
i
n:28
Sou
r
ce: p
r
im
ar
y
d
a
ta, 2
015
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
K
now
l
e
d
g
e
a
n
d
Be
h
a
vi
o
u
r A
b
o
u
t
A
d
ol
scent
Repr
o
duct
i
ve
Heal
t
h
i
n
Yo
gy
aka
r
t
a
,
I
n
d
o
n
e
s
i
a
(
S
ol
i
k
ha
h)
32
9
Tab
l
e
2
.
Effect of co
un
seling
o
n
th
e lev
e
l
o
f
k
nowledg
e an
d attitu
d
e
s
F
actors
Bivari
ate an
al
y
s
i
s
of knowledg
e and at
titud
e
adolescent
n
M
ean
differen
ces
95% CI
PValu
e
Knowledge 37
10.216
6.622-13.809
.000
Attitude 37
65.417
11.176-61.690
.000
Sou
r
ce: p
r
im
ar
y
d
a
ta, 2
015
Th
e resu
lts on
Tab
l
e 2
sh
ow
s
th
at th
e av
erage ag
e o
f
th
e y
o
u
n
g
e
st teen
s
wh
o
fo
llow
counsellin
g
w
a
s
10
.7
0 y
e
a
r
s,
w
i
t
h
a st
an
da
rd
devi
at
i
o
n
of
6
.
07
8.
It
s
l
e
vel
o
f
e
ducat
i
o
n
wa
s hi
gh
sc
ho
ol
a
n
d
j
u
ni
o
r
hi
g
h
.
Fr
om
t
h
e resea
r
c
h
fi
ndi
ng
s can
al
s
o
be see
n
t
h
at
t
eenage
r
s m
o
st
oft
e
n g
o
t
i
n
f
o
r
m
at
i
on o
n
re
p
r
od
uct
i
v
e
heal
t
h
of t
h
e
electronic m
e
dia. Close frie
n
ds also
p
l
ayed
a
m
a
j
o
r
ro
le in p
r
o
v
i
d
i
ng
inform
at
io
n
abou
t reprodu
ctiv
e health,
as seen fr
om
the dat
a
cha
r
ac
t
e
ri
st
i
c
s of t
h
e sam
p
l
e
by
75%. The r
o
l
e
of
parent
s a
nd t
e
achers i
n
sc
ho
ol
was
very
im
port
a
nt
i
n
bri
d
gi
n
g
m
i
sconcept
i
o
n
s
abo
u
t
rep
r
o
d
u
ct
i
v
e heal
t
h
[
22]
. F
r
om
t
h
e
researc
h
dat
a
sho
w
e
d
t
h
e i
n
vol
vem
e
nt
o
f
pare
nt
s i
n
t
a
ki
ng
t
h
e
d
eci
si
on t
o
ha
v
e
a cl
ose
fri
e
n
d
or a
gi
rl
fri
e
n
d
.
T
h
e m
a
jor
i
t
y
of
pare
nt
s (
6
2
.
2%
) k
n
ew t
h
ei
r chi
l
d
re
n ha
ve a cl
ose fri
e
nd
or
boy
f
r
i
e
n
d
, a
n
d 3
7
.
8
% o
f
pa
r
e
nt
s di
d
not
k
n
o
w i
f
their c
h
ildre
n
h
a
ve a cl
ose
frie
n
d
o
r
b
o
y
frie
n
d.
Resu
lts of
p
a
ired
t-test analysis sh
owed th
at
ed
u
cation
ab
ou
t
reprod
u
c
tiv
e health effect
on
k
nowledg
e abou
t rep
r
o
d
u
c
tiv
e h
ealth
(m
ean
d
i
fferen
ce: 10
.2
16
,
95
% CI:
6
.
6
2
2
to
13
.8
09
) and
attitu
d
e
ab
ou
t
r
e
pr
odu
ctiv
e
health
in
ado
l
escen
ts (
m
ean
d
i
f
f
e
r
e
n
ce: 65
.4
17
,
95
% CI
:
1
1
,176
-61
.
69
0)
.
Kn
ow
ledg
e of
ad
o
l
escen
t
s abo
u
t
rep
r
od
u
c
ti
v
e
h
ealth
will b
e
b
e
n
e
ficial to
equ
i
p
you
ng p
e
op
le in
th
eir co
rrect in
fo
rmatio
n
ab
ou
t
reprodu
ctiv
e h
ealth, so
ex
p
ect teen
ag
ers
d
o
no
t
d
e
v
i
ate fro
m
th
e no
rm
s p
r
ev
ailin
g in
th
e co
mm
u
n
ity. A
stu
d
y
rev
ealed th
at a g
o
o
d
kn
owledg
e will su
pp
ort th
e realizatio
n
o
f
go
od
b
e
h
a
v
i
ou
r to
o
.
Th
e h
i
gher the
knowledge, the
m
o
re extensi
v
e unde
rstandi
ng a
nd
beha
vi
our of indi
viduals to what
it faces, so expect
ed the
in
d
i
v
i
d
u
a
l
was ab
le to
tak
e
a d
ecision
in
any actio
n
to
b
e
tak
e
n
[23
]
. Prov
id
es
k
nowledg
e abou
t th
e ph
ysical
ch
ang
e
s, p
s
ych
o
l
o
g
i
cal an
d
sexu
al m
a
tu
rity will allo
w
teen
ag
ers to
un
derstand
and
o
v
erco
m
e
th
e p
u
zzling
circu
m
stan
ces. Th
e h
i
g
h
e
r t
h
e
k
nowledg
e abo
u
t
rep
r
odu
ctiv
e
h
ealth
,
th
e m
o
re po
si
tiv
e attitu
d
e
t
o
ward
s
han
d
l
i
n
g wel
l
[
24]
.
A t
r
ue
un
der
s
t
a
ndi
ng
o
f
t
h
e
f
unct
i
o
n
of
re
pr
od
uct
i
v
e
or
ga
n
s
b
o
t
h
i
n
y
o
u
n
g
m
e
n and
w
o
m
e
n was
ver
y
im
port
a
nt
.
Fo
r
wom
e
n, a t
r
ue
un
de
rst
a
n
d
i
n
g
of t
h
ei
r re
p
r
o
d
u
ct
i
v
e
or
gan
s
a
nd
f
unct
i
o
ns ca
n hel
p
i
d
e
n
t
i
f
y
t
h
ei
r
reproductive c
y
cle such a
s
menstr
uat
i
o
n
and
so
o
n
.
B
y
reco
gni
zi
ng
th
e r
e
pr
odu
ctiv
e or
gan
s
and
th
ei
r
fu
nct
i
o
ns,
w
o
m
e
n can
rec
o
gni
ze,
e
v
en
a
voi
di
n
g
rep
r
o
duct
i
v
e
di
seas
es o
r
di
seases
t
h
at
were t
r
a
n
sm
i
t
t
e
d
th
ro
ugh
sexu
al
in
tercou
rse as
an
STD (sexu
a
lly tran
s
m
i
t
t
e
d
di
sease)
,
an
d
e
v
en HI
V or AI
DS. Fo
r
m
e
n,
kn
o
w
th
eir reprodu
ct
iv
e o
r
g
a
ns o
r
partn
e
r
will b
e
a
b
le to
g
r
o
w
a tru
e
und
erstan
din
g
of
th
e repro
d
u
c
tiv
e organs and
fu
nct
i
o
ns
of
t
h
em
sel
v
es an
d t
h
ei
r
pa
rt
ner
s
.
M
o
re
ove
r,
he
m
a
y
keep a
w
a
y
fr
om
di
seases cause
d
by
di
sor
d
e
r
s
of
re
pr
o
duct
i
v
e
heal
t
h
[
10]
.
R
e
pr
od
uct
i
v
e
heal
t
h
di
s
o
r
d
e
r
s i
n
ad
ol
escen
ce can occ
u
r
f
r
om
t
h
e conse
que
nces
of
de
vi
ant
sex
u
al
b
e
h
a
v
i
our [1
9
]
. Th
e ex
am
p
l
es are: un
wan
t
ed
pregn
a
n
c
y
or sexu
ally transmitted
d
i
seases, in
fertility o
r
rap
e
.
Fo
r teen
ag
e boys, th
e b
i
g
g
e
st
risk
w
a
s expo
sed
t
o
a se
xu
ally tran
sm
itted
disease (STD) t
h
at
w
a
s
go
no
rrh
o
e
a,
wh
ich
is it
g
e
ts spread to
t
h
e t
e
sticles will cau
se sterility in
men
,
HIV
o
r
AIDS.
M
o
re
ove
r, d
u
e
t
o
t
h
e i
n
fl
uen
ce of m
e
nst
r
uat
i
on, t
h
e ad
ol
e
s
cent
gi
rl
s we
r
e
oft
e
n ex
p
o
se
d t
o
anem
i
a
whi
c
h w
oul
d i
n
t
e
rfe
re wi
t
h
t
h
ei
r re
pr
o
duct
i
ve heal
t
h
.
Reprodu
ctiv
e d
i
sord
ers in
t
eena
g
e years are gre
a
ter if
she
was m
a
rri
ed a
nd
p
r
eg
na
nt
i
n
t
eena
g
e y
e
a
r
s. Tee
n
a
g
e
wa
s t
h
e a
g
e
of
ra
pi
d
gr
o
w
t
h
t
h
a
t
req
u
i
r
es e
n
or
m
ous
en
erg
y
. If sh
e
is p
r
eg
n
a
n
t
, the seizu
r
e
will o
ccur
b
e
twee
n th
e bo
d
y
an
d
th
e fo
etu
s
[25
]
. As a
resu
lt,
o
n
e
or
b
o
t
h
lo
se. If th
e fo
etu
s
were lo
st, th
en
th
e b
a
b
y
will b
e
b
o
rn
prem
atu
r
ely, if th
e m
o
t
h
er l
o
ses,
h
e
will b
e
m
a
l
nou
ri
she
d
a
n
d
p
r
one
t
o
bl
e
e
di
n
g
du
ri
n
g
c
h
i
l
dbi
rt
h
[1
0]
.
Attitu
d
e
abou
t ad
o
l
escen
t
rep
r
od
u
c
tiv
e
h
e
alth
was v
e
ry im
p
o
r
tan
t
in
o
r
d
e
r to
h
a
v
e
a
respon
sib
l
e
beha
vi
o
u
r
. A
st
udy
f
r
om
Iri
ani
[2
6]
sh
o
w
ed w
h
i
c
h
o
b
t
a
i
n
ed t
h
e
val
u
e
t
= 3.6
61 a
n
d
p = 0.
0
0
0
,
p
<0.
0
5
,
m
eaning that there
was a signifi
cant di
ffe
re
nce of attitudes toward prem
arital sex am
ong a
dolesce
nts
who
w
e
re edu
cated
an
d d
i
d
n
o
t
g
i
v
e
n h
ealth educatio
n
o
n
ado
l
escen
t reproductiv
e. A
ttitud
e
is en
clo
s
ed
resp
on
se
to
th
e stim
u
l
u
s
or obj
ect,
o
f
a p
e
rson
, th
e attitu
d
e
can be reg
a
rd
ed as
a syn
d
ro
m
e
o
r
set o
f
sym
p
to
m
s
in
resp
o
n
se t
o
a
st
im
ul
us or
o
b
ject
,
w
h
i
c
h
i
n
v
o
l
v
e
s
t
h
e t
h
ou
g
h
t
s
,
feel
i
n
gs, c
o
ncer
ns,
and
ot
her
psy
c
hi
at
ri
c
sy
m
p
to
m
s
. Teen
s
with
a goo
d
attitu
d
e
were
m
o
re lik
ely to
ach
iev
e
or
g
ood
b
e
h
a
v
i
our.
The i
n
creasi
n
g
sex
u
al
a
n
d
re
pr
o
duct
i
v
e
be
h
a
vi
o
u
r
am
ong
adol
esce
nt
s l
e
a
d
i
n
c
r
easi
ngl
y
vul
nera
bl
e
adol
esce
nt
s ar
e exp
o
se
d t
o
a wi
de ra
nge
of re
p
r
o
d
u
ct
i
v
e heal
t
h
pr
o
b
l
e
m
s
. They
ne
ed t
o
get
t
h
e
ri
ght
i
n
f
o
rm
at
i
on ab
out
t
h
e re
p
r
o
d
u
ct
i
v
e p
r
oce
s
s
and t
h
e
vari
ous factors that
influe
nce
i
t
.
The m
o
st
appr
op
ri
at
e
pers
o
n
t
o
a
n
s
w
er t
h
e c
u
ri
os
i
t
y
of adol
esce
nt
s o
n
re
pr
oduction are t
h
e people closes
t to
th
em
, th
at is
th
ei
r
p
a
ren
t
s and
teach
er. Paren
t
s were th
e
p
e
op
le wh
o
sho
u
l
d
b
e
m
o
st familiar with
th
eir ch
ild
ren
,
what th
eir
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
IJPHS Vol. 4, No. 4, D
ecem
ber 2015
:
326 – 331
33
0
n
eeds and
how to
fu
lfil it. Paren
t
s were i
n
stru
m
e
n
t
al in
cau
sing
po
sitiv
e v
a
l
u
es reg
a
rd
i
n
g
their sexu
al life,
suc
h
as t
h
e
dan
g
er
o
f
S
T
Ds
an
d
HI
V /
AI
DS
,
sex a
n
d
pre
gna
ncy
y
o
u
n
g
a
g
e
[9]
,
[2
7]
.
Sev
e
ral stud
ies rep
r
esen
ted
th
at edu
cation bo
th
o
f
know
ledg
e an
d attitu
d
e
abou
t sex
ed
u
cation
associated
with se
xual be
ha
viour in
a
d
olescents. Base
d
on these
res
u
lts the
pare
nts i
s
expected to i
n
crea
s
e
k
nowledg
e abo
u
t
sex
ed
ucatio
n
,
po
sitiv
e t
h
ink
i
ng
towa
rd
s sex
ed
u
cati
o
n, and
t
o
prov
id
e sex
edu
c
atio
n
to
adolesce
nts ac
cording t
o
thei
r a
g
e [11].
M
a
ny
fact
ors
cont
ri
b
u
t
e
t
o
t
h
e
facts above
,
suc
h
as, lack of
knowledge held a
d
olescents about
sexu
ality (sex
, con
t
racep
tio
n, p
r
egn
a
n
c
y, et
c.), ofte
n
i
n
com
p
le
te an
d
m
i
slead
ing
k
nowled
g
e
ob
tain
ed fro
m
errone
ous s
o
urces, for e
x
am
ple from
peers, porn m
a
gazines, adult m
ovies,
and m
y
th in s
o
ciety [23].
4.
CO
NCL
USI
O
N
Co
un
sellin
g on
reprodu
ctiv
e h
ealth
h
a
v
e
an
im
p
act o
n
ad
o
l
escen
t
repro
d
u
c
tiv
e
h
ealth
. Relevan
t
h
ealth
au
tho
r
ities h
a
v
e
t
o
p
r
o
v
id
e gu
id
an
ce so
th
at y
o
ung
peo
p
l
e
do
n
o
t
cau
g
h
t
u
p
in
promiscu
ity
ACKNOWLE
DGE
M
ENTS
Thi
s
st
u
d
y
wa
s p
r
i
m
ari
l
y
fu
nde
d
by
gra
n
t
s
fr
om
t
h
e M
i
ni
st
ry
R
e
searc
h
, T
ech
n
o
l
o
gy
, an
d
Hi
g
h
er
Ed
ucat
i
on
In
d
one
si
a. The a
u
t
h
o
r
s t
h
a
n
k al
l
sur
v
ey
pa
rt
i
c
ipan
ts fo
r th
eir i
n
vo
lv
em
en
t, and t
h
e m
e
m
b
er
s of the
comm
unity service age
n
cy
from
Ah
m
a
d
Dah
l
an
Un
iv
ersity 2
015
REFERE
NC
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