The Effectiveness of Education Using Comic Books and Video Media on Knowledge and Skills in Menstrual Hygiene Management Among Adolescent Girls at SMP Negeri 6 Malang

Abstract

Menstrual hygiene management (MHM) education is needed to support adolescent girls in managing menstruation safely, confidently, and with dignity. This study compared comic book-based and video-based education for improving MHM knowledge and skills. A quasi-experimental two-group pretest–posttest design was used among 56 female students aged 12–14 years at SMP Negeri 6 Malang, selected through proportional stratified random sampling and divided equally between the video and comic book groups. Knowledge was measured using a researcher-modified questionnaire, and skills were assessed using an observation checklist. Paired-samples t-tests examined within-group changes, while independent-samples t-tests compared gain scores between groups. Knowledge improved in the video group by 26.19 points and in the comic book group by 23.33 points; the between-group difference was not significant (mean difference = 2.86, 95% CI -7.76 to 13.47; p = 0.592; Cohen's d = 0.14). Skills improved in the video group by 23.11 points and in the comic book group by 28.45 points; this difference was also not significant (mean difference = -5.34, 95% CI -16.48 to 5.79; p = 0.340; Cohen's d = -0.26). Both media were associated with significant short-term improvements within groups, but the statistical superiority of either medium was not demonstrated.