The Effectiveness of a Child-Centered Learning Approach as a Nursing Intervention in Improving Adolescents’ Knowledge about Early Marriage: A Quasi-Experimental Study

Authors

  • Wahyuningsih Nursing Science Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia
  • Brajakson Siokal Department of Nursing, Faculty of Public Health, Indonesian Muslim University, Makassar, Indonesia
  • Setiawan Kasim Public Health Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia https://orcid.org/0009-0002-3244-7520
  • Fhirawati Nursing Science Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia
  • Sainah Midwifery Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia

DOI:

https://doi.org/10.32382/medkes.v21i1.2050

Keywords:

Child-centered learning, early marriage, adolescents, nursing intervention, knowledge

Abstract

Early marriage remains a significant public health concern with adverse consequences for adolescents’ health, education, and psychosocial development. This study aimed to evaluate the effectiveness of child-centered learning Approach as a nursing intervention in improving adolescents’ knowledge regarding early marriage. A quasi-experimental study with a pretest–posttest control group design was conducted in Borongloe Subdistrict, Bontomarannu District, Gowa Regency. A total of 100 adolescents aged 15–18 years participated in the study and were assigned to either an intervention group (n = 50) and a control group (n = 50). The intervention group received health education based on a Child-Centered Learning Approach that emphasized active learner engagement, collaborative learning, critical thinking, problem-solving activities, and the use age-appropriate educational materials. The control group received conventional lecture-based health education. Adolescents’ regarding early marriage was measured before and after the intervention using a structured questionnaire. Data were analyzed using the Wilcoxon signed-rank test for within-group comparisons and the Mann–Whitney U test for between-group comparisons. The mean knowledge score in the intervention group increased from 55.44 to 87.00, while the control group showed only a slight change from 58.00 to 75.36. Statistical analysis showed a significant improvement in knowledge scores among adolescents in the intervention group after receiving child-centered learning–based health education (p < 0.001). In contrast, no significant change was observed in the control group. Comparative analysis between the two groups revealed a statistically significant difference in post-test knowledge scores (p < 0.001), indicating the effectiveness of the child-centered learning approach. These findings indicate that health education delivered through a child-centered learning approach can significantly improve adolescents’ knowledge regarding early marriage.

Author Biographies

Wahyuningsih, Nursing Science Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia

Nursing Science Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia

Brajakson Siokal, Department of Nursing, Faculty of Public Health, Indonesian Muslim University, Makassar, Indonesia

Department of Nursing, Faculty of Public Health, Indonesian Muslim University, Makassar, Indonesia

Setiawan Kasim, Public Health Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia

Public Health Study Program, Faculty of Health, Patria Artha University, Gowa, Indonesia

References

1. Anisa AN, et al. Determinants of child marriage in Indonesia: a systematic review. J Community Med Public Health Res. 2024;5(2). Available from: https://jcmphr.com/index.php/jcmphr

2. Yoosefi Lebni J, Solhi M, Ebadi Fard Azar F, Khalajabadi Farahani F, Irandoost SF. Exploring the consequences of early marriage: a conventional content analysis. Inquiry. 2023;60:1–12. doi:10.1177/00469580231155607

3. UNICEF. Child marriage: a global overview. New York: United Nations Children’s Fund; 2021.

4. Feyissa GT, Tolu LB, Soboka M, Ezeh A. Effectiveness of interventions to reduce child marriage and teen pregnancy in sub-Saharan Africa: a systematic review of quantitative evidence. Front Reprod Health. 2023;5:1123456. doi:10.3389/frph.2023.1123456

5. Greene ME, Siddiqi M, Abularrage TF. Systematic scoping review of interventions to prevent and respond to child marriage across Africa: progress, gaps and priorities. BMJ Open. 2023;13(5):e069123. doi:10.1136/bmjopen-2022-069123

6. Singh M, Shekhar C, Gupta J. Distribution and determinants of early marriage and motherhood: a multilevel and geospatial analysis of 707 districts in India. BMC Public Health. 2024;24(1):2844. doi:10.1186/s12889-024-19061-5

7. Setiadi S. Getting married is a simple matter: early marriage among Indonesian Muslim girls in rural Java. JSW (Jurnal Sosiologi Walisongo). 2021;5(2):143–154. doi:10.21580/jsw.2021.5.2.7091

8. Reisz T, Kim M, Gonzalez AJ. Associations between child marriage and maternal health outcomes in Liberia and Sierra Leone. PLoS One. 2024;19(3):e0300982. doi:10.1371/journal.pone.0300982

9. Sagalova V, Zagre NM, Vollmer S. Long-term consequences of early marriage and maternity in West and Central Africa. BMJ Glob Health. 2021;6:e005789. doi:10.1136/bmjgh-2021-005789

10. Elnakib S, Elsallab M, Wanis MA, Elshiwy S, Krishnapalan NP, Naja NA. Impacts of child marriage on adolescent girls’ health in urban Egypt. Reprod Health. 2022;19(1):10. doi:10.1186/s12978-021-01315-4

11. Curtin EL, Widnall E, Dodd S, Limmer M, Simmonds R, Russell AE, et al. Exploring mechanisms in a peer education project to improve mental health literacy in schools. Health Educ Res. 2024;39(1):40–54. doi:10.1093/her/cyad035

12. Freire K, Pope R, Jeffrey K, Andrews K, Nott M, Bowman T. Engaging with children and adolescents: a systematic review of participatory methods. Adolesc Res Rev. 2022;7(3):335–354. doi:10.1007/s40894-022-00181-w

13. van Boxtel W, Jerković-Ćosić K, Schoonmade LJ, Chinapaw MJM. Health literacy in child health promotion: a scoping review. BMC Public Health. 2024;24:1122. doi:10.1186/s12889-024-18541-y

14. Miao X, Ziyou I, Han Y, Kin Z, Michael W. Participatory research methods for promoting children’s psychological well-being. Appl Res Qual Life. 2025;20:1629–1664. doi:10.1007/s11482-025-10490-6

15. Chrifou R, Anselma M, Christens BD, Israel BA, Jurkowski JM, Perkins DD, et al. Actualizing child and adolescent empowerment in participatory action research. Int J Adolesc Youth. 2024;29(1):2354907. doi:10.1080/02673843.2024.2354907

16. Nicholas M, Rouse E, Paatsch L. Child-centred teaching: helping each child to reach their full potential. Educ Sci. 2021;11(8):401. doi:10.3390/educsci11080401

17. Leung C, Leung T, Lau D, Ng R, et al. Improving children and adolescents’ quality of life through health behavioral education: a pre–post intervention study. Child Youth Serv Rev. 2025;77:105987. doi:10.1016/j.childyouth.2025.105987

18. Widiyastuti NE, Hakiki M. Impact of reproductive health education on adolescent knowledge and attitude. J Kebidanan Malahayati. 2022;8(2):349–357.

19. Nurhasanah R. Effectiveness of health counseling using leaflet and video media on adolescents’ knowledge about early marriage risks. J Nusant Public Health. 2021;6(2):85–92.

20. Haberland N, Rogow D. Sexuality education: emerging trends in evidence and practice. J Adolesc Health. 2022;71(5):567–574. doi:10.1016/j.jadohealth.2022.06.010

21. Chandra-Mouli V, Plesons M, Hadi S, Bauman A, Chou D. Adolescent sexual and reproductive health and rights: a stock-taking and call to action. J Adolesc Health. 2021;68(2):S3–S15. doi:10.1016/j.jadohealth.2020.11.004

22. Keats EC, Rappaport AI, Shah S, Oh C, Jain R, Bhutta ZA. The impact of school-based health education on adolescent health outcomes: a systematic review. Lancet Child Adolesc Health. 2022;6(9):634–646. doi:10.1016/S2352-4642(22)00160-7

23. Salam RA, Faqqah A, Sajjad N, Lassi ZS, Das JK, Kaufman M, Bhutta ZA. Improving adolescent sexual and reproductive health: a systematic review of potential interventions. J Adolesc Health. 2021;69(6):S11–S28. doi:10.1016/j.jadohealth.2021.08.002

24. Yakubu I, Salisu WJ. Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 2021;18:15. doi:10.1186/s12978-021-01074-5

25. Viner RM, Gireesh A, Stiglic N, Hudson LD, Goddings AL, Ward JL, Nicholls DE. Roles of schools and education in supporting adolescent health. Lancet Child Adolesc Health. 2023;7(2):142–151. doi:10.1016/S2352-4642(22)00336-5

26. Mathews C, Eggers SM, Townsend L, Aarø LE, de Vries PJ. Effects of school-based interventions on sexual health knowledge among adolescents: a cluster randomized trial. BMC Public Health. 2021;21:1608. doi:10.1186/s12889-021-11614-7

27. Laski L, Amin A. Transforming education to prevent gender inequality and child marriage. BMJ Glob Health. 2022;7:e008123. doi:10.1136/bmjgh-2021-008123

28. John NA, Edmeades J, Murithi L. Child marriage and psychological well-being among adolescent girls. Child Abuse Negl. 2022;125:105473. doi:10.1016/j.chiabu.2021.105473

29. Chae S, Ngo TD. The global state of evidence on interventions to prevent child marriage. J Adolesc Health. 2021;68(5):847–854. doi:10.1016/j.jadohealth.2020.11.016

30. Darling-Hammond L, Flook L, Cook-Harvey C, Barron B, Osher D. Implications for educational practice of the science of learning and development. Appl Dev Sci. 2021;25(2):97–140. doi:10.1080/10888691.2018.1537791

31. Hattie J, Zierer K. Ten mindframes for visible learning: teaching for success. Educ Sci. 2022;12(3):176. doi:10.3390/educsci12030176

32. Zimmerman BJ, Schunk DH. Self-regulated learning and academic achievement: theoretical perspectives. Educ Psychol Rev. 2022;34(2):1583–1600. doi:10.1007/s10648-021-09628-5

33. Kolb AY, Kolb DA. Experiential learning theory as a guide for experiential educators in higher education. Experiential Learn Teach High Educ. 2021;4(1):7–44. doi:10.46787/elthe.v4i1.336

34. Bandura A. Toward a psychology of human agency: pathways and reflections. Perspect Psychol Sci. 2021;16(6):1301–1315. doi:10.1177/1745691620977188

35. Widman L, Nesi J, Kamke K, Choukas-Bradley S, Stewart JL. Technology-based interventions to reduce sexually transmitted infections among youth. J Adolesc Health. 2021;69(3):387–395. doi:10.1016/j.jadohealth.2021.03.015

36. Fonner VA, Armstrong KS, Kennedy CE, O’Reilly KR, Sweat MD. School-based sex education and HIV prevention in low- and middle-income countries. PLoS One. 2021;16(3):e0248882. doi:10.1371/journal.pone.0248882

37. Denno DM, Hoopes AJ, Chandra-Mouli V. Effective strategies to provide adolescent sexual and reproductive health services and education. J Adolesc Health. 2022;70(3):S6–S15. doi:10.1016/j.jadohealth.2021.11.002

38. Melesse DY, Mutua MK, Choudhury A, Wado YD, Faye CM, Neal S. Adolescent sexual and reproductive health in sub-Saharan Africa: progress and challenges. Lancet Glob Health. 2021;9(6):e784–e795. doi:10.1016/S2214-109X(21)00039-5

39. Kennedy CE, Yeh PT, Pandey S, Betran AP, Narasimhan M. Community-based interventions to prevent early marriage and adolescent pregnancy. Reprod Health. 2022;19:180. doi:10.1186/s12978-022-01492-5

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Published

2026-06-29

How to Cite

Wahyuningsih, W., Siokal, B., Kasim, S., Fhirawati, F., & Sainah, S. (2026). The Effectiveness of a Child-Centered Learning Approach as a Nursing Intervention in Improving Adolescents’ Knowledge about Early Marriage: A Quasi-Experimental Study. Media Kesehatan Politeknik Kesehatan Makassar , 21(1), 33–41. https://doi.org/10.32382/medkes.v21i1.2050