The Influence of Peer Group Education on Menstrual Hygiene on Knowledge of Pruritusvulvae Prevention in Adolescent Girls at SMP Muhammadiyah 4 Medan

ABSTRACT


INTRODUCTION
Reproduction health in teenagers is something that affects the health of reproductive systems, functions, and processes in teenagers.One of life's most significant problems is health reproduction among youth, and development health in Indonesia is a necessary consideration.Problem teenagers appear Because they do not know information about problems that occur during the transition period from children to adults.Therefore, teenagers must have good knowledge about health reproduction and the factors that influence it so that they do not take possible actions that endanger health reproduction.
Remember, part big teenager If they are still in high school and spend a lot of time at school, it is important to educate them about sexuality, health reproduction, and healthy behavior at school.Muhammadiiyah Middle School 4 Medan is one of these types of institutions in Indonesia.Schools provide various functions besides education, including religion, scientific knowledge, research, training, and even public development.This also works as a relationship culture.Therefore, you can contribute to education by developing the abilities and skills of unique students.
Culture-ecosystem education at school is different from society in general.Simplicity is appreciated above everything when staying at school.Majority student especially at school intermediate First, we are still teenagers, that is, in the range of 10 to 24 years.Various holders of interest still need to give attention to problems affecting children's health at school, like access to services, health, practice, a good life, and the health environment.

Int Jou of PHE  480
A teenage daughter has put forward a number of related problems with health reproduction, such as anemia, vaginal discharge, dysmenorrhea, and bad hygiene.Improved understanding among teenagers about menstruation and a change in attitude toward cleanliness are two possible prevention strategies used to prevent problems with health reproduction.One of these strategies is education and health via audiovisual media.Support Friend peers are very important in motivating and reminding teenagers to guard their cleanliness, especially in matters of health reproduction.
Based on the findings of the study beforehand, understanding schoolgirls health reproduction is influenced by education peers.This is what is necessary to be carried out by the Muhammadiiyah 4 Medan Middle School, among others, to make the curriculum for health reproduction and routinely give service counseling for health reproduction to students.Peer education also influences understanding and effort students need to fulfill their food needs, as well as commitment students need to undergo healthy life and protect reproductive organs.
Service program This aim is to strengthen the ability of students as educator peers with increased understanding of education peers, health reproduction teenagers, and both.Peer education is recognized as useful, and programbased school and/or community-based friend peers who cope with various health problems can increase knowledge and change attitudes and behaviors among teenagers.Good educator peer or non-peers can get benefit from activity here, which also helps generational mental health young and lowering use drugs and violence.

RESEARCH METHODS
Coordination activity public with partner devotion, specifically Head of Muhammadiyah Middle School 4 Medan.Stage preparation started with licensing to party related for do series activity service.After that's it, team devotion meets with supervisor location devotion to discuss more carry-on time and location activity.Students who follow project devotion are also recruited by the team.In addition, at stage preparation, society targets are also socialized with the spread of information through flyers or posters in various places, such as point-boarding schools or schools.Checking room and everything accompanying equipment, such as LCD, board writing, markers, seating, and sound system, are part of preparation equipment and venue.Preparation of material media education and training, including modules, posters, pamphlets, and videos.The team is also developing tool evaluation activities.
Muhammadiyah Middle School 4 Medan held sessions of peer education training without constraint.The target main program is for 30 teenagers with daughter-level aliyah, and the target other is for teenagers with daughter-level aliyah who attended Islamic boarding school.Lectures, games, roles, simulations, and debates are all used to convey session training, education, and colleagues.Material presented to group target is as as follows: For maximizing delivery material, discussion, and simulation, participants were trained in two small groups.The first part is from educational programs.This involves brainstorming about issues such as health and frequent reproduction that influence students and their knowledge base about education.Activities facilitated by a person facilitator This try align corner look participant before session training started.The service team also provides all participants with paper activities and sheet simulations.Session Then, with peer education training using flipcharts, modules, and sheet simulation for a total of 2 hours, Comparison score knowledge before and after training, precision answer quizzes, and practice guided by the below guidance facilitator were used for evaluation.
The practical approach used for participant training can directly apply knowledge gained during the presentation and questioning process.The facilitator will give a number of examples already practiced, like practice application counseling peers and creating health IEC media reproduction teenagers, as one method to help the participant deepen his understanding.To demonstrate method implementation practice, participants get teaching directly.
The team creates various modules for education and training, flipcharts, presentations, PowerPoint, and posters as media for communication, information, and education.The purpose of module in training This is for participants can utilized as guidelines reference during activity taking place for help understanding they to information submitted by members team.Fill in the modules used, which are summary results considered necessary by the team executor.Accompanying team-group-related targets and programs for existing teenagers to be active in conveying information related to health, reproduction, and teenage girls at the end of activity devotion.The service team initiates establishment center information and counseling teenagers and adolescents in the environment of boarding school after doing training to group-choose the target of becoming a peer educator.Additionally, team service requests that schools and other organizations participate actively and provide the necessary infrastructure to support initiatives promoting health in space classes and boarding schools.
The three criteria following give proof of success in implementation activity devotion: (1) Indication input form letter Work The same from partners, the planning performance team, the information budget, as well as facilities and infrastructure supporters such as KIE Media; (2) Process indicators: can be seen from implementation good coordination, presence and activeness of participants, implementation of all suite actions in accordance with planning, and delivery of all material that has been prepared.Tables 1 and 2

RESEARCH RESULTS AND DISCUSSION
The team coordinates with partner services to carry out scheduled activities gradually.Education about health and reproduction among teenagers becomes the first thing to do.Activity methods for presentation the team spreads information about health reproduction using PowerPoint media and module activities.So that participants are not bored during the 45-minute session, the team includes additional media power points.Activity next with session ask answer, where participant invited to put forward a problem What is just not yet answered, okay, through function comments in the column, nor in a direct way when invited in a way specifically by the moderator.
Training education peer is action-following.Activity This is still a continuation of the activity before, where participants formerly learned about various related problems with health reproduction.They then introduced one strategy to improve the health status of reproduction teenagers, which is education.The purpose of stages This is to introduce participants to various KIE media and prepare them for compiling related IEC media with the help of a facilitator from our team.Posters, pamphlets, and flipcharts are just a few of the IEC media introduced and created by participants.Succeed in making a poster about preventing violence in schools, for one problem a child claimed youth often experienced at school or madrasah.About the booklet, there are two, the first entitled "Reproductive Health Education Series for Young Women at SMP Muhammadiyah 4 Medan" and the second entitled "Peer Education Training for Teenagers at Muhammadiyah Middle School 4 Medan."The flipchart also contains information about education, peers, health, reproduction, and teenagers.
In this implementation, devotion to the public end for evaluation, as continued by the team executor, participants requested to do activity counseling on health.Team then explained evaluation overall and action strategy carry on series of service programs public This was before, finally, the event ended.Material used in devotion This refers to teaching materials and results study literature as well as discussion done together as a team executor with partner devotion.Development material is also considered a level-understanding participant in information, so use clear and straightforward language as well as be equipped with illustration support like pictures and graphs.
There is still minimal knowledge about issues related to health reproduction among teenagers, like wedding early, family planning, nutrition, youth sexuality, and other related topics.It is important to investigate related topics with health reproduction and sexuality among teenagers, such as sexual premarital activities, pregnancy that is not desired, abortion, infectious sexually transmitted infections (STIs), and HIV/AIDS.One of influencing things behavior sexual risky teenager is knowledge.Index knowledge about health reproduction among teenagers in Central Java is still low, amounting to 58.1%.

Implementation of research with Peer Education Training Evaluation and research assistance
Giving information Good online or offline, namely, an effort to increase knowledge among teenagers about health reproduction and sexuality to be avoided from dangerous behaviors.Training teenagers for education, health, reproduction, and the latest technology is known to increase knowledge, audience goals, and change attitudes among teenagers to the importance of maturation age wedding.There are many intervention health sexual intercourse in some teenagers big proven give impact positive.Due to its wide acceptance and problems with privacy, mobile application usage can be more beneficial, specifically for vulnerable individuals.Education about health and reproduction is very important.For the development of a teenager's daughter, To build a healthy society, physical, spiritual, social, and economic education is required.Instructions given relate to guarding the health of reproduction teenagers, preventing connection sex without condoms, and minimizing the possibility of a wedding early.Table 1 shows the results of education for participants about health and reproduction among teenagers.
The average score of knowledge, health, and reproduction among teenagers increased from 8.28 before to 8.32 after following activities, accordingly.Table 3.The knowledge score before and after the follow-activity was different in a way that was significant, as indicated by the findings of the existing statistical tests with a value of 0.001.At first, some big participants did not understand related topics with health reproduction, like nutrition problems in teenagers such as anemia and cleanliness.However, the prevalence of stunting and underweight among students, whose causes are knowledge and behavior, Eat No Healthy is still often reported.Therefore, that's the problem.This must be overcome through education and intervention in nutrition-based school special.This matter shows how education and training can increase the understanding and attitude of teenagers toward health reproduction.
Research results previously show enhancement of knowledge in adolescents after following education and health reproduction (Handayani, 2019;Johariyah & Mariati, 2018;Wijaya & Matahari, 2018).This matters because the participants get new information and are given reading media to deepen their knowledge about health reproduction.However, the ability of respondents to obtain knowledge through sense hearing is relatively limited, so the knowledge possessed by every respondent is also different.Therefore, it is necessary to educate for efficient health.Media used in education health to help make information provided more clear, like a presentation that's more interesting visually, easy to use, and rich in sensory.According to research, using the Android app for health reproduction can help people learn more and have a more positive attitude.Good about sex pre-wedding.
Research result previous show that education health influential to knowledge, attitudes and behavior cleanliness self schoolgirl good at times menstruation nor in life daily.Students study lots about how to guard health reproduction, avoid vaginal infections, and avoid infectious sexual infections because of behavior and sexual risk, and grow as teenagers through education on health reproduction.Therefore, it is recommended that certain techniques and media be used regularly at the Islamic boarding school to promote education and health.
Friends education peer or learning process through discussion something eye lesson with everyone who becomes her friend is one strategy for increasing knowledge and behavior in teenagers.Survey Results The 2012 Indonesian Health Demography (SDKI) revealed that teenagers 15-19 years old, neither men nor women, are more likely to talk about problems with health reproduction with friends and peers.Giving education on health reproduction with proven peer education increases knowledge among respondents.The purpose of project devotion is to increase participants' peer education knowledge and abilities.The team did an evaluation with a questionnaire before and after the implementation activity of peer education training to see what objective they had achieved.Average knowledge score proficiency life before and after involvement in the event of an increase of 5.17 points, according to Table 2. Considering statistical tests produce a value of 0.001, it is obvious that abilities and knowledge of participants in education peer increase along with enhancement.Results from activity training This .Well, before and after the course, participants were required to answer 20 question items.Investigation This focuses on terms, advantages, types of activities, phases, and elements supporting and inhibiting education.
Participant initially did not understand enough about education, peer.This matter was seen from a large participant who gave no response accurate to the question about benefits, stages, and components of education.Based on the findings discussion, This was caused by the generation of young people attending Islamic boarding schools.I do not yet have access to sufficient knowledge about policies, programs, and types of service-related health reproduction among teenagers.
Findings of the study previously disclosed the necessity of intervention education related to behavior, environment, and high students level cleanliness.Additionally, we found that knowledge, behavior, personal, and cleanliness room everything increased in a significant way after intervention.It is important to give this information to group teenagers before they start teaching them about health.This matter is in line with the method of training educator peers, according to BKKBN (2008), which also states that educator peers get guidance and training so that they can communicate information about health in a way that is effective to their friends.Educator peers are given gathering material based on a topic that has been determined as a reference to give information to members of their group.
Most of the participants at first did not know quite enough about the responsibilities and obligations of the educator peer in this matter.Not quite enough answer, an educator peer is giving information in almost any language.The same is true with language target to make friends easily understand it.Friends of the same age teenager own role important in life social Because they use up more Lots time together.A teenager usually considers her friend as a role model.Peers can too communicate in a way open and relaxed with educator other with method share views and feelings, so possible they convey message confidential.
Peer education is known to increase knowledge and attitudes among teenagers about dysmenorrhea, cleanliness, self-moment menstruation, and vaginal discharge.Apart from that, education has a peer-proven impact on prevention of abuse drugs, prevention of sex pre-wedding, attitude-checking, understanding about HIV infection and HIV-AIDS prevention, as well as prevention behavior and sexual risk during adolescence.Educators will do peer education with more effectiveness.If they can focus and learn, choose the right time for teaching and providing a friendly environment.In the center of information and counseling for teenagers, function educator competent peers increase knowledge among teenagers about three aspects of key health reproduction, which is 2.74 times greater than compared to role educator less peers.Additionally, the effectiveness of application education and health relies on the use of media such as flip charts and videos.
Transition method implementation stares advanced online, with very limited participation among participants who took part in online activities because they were not yet used to using online meeting platforms (such as Google Meet) and lacking a stable network became factors in the barrier.implementation activity This Apart from that, though group communication has been formed, only a few participating participants are active in responding to the material and information provided by the team executor and the public.Support massively from the party school and a fast response from the representative school will help team devotion and the public become possible aspects of the successful implementation of this program.Compactness in the team and effective communication between member teams; always responding quickly and precisely to every problem that arise; become a factor in others.Distribution roles and tasks are also very helpful for smoothing tasks.

CONCLUSION
Service program participants, in particular teenagers, hopefully can learn new skills and acquire new knowledge.This program aims to increase knowledge and abilities of participant-related education peers and health-reproduction teenagers.Implementation of this program is divided into 3 stages, namely, stage planning, implementation, and evaluation.Components important to reaching the purpose of this program with success are using technology, working with the same team, partners, equipment, and facility supporters.After participating in this program, participants reported a better understanding of health reproduction among teenagers, women, and education peers.After this session, teenagers become more capable of serving information with the use of flipchart paper and books.Through activity here, students can be inspired to contribute to maintaining and improving their health to realize objective creation of healthy schools and students.
present timetable activity education and training; (3) indicators output: identified with enhancement score knowledge and practice after implementation activity.To Int Jou of PHE  481 evaluate skills participants, teams have to make sheet evaluations where participants have requested For practice counseling, peer.Graph 1. Research Timeline

Table 1 .
Distribution of average levels knowledge education about health reproduction in adolescents daughter at SMP

Table 2 .
Distribution of average levels knowledge about peer education training for teenagers daughter at SMP