The Effectiveness of Proactive Cognitive Game Method Based on Self-Control Theory on Knowledge and Premarital Sexual Behavior of Indonesian Female Adolescents in Surabaya City: A Quasi-experimental Study

Background and aims: In Indonesia, premarital sex is currently a common concern among many sexual problems affecting adolescents. This study aimed to determine the effect of proactive cognitive game methods based on self-control theory on knowledge and premarital sexual behavior of adolescent girls.
Methods: A total of 128 female adolescent students from two senior high schools in Surabaya City, Indonesia, were included in this quasi-experimental . They were selected using simple random sampling and equally divided into two groups. The students received health education on premarital sexual behavior through a proactive cognitive game (treatment group) and lecture method (control ) in one session each for 60 minutes. Evaluation of participants’ knowledge and premarital sexual behavior in two groups was performed using knowledge and premarital sexual behavior questionnaires before and three days after intervention. Data were analyzed by Wilcoxon signed-rank test and Mann–Whitney test using SPSS version 26.
Results: There was a significant difference in knowledge (lecture: P=0.003; game: P=0.000) and sexual behavior (lecture: P=0.000; game: P=0.000) between pre- and post-test. Moreover, there was a significant difference in knowledge (P=0.023) and sexual behavior changes (P=0.001) between the game and control groups. The game group showed more impact on improving participants’ knowledge and reducing sexual behavior than the control .
Conclusion: The game group was more effective in enhancing the knowledge of participants and reducing sexual behavior than the lecture group. This proactive cognitive game method is recommended as a reference for health education to prevent premarital sexual behavior in adolescents. We consider that this study is included in a quasi-experiment because this research is used to study the effects of an action or treatment on a pre-existing group, where the sample is female teenagers from senior high school class XI in Surabaya City. Also, quasi-experimental studies often take place in real-world settings where researchers cannot manipulate variables as freely as in a controlled laboratory environment. This can include studies conducted in schools, hospitals, or communities. As mentioned earlier, this study was performed in senior high school with study participants: students.