Effect of Cultural Communication Strategy in Preventing Child Marriage in a Region with Strong Cultural Resistance A Quasi-Experimental Study
DOI:
https://doi.org/10.56294/saludcyt20251789Keywords:
Child Marriage, Adolescent, Interpersonal Communication, Reproductive Health, Social Change, FamilyAbstract
Background: Child marriage persists due to strong cultural values, social norms, and ethnic influences, compounded by inadequate strategic cultural communication. This study aims to analyze the effectiveness of cultural communication strategies in enhancing knowledge, attitudes, and self-efficacy in preventing child marriage in a region characterized by strong cultural resistance.
Methods: This quasi-experimental study involved 200 Bugis residents in Parepare, South Sulawesi, Indonesia (December 2023-January 2024), using a purposive sampling. Participants were divided into treatment (KP) and control (KK) groups based on previous exposure to child marriage prevention assistance. Inclusion criteria: families with adolescents, living for ≥ 10 years, and willing to participate. KP received educational modules and family mentoring, while KK only received mentoring. Pretest and post-test (after 12 weeks) measured knowledge, attitude, and self-efficacy. Data were analyzed using Kolmogorov-Smirnov, Mann-Whitney U, and Wilcoxon tests.
Results: The intervention group demonstrated significant improvements in knowledge, attitudes, self-efficacy, and cultural communication compared to the control group at both post-intervention measurements (p < 0.005). Baseline measurements showed no significant differences. Within the intervention group, Wilcoxon tests confirmed significant improvements from pre-test to both post-tests (p < 0.001). The control group showed mixed results, with some variables improving initially but later declining or remaining unchanged, highlighting the intervention's effectiveness.
Conclusion: Cultural communication-based interventions with educational modules and mentoring effectively enhance family knowledge, attitudes, and self-efficacy in preventing child marriage, with a sustained long-term impact.
References
1. Fan S, Koski A. The health consequences of child marriage: a systematic review of the evidence. BMC Public Health. 2022;22: 309. doi:10.1186/s12889-022-12707-x
2. Cameron L, Contreras Suarez D, Wieczkiewicz S. Child marriage: using the Indonesian family life survey to examine the lives of women and men who married at an early age. Rev Econ Househ. 2022;21(3):725-756. doi:10.1007/s11150-022-09616-8.
3. WHO. Violence against women. WHO. 2022. https://www.who.int/news-room/fact-sheets/detail/violence-against-women
4. WHO. Adolescent pregnancy. 2022. Accessed March 30, 2025. https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy
5. Hongo R, Dyalchand A, Viera R, Chayelela N. The latest evidence on child marriage: Trends in prevalence and burden around the world. 2023. https://www.girlsnotbrides.org/learning-resources/events/the-latest-evidence-on-child-marriage-trends-in-prevalence-and-burden-around-the-world/
6. Yakub H, Foltysova J, Connors J. Child marriage: parents’ lived experience of decision-making processes and consequential health effects. Walden Faculty and Staff Publications. 2020;(731). https://scholarworks.waldenu.edu/facpubs/731.
7. Pourtaheri A, Sany SBT, Aghaee MA, Ahangari H, Peyman N. Prevalence and factors associated with child marriage, a systematic review. BMC Womens Health. 2023;23:531. doi:10.1186/s12905-023-02634-3
8. Grijns M, Horii H. Child marriage in a village in West Java (Indonesia): compromises between legal obligations and religious concerns. Asian Journal of Law and Society. 2018;5(2):453-466. doi:10.1017/als.2018.9
9. Sopyan Y, Muttaqin ZZ, Solihat C, Aripin J. Child exploitation by parents in early marriage: case study in Cianjur West Java. Indonesia Samarah. 2023;7(3):1921-1942. doi:10.22373/sjhk.v7i3.14804.
10. Keenan-Devlin LS, Borders AEB, Freedman A, et al. Maternal exposure to childhood maltreatment and adverse birth outcomes. Sci Rep. 2023;13(1). doi:10.1038/s41598-023-36831-9.
11. Mujica OJ, Sanhueza A, Carvajal-Velez L, et al. Recent trends in maternal and child health inequalities in Latin America and the Caribbean: analysis of repeated national surveys. Int J Equity Health. 2023;22(1):45. doi:10.1186/s12939-023-01932-4
12. UNICEF. Child Marriage Report 2020.; 2020.
13. Surbakti E, Hasibuan Y, Pasaribu R. The effectiveness of local-leader-based social interventions on knowledge and attitudes of early marriage among mother who have teenage children. Open Access Maced J Med Sci. 2022;10(10(E)):1215-1220. doi:10.3889/oamjms.2022.8544
14. Verawati B. Community empowerment as an effort to prevent child marriage. Journal of Midwifery. 2019;4(2).
15. Paulina M, Puspitasari G. The effectiveness of the Trenggalek Regent’s 2022 instructions on child marriage prevention strategies in Trenggalek. Jurnal Keluarga Berencana. Published online 2024:56-64. doi:10.37306/18fvw595.
16. Erulkar A, Medhin G, Weissman E, Kabore G, Ouedraogo J. Designing and evaluating scalable child marriage prevention programs in Burkina Faso and Tanzania: A Quasi-Experiment and Costing Study. Glob Health Sci Pract. 2020;8(1):68-81. doi:10.9745/GHSP-D-19-00132
17. Chowdhury M, Morium S. Child marriage: historical reality around the globe and in Bangladesh – A literature review. Archives Of Psychology. 2018;2(7). https://www.archivesofpsychology.org/index.php/aop/article/view/80
18. Dahlan M. Sample Size and Sampling Methods in Medical and Health Research [Besar Sampel Dan Cara Pengambilan Sampel Dalam Penelitian Kedokteran Dan Kesehatan]. Salemba Medika; 2013.
19. Zakaria M, Nachrin T, Azad MAK. Evaluating the effectiveness of utilization of health communication interventions on sexual and reproductive health of the Rohingya women living in Cox’s Bazar refugee camp. Heliyon. 2020;8(12). doi:10.1016/j.heliyon.2022.e12563
20. Bae KE, Jeong GH. Effect of a transcultural nursing course on improving the cultural competency of nursing graduate students in Korea: a before-andafter study. J Educ Eval Health Prof. (20). doi:10.3352/jeehp.2023.20.35
21. Ralph AP, McGrath SY, Armstrong E, et al. Improving outcomes for hospitalised First Nations peoples though greater cultural safety and better communication: the Communicate Study Partnership study protocol. Implementation Science. 2023;18(1). doi:10.1186/s13012-023-01276-1
22. Billey T, Kushman E, Meese J, et al. Development of a culturally enhanced caregiver-facilitated language nutrition intervention “+Language is Medicine. Front Public Health. 2024;(12). doi:10.3389/fpubh.2024.1376742
23. Saudah N, Lestari I, Dewi CPL, et al. Communication, information, and education on self-awareness about marriage age maturation among adolescent girls. Kemas. 2023;18(3):325-333. doi:10.15294/kemas.v18i3.36740
24. Schuler E, Mott S, Forbes PW, Schmid A, Atkinson C, DeGrazia M. Evaluation of an evidence-based practice mentorship programme in a paediatric quaternary care setting. Journal of Research in Nursing. 2021;26(1–2):149-165. doi:10.1177/1744987121991417
25. Webb L, Kyaddondo D, Ford T, Bergqvist A, Cox N. Psychosocial health in adolescent unmarried motherhood in rural Uganda: Implications for community-based collaborative mental health education, and empowerment strategies in the prevention of depression and suicide. Transcult Psychiatry. 2023;60(3):537-551. doi:10.1177/13634615221147361
26. Ellington LE, Becerra R, Mallma G, et al. Knowledge acquisition and retention after a high flow training programme in Peru: A quasi-experimental single group pre-post design. BMJ Open. 2020;10(6). doi:10.1136/bmjopen-2019-035125
27. Minnick W, Cekada T, Marin L, Zreiqat M, Seal B, Mulroy J. The impact of active learning strategies on retention and outcomes in safety training. Creat Educ. 2022;13(02):526-536. doi:10.4236/ce.2022.132031
28. Rusmansyah R, Emelia E, Winarti A, Hamid A, Mahdian M, Kusuma AE. Development of interactive E-modules of PjBL models to improve understanding of colloidal concepts. Jurnal Penelitian Pendidikan IPA. 2023;9(4):2173-2183. doi:10.29303/jppipa.v9i4.1853
29. Dini A, Rahmatan H, Muhibbudin N, C., Safrida. Application of the E-module combined with the guided inquiry learning model to increase student motivation and learning outcomes on the structure and function of plant tissues. Jurnal Penelitian Pendidikan IPA. 2023;9(6):4768-4776. doi:10.29303/jppipa.v9i6.3857
30. Arpaci I, Dogru MS, Kanj H, Ali N, Bahari M. An Experimental Study on the Implementation of a STEAM-Based Learning Module in Science Education. Sustainability (Switzerland. 2023;15(8). doi:10.3390/su15086807
31. Truong M, Fenton SH. Understanding the Current Landscape of Health Literacy Interventions within Health Systems. Perspect Health Inf Manag. 2022;19(19(Spring)):1.
32. Kong Y. The role of experiential learning on students’ motivation and classroom engagement. Front Psychol. 2012;12. doi:10.3389/fpsyg.2021.771272
33. Yen PH, Leasure AR. Use and effectiveness of the teach-back method in patient education and health outcomes. In: Federal Practition. ; 2019:284-289.
34. Tise JC, Hernandez PR, Wesley Schultz P. Mentoring underrepresented students for success: Self-regulated learning strategies as a critical link between mentor support and educational attainment. Contemp Educ Psychol. 2023;75(75). doi:10.1016/j.cedpsych.2023.102233
35. Ermawati IR, Hartini TI, Sugianto NNS, Widyanti ST, Wahyuni PS, Ningsih M. Training of Kurikulum Merdeka teaching module using experiential learning cycle in Physics MGMP. International Journal of Community Service Learning. 2024;8(2):149-157. doi:10.23887/ijcsl.v8i2.78671.
36. Joshi D, Zalte SM, Robin Johny K, Mahajan DA. the impact of blended learning on student engagement in the digital era. Eur Chem Bull. Published online 2023:727-735. doi:10.48047/ecb/2023.12.si12.063
37. Luhung M, Soedirham O, Fatah MZ. Mentoring influence among teenage capacity on early marriage prevention. International Journal of Public Health and Clinical Sciences. 2018;5(6). doi:10.32827/ijphcs.5.6.132
38. Pradikta HYP, Sanjaya P, Rica Dayani T, Shulton Asnawi H. Efforts to prevent marriage at child age through socialization and education on the risks of early marriage from the perspective of Islamic law. J-Dinamika : Jurnal Pengabdian Masyarakat. 2023;8(1):35-41. doi:10.25047/j-dinamika.v8i1.3852
39. Mitchell A, Puri MC, Dahal M, Cornell A, Upadhyay UD, Diamond-Smith NG. Impact of Sumadhur intervention on fertility and family planning decision-making norms: a mixed methods study. Reprod Health. 2023;20(1). doi:10.1186/s12978-023-01619-7
40. Schwarzer R, Warner LM. Perceived self-efficacy and its relationship to resilience. Prince-Embury S, Saklofske DH, eds. Resilience in children, adolescents, and adults. 2012;(Springer):139-150. doi:10.1007/978-1-4614-4939-3_10
41. Kounenou K, Kalamatianos A, Garipi A, Kourmousi N. A positive psychology group intervention in Greek university students by the counseling center: Effectiveness of implementation. Front Psychol. Published online 2022:13. doi:10.3389/fpsyg.2022.965945
42. Mikkelsen HT, Haraldstad K, Helseth S, Skarstein S, Småstuen MC, Rohde G. Health-related quality of life is strongly associated with self-efficacy, self-esteem, loneliness, and stress in 14–15-year-old adolescents: a cross-sectional study. Health Qual Life Outcomes. 2020;18(1). doi:10.1186/s12955-020-01585-9.
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Copyright (c) 2025 Ayu Dwi Putri Rusman , Muhammad Syafar, Lalu Muhammad Saleh , Stang, Wahiduddin , Muhammad Alwi Arifin , Anwar Mallongi , Sumarni Marwang (Author)
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