The effectiveness of peer health educator interventions in improving clean and healthy living behaviours at the Santri of Islamic Boarding School

Abstract

Background: Islamic boarding schools (pesantren) are traditional educational institutions in Indonesia with a high density of students (santri). Unhealthy habits such as eating together from a single tray, not washing hands with soap before meals, sharing bathing equipment, and even exchanging clothes increase the risk of infectious diseases including respiratory infections, diarrhea, typhoid, and scabies. Clean and Healthy Living Behavior (PHBS) is essential in pesantren to develop healthy habits and create a healthier environment. Objective: This study aimed to evaluate the effectiveness of the peer health educator method in improving students' knowledge and attitudes toward PHBS in Islamic boarding schools. Methods: A quasi-experimental study was conducted using a two-group pretest-posttest control group design. The total sample consisted of 120 students, with 60 in the intervention group (peer health educator) and 60 in the control group, selected purposively. Inclusion criteria were active students who could read and write and were willing to participate, while exclusion criteria included students who were ill or transferred during the study. The research instrument was a PHBS questionnaire using a Likert scale. Data were analyzed using the Wilcoxon test to assess differences in scores before and after the intervention. Results: The findings showed significant improvements in the intervention group, both in knowledge (p=0.006) and attitudes (p=0.003). Changes were also observed in the control group, but the effect was less significant compared to the intervention group (knowledge p=0.000; attitude p=0.009). Conclusion: The peer health educator method was effective in improving students' knowledge and attitudes regarding PHBS in Islamic boarding schools in Batanghari Regency. This approach is recommended as a community-based health promotion strategy in pesantren.