Comparing the effect of LINE-based and WhatsApp-based educational interventions on reproductive health knowledge, attitudes, and behaviors among Triad adolescents: A quasi-experimental study


reproductive health
health knowledge
mobile applications
health education

How to Cite

Kosasih, C. E., Solehati, T., & Maryati, I. (2024). Comparing the effect of LINE-based and WhatsApp-based educational interventions on reproductive health knowledge, attitudes, and behaviors among Triad adolescents: A quasi-experimental study. Belitung Nursing Journal, 10(1), 87–95.
Google Scholar

Link to Google Scholar

Accepted for publication: 2023-12-25
Peer reviewed: Yes

Related articles in

Search Relations - Article by Author(s)

Share this article on:


Background: Adolescent populations face reproductive health challenges. Persisting gaps in Triad Adolescent Reproductive Health (ARH) comprehension and risky behaviors emphasize the necessity of integrating social media apps into health education to address Triad ARH risks among youths. Teenagers commonly use WhatsApp and LINE for social media communication, and determining the effectiveness of these two apps is scarce.

Objective: This quasi-experimental study aimed to investigate and compare the impacts of educational interventions delivered through WhatsApp and LINE platforms on enhancing the knowledge, attitudes, and behaviors of adolescents concerning the Triad ARH.    

Methods: A total of 154 senior high school students were randomly recruited from two public schools in Bandung Regency, West Java, Indonesia. These students were divided into two groups: Group A, consisting of 78 students who received material messages using LINE, and Group B, consisting of 76 students who received material messages using WhatsApp. Participants completed a pre-test prior to the intervention and a post-test one month after the intervention. Data were collected using validated questionnaires and analyzed using Chi-square and Wilcoxon tests.

Results: In the LINE group, there was an average increase in knowledge from 15.68 to 20.21, attitudes from 29.05 to 59.12, and behavior from 55.95 to 64.81 before and after the intervention period (p = 0.001). In the WhatsApp group, there was an increase in knowledge from 15.16 to 19.67, in attitudes from 34.71 to 59.54, and behavior from 54.75 to 65.97 before and after the intervention period (p = 0.001). Further analysis showed no significant difference between the LINE and WhatsApp groups in increasing the average level of knowledge (p = 0.973), attitude (p = 0.682), and behavior (p = 0.067) before and after the intervention. However, it was observed that the increase in knowledge and attitude was slightly higher in the LINE group, while the increase in behavior was slightly higher in the WhatsApp group.

Conclusion: This study demonstrates that educational interventions using LINE and WhatsApp both increased the knowledge, attitudes, and behavior of adolescents related to the Triad ARH. This finding is valuable, considering the popularity of LINE and WhatsApp as mobile applications. Leveraging these platforms by nurses and other healthcare professionals can significantly improve adolescents’ health, influencing their knowledge, attitudes, and behavior regarding reproductive health.


Copyright (c) 2024 Cecep Eli Kosasih, Tetti Solehati, Ida Maryati

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Article Metrics

Total views 123 [Abstract: 51 | PDF: 72 | XML: 0 ]


Download data is not yet available.

PlumX Metrics

Declaration of Conflicting Interest

The authors declared no conflict of interest in this study.


The authors want to thank the Director of Research and Community Services Universitas Padjadjaran.

Authors’ Contributions

CEK: validation, investigation, resources, data curation, writing original draft, reviewing and editing manuscript, visualization, supervision, project administration, and funding acquisition. TS: formal analysis, investigation, reviewing and editing manuscript, visualization, and project administration. IM: software and resources, reviewing and editing the manuscript. All authors were accountable in each step of the study, and they read and agreed to the published version of the manuscript.

Data Availability

The datasets generated and analyzed in this article are available from the corresponding author.

Declaration of Use of AI in Scientific Writing

There is nothing to declare.


Adjie, J. M. S. (2013). Adolescent reproductive health in social aspects [in Bahasa].

Ahad, A. D., & Lim, S. M. A. (2014). Convenience or nuisance?: The ‘WhatsApp’ dilemma. Procedia - Social and Behavioral Sciences, 155, 189-196.

Anggraeni, F., Solehati, T., & Mardiah, W. (2018). Perbedaan metode peer teaching dengan metode jigsaw terhadap tingkat pengetahuan kesehatan reproduksi [The difference between the peer teaching method and the jigsaw method on the level of reproductive health knowledge]. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 3(1), 17-28.

Bappeda Kabupaten Bandung. (2015). Bandung Regency Regent Regulation (PERBUP) Number 23 of 2015 concerning Bandung Regency Regional Development Work Plan for 2016 [in Bahasa].

Callaghan, N., & Bower, M. (2012). Learning through social networking sites–the critical role of the teacher. Educational Media International, 49(1), 1-17.

Ceci, L. (2018). WhatsApp - Statistics & facts. Statista.

Cetinkaya, L. (2017). The impact of Whatsapp use on success in education process. The International Review of Research in Open and Distributed Learning, 18(7).

Chen, N., Zhou, M., Dong, X., Qu, J., Gong, F., Han, Y., Qiu, Y., Wang, J., Liu, Y., & Wei, Y. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. The Lancet, 395(10223), 507-513.

Church, K., & Oliveira, R. d. (2013). What's up with whatsapp? comparing mobile instant messaging behaviors with traditional SMS Proceedings of the 15th international conference on Human-computer interaction with mobile devices and services, Munich, Germany.

Cleland, J., Ingham, R., & Stone, N. (2001). Illustrative questionnaire for interview-surveys with young people. World Health Organization.

Gachago, D., Strydom, S., Hanekom, P., Simons, S., & Walters, S. (2015). Crossing boundaries:Llectures' perspectives on the use of WhatsApp to support teaching and learning in higher education. Progressio, 37(1), 172-187.

Gasaymeh, A.-M. M. (2017). University students’ use of WhatsApp and their perceptions regarding its possible integration into their education. Global Journal of Computer Science and Technology, 17(1), 1-9.

Gonenc, I. M., Alan Dikmen, H., & Golbasi, Z. (2021). The effect of whatsapp-based and conventional education methods on sexual myths and sexual health knowledge: A comparative intervention study in midwifery students. International Journal of Sexual Health, 33(3), 326-341.

Kominfo. (2018). Government reviews rules restricting smartphone use in schools [in Bahasa].

Kosasih, C. E., Solehati, T., Utomo, W., Heru, H., & Sholihah, A. R. (2021). Determinants factors of high-risk sexual behavior pregnancy among adolescent in Indonesia. Open Access Macedonian Journal of Medical Sciences, 9(T6), 69-79.

Krishnan, M., J, N., A, K., Nasimuddin, S., Malayan, J., & G, S. (2017). Whatsapp enhances Medical education: Is it the future? International Journal of Medical Science and Public Health, 6(1), 353-358.

Kunaboot, W., Chaipoopirutana, S., & Combs, H. (2015). A study of the factors influencing LINE stickers purchase intention in Thailand. ASBBS Proceedings, Las Vegas.

Liang, M., Simelane, S., Fillo, G. F., Chalasani, S., Weny, K., Canelos, P. S., Jenkins, L., Moller, A.-B., Chandra-Mouli, V., & Say, L. (2019). The state of adolescent sexual and reproductive health. Journal of Adolescent Health, 65(6), S3-S15.

Ministry of Health. (2015). Infodatin: situation of adolescent reproductive health [in Bahasa]. Jakarta: Pusat Data dan Informasi Kementrian Kesehatan Republik Indonesia.

Ministry of Health. (2017). Report on the situation of the development of HIV/AIDS and PIMS in Indonesia January-June 2019 [in Bahasa]. Jakarta: Direktorat Jenderal Pencegahan dan Pengendalian Penyakit, Ministry of Health.

Mulyono, H., Suryoputro, G., & Jamil, S. R. (2021). The application of WhatsApp to support online learning during the COVID-19 pandemic in Indonesia. Heliyon, 7(8), e07853.

National Family Planning Coordinating Board, Statistics Indonesia, & Ministry of Health. (2018). 2017 Indonesian demographic and health survey: Adolescent reproductive health [in Bahasa].

National Population and Family Planning Board. (2012). Guidelines for managing the youth and student information and counseling center (PIK adolescent/student) [in Bahasa]. Jakarta: Direktorat Bina Ketahanan Remaja, BKKBN.

Nobelius, A.-M., Kalina, B., Pool, R., Whitworth, J., Chesters, J., & Power, R. (2010). Sexual and reproductive health information sources preferred by out-of-school adolescents in rural southwest Uganda. Sex Education, 10(1), 91-107.

Nurrahman, Y. (2017). LINE application users in Indonesia are dominated by teenagers [in Bahasa].

Ramadanty, S., & Widayanti, R. (2020). Sales promotion and brand loyalty through mobile application line official account. Journal of Critical Reviews, 7(17), 1720-1727.

Rani, N. N., & Ali, D. S. F. (2019). Analisis faktor pemilihan media sosial Line di kalangan remaja Kota Bandung [Analysis of factors in choosing Line social media among teenagers in Bandung City]. Jurnal Jurnalisa, 5(1), 91-105.

Richter, F. (2016). The most popular apps in the world.

Schroeder, J., & Greenbowe, T. J. (2009). The chemistry of Facebook: Using social networking to create an online community for the organic chemistry laboratory. Innovate: Journal of Online Education, 5(4), 3.

Sedlecki, K., Markovic, A., & Rajic, G. (2001). Medical aspects of adolescent sexuality. Srpski arhiv za celokupno lekarstvo, 129(5-6), 109-113.

Shih, R.-C., Lee, C., & Cheng, T.-F. (2015). Effects of English spelling learning experience through a mobile line app for college students. Procedia - Social and Behavioral Sciences, 174, 2634-2638.

Solehati, T., Pramukti, I., Rahmat, A., & Kosasih, C. E. (2022). Determinants of adolescent reproductive health in West Java Indonesia: A cross-sectional study. International Journal of Environmental Research and Public Health, 19(19), 11927.

Statista Research Department. (2017). Number of monthly active LINE users worldwide as of 4th quarter 2016.

Statistics Indonesia. (2013). 2012 Indonesian demographic and health survey: Adolescent reproductive health [in Bahasa]. Jakarta: Badan Pusat Statistik Indonesia.

Statistics Indonesia. (2021a). Population growth rate according to regency/city 2019-2021.

Statistics Indonesia. (2021b). Percentage of population by age group (10 years) and gender.

Steinberg, M. (2020). LINE as super app: Platformization in East Asia. Social Media+ Society, 6(2), 2056305120933285.

Susanto, T., Rahmawati, I., Wuryaningsih, E. W., Saito, R., Kimura, R., Tsuda, A., Tabuchi, N., & Sugama, J. (2016). Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent. Epidemiology and Health, 38, e2016041.

Van De Bogart, W., & Wichadee, S. (2015). Exploring students’ intention to use LINE for academic purposes based on technology acceptance model. International Review of Research in Open and Distributed Learning, 16(3), 65-85.

Ventola, C. L. (2014). Social media and health care professionals: benefits, risks, and best practices. Pharmacy and Therapeutics, 39(7), 491-499.

Vlachopoulou, E., & Boutsouki, C. (2014). Facebook usage among teenagers–the effect of personality and peer group pressure; an exploratory study in Greece. International Journal of Internet Marketing and Advertising, 8(4), 285-299.

Wang, Q., Woo, H. L., Quek, C. L., Yang, Y., & Liu, M. (2012). Using the Facebook group as a learning management system: An exploratory study. British Journal of Educational Technology, 43(3), 428-438.

Readers are able to give us their valuable feedbacks here. The comments will be reviewed by the editors and then published here. Important Note: The "Comments" related to the Galley Proof PDF must NOT be submitted via this form. Authors should submit their comments on their galley proofs only via system