Journal of Health Technology Assessment in Midwifery ISSN 2620-8423 (print) | 2620-5653 (online) Vol. 4, No. 1, May 2021, pp. 44-51 44 10.31101/jhtam.1933 The influence of MEDULA (Education Media for Snakes and Ladders) on adolescent knowledge levels on reproductive health Ema Waliyanti a,1,* , Anindya Sekar Utami a,2 , Evi Novitasari a,3 , Miranda Ayu Fitri Amelia a,4 , Rahmawati a,5 , Faudyan Eka Satria a,6 a Program Studi Ilmu Keperawatan, Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Muhammadiyah Yogyakarta, Indonesia. 1 emawaliyanti@yahoo.com*; 2 anindyasekar94@yahoo.co.id; 3 evinovitasari399@gmail.com; 4 mirandaayufitriamelia@gmail.com; 5 rahmawati150294@gmail.com; 6 fesdio@gmail.com *corresponding author 1. Introduction Adolescence is a period of rapid growth and development, physically, psychologically, and intellectually. Based on data from the Ministry of Health Republic of Indonesia, the age group of 10- 19 years in Indonesia in 2020 was 75.49 million or around 27.94% of the total population (2020 Population Census Results., 2020) Related to this, adolescents are known to have distinctive characteristics, namely great curiosity, like adventure and challenges, and tend to be brave enough to take risks without being preceded by careful consideration. These traits transform adolescents as a population that is vulnerable to health problems. The developing reproductive organs of adolescents and their great curiosity encourage adolescents to try negative behaviors such as premarital sexual behavior (Alfiasari & Oktriyanto, 2019). Many adolescents aged 15-19 have had children, especially in developing countries and married before 18. The high rate of marriage at a young age and the large number of pregnant women under 20 years are mostly due to premarital pregnancy. Premarital sexual behavior has many risks, such as pregnancy in adolescence and infection with sexually transmitted diseases. Psychologically, adolescents will feel anxious and inferior immediately after being in this situation. In addition, other ARTICLE INFO ABSTRACT Article history Received, 13 th March 2021 Revised, 10 th May 2021 Accepted, 8 th May 2021 Adolescents have a distinctive characteristic of great curiosity to take risks without careful consideration. This makes teenagers enter susceptible to perform behaviors such as pre-marital sexual behavior which bring many negative effects, physically, psychologically, and socially. Therefore, it is required the availability of reproductive health services that are friendly and appealing to teenagers, such as a playful education by using the ladder snake games, so that the respondents catch much information is submitted. This study was tried to determine the effect of health education with the ladder snake games to students’ knowledge level about adolescent reproductive health. This quasi- experimental study used pre-posttest design with control group. The sample used was 116 students in the secondary school, selected through the total sampling method. Instruments in this study used questionnaires that its validity and reliability had been tested. As well as ladder snakes measuring 2x2 meters. Data were analyzed by nonparametric Statistic test. Wilcoxon test showed a significance value of 0.000 (p <0.05) which means there are significant differences in the intervention group before and after health education with snake ladder. This research concluded that there was ladders snake game influence to the students’ knowledge about adolescent reproductive health. This is an open access article under the CC–BY-SA license. Keywords Adolescent Ladder snake Reproduction