Kidney Risk Education (KREN) as Audiovisual Edutainment to Enhance Adolescents’ Knowledge of Chronic Kidney Disease Prevention: A Pre-Experimental Study
DOI:
https://doi.org/10.51143/jksi.v11i1.1121Abstract
The prevalence of Chronic Kidney Disease (CKD) is increasing globally, including among adolescents. Limited knowledge about CKD prevention may predispose to unhealthy lifestyle behaviors that increase the risk of kidney damage. This study aimed to examine the effect of Kidney Risk Education (KREN), an audiovisual edutainment-based intervention on adolescents’ knowledge on CKD prevention at SMPN 21 Central Bengkulu, Indonesia. A pre-experimental one group pretest-posttest design was conducted involving 81 students. Knowledge was assessed using validated and reliable questionnaire administered before and after the intervention. KREN was delivered through audiovisual edutainment focusing on CKD risk factors, prevention strategies, and healthy lifestyle behaviors. Data were analyzed using the Wilcoxon signed-rank test. The results showed a statistically significant increase on students’ knowledge scores after the intervention (p = 0.0001), indicating that KREN effectively enhanced adolescents’ knowledge of CKD prevention. Audiovisual-based health education can serve as a practical and scalable health promotion strategy in school settings to support early prevention of chronic kidney disease. However, further studies with control groups are needed to strengthen the validity of these findings.
References
Adesope, O., & Proença, L. (2024). Video-based approaches in health education?: a systematic review and meta-analysis. Scientific Report, 14(1), 23651. https://doi.org/10.1038/s41598-024-73671-7
Bas, F., Kleden, S., & Hamu, A. (2024). The Effect of audiovisual health education on early detection and prevention of cervical cancer on female students’ knowledge. Journal of Tropical Disease and Health Science, 4(1), 1–5. https://doi.org/10.31965/jtdhs.v4i1.2181
Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Brown, M. P. M. G. (2023). Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease?: a systematic review. Journal of Nephrology, 36(5), 1267–1281. https://doi.org/10.1007/s40620-022-01537-0
Cirillo, L., De Chiara, L., Innocenti, S., Errichiello, C., Romagnani, P., & Becherucci, F. (2023). Chronic kidney disease in children: an update. Clinical Kidney Journal, 16(10), 1600–1611. https://doi.org/10.1093/ckj/sfad097
Dryjanska, N., & Kili, K. (2023). Depression in children and adolescents with chronic kidney disease-review of available literature. Journal of Clinical Medicine, 12, 3554. https://doi.org/10.3390/jcm12103554
Eghbal, S. B., Kenari, Z. A., Ashouri, A., Tonekaboni, N. R., & Kasmaei, P. (2023). The effectiveness of educational program based on health belief model on promotion of puberty health concepts among teen girls: a cross?sectional study in north of Iran. BMC Women’s Health, 1–9. https://doi.org/10.1186/s12905-023-02391-3
Fashafsheh N, Chui P, Danaee M, Ayed A, Lai L. (2025). Enhancing knowledge in adolescents undergoing hemodialysis in palestine: the Impact of a video-assisted educational program. Hemodialysis International, 30(1), 215-223. https://doi.org/10.1111/hdi.70015
Ishpuz, M. (2019). Association of adolescent hypertension with future end-stage renal disease. JAMA International Medication, 179(4), 517-523. https://doi.org/10.1001/jamainternmed.2018.7632
Khairunnisa, Y., Jeki, A. G., Wulansari, A., & Indrawati, I. (2025). The effect of nutrition education via video on adolescents’ knowledge of balanced nutrition at SMAN 7 Batang Hari. Jurnal Akademika Baiturahim Jambi, 14(2), 307–313. https://doi.org/10.36565/jab.v14i2.939
Kuma, A., & Kato, A. (2022). Lifestyle-related risk factors for the incidence and progression of chronic kidney disease in the healthy young and midle age population. Nutrients, 14(18), 3787. https://doi.org/10.3390/nu14183787
Kementerian Kesehatan Republik Indonesia. (2024). Kasus Gagal Ginjal Akut Pada Anak Meningkat, Orang Tua Diminta Waspada. 021, 2024–2026.
Li, Z., He, R., Wang, Y., Qu, Z., Liu, J., Yu, R., & Yang, S. (2025). Global trends of chronic kidney disease from 1990 to 2021: a systematic analysis for the global burden of disease study 2021. BMC Nephrology, 26(385). https://doi.org/10.1186/s12882-025-04309-7
Mackowiak, K., Danuta, L., Nowicka, O., & Zaorska, K. (2022). Chronic kidney disease predictors in obese adolescents. Pediatric Nephrology, 37(1), 2479–2488. https://doi.org/10.1007/s00467-021-05403-2
Meidiana, R., Simbolon, D., & Wahyudi, A. (2018). The effect of education through audiovisual media on the knowledge and attitudes of overweight adolescents. Jurnal Kesehatan, 9(3), 478–484.
Mi, A., Luh, N., Ariastuti, P., Ayu, K., Sari, K., & Sawitri, A. S. (2025). The influence of audiovisual media on increasing knowledge about chronic kidney disease in diabetes mellitus patients at RSUD Dr. Soedomo Trenggalek Regency. Jurnal Medika Udayana, 14(01), 57–65. https://doi.org/10.24843/MU.2025.V14.i1.P12
Muthmainnah, M., Salim, L. A., Nurmala, I., Nadia, A., & Salsabila, A. C. (2025). Enhancing health education using edutainment: a quantitative study in Malang Regency, Indonesia. Media Publikasi Promosi Kesehatan Indonesia, 8(5), 326-336. https://doi.org/10.56338/mppki.v8i5.7134
Nakamura, J., Kaseda, R., Takeuchi, M., Kitabayashi, K., & Narita, I. (2024). Adolescents and parents’ knowledge of chronic kidney disease: the potential of school-based education. Clinical and Experimental Nephrology, 29(3), 292–300. https://doi.org/10.1007/s10157-024-02574-8
Neto, V., Martins, B., Branquinho, A., Figueiras, A., & Teresa, M. (2025). Educational interventions for the adoption of healthy lifestyles and improvement of health literacy: a systematic review. Public Health, 245(1). https://doi.org/10.1016/j.puhe.2025.105788
Öztürk FÖ, Do?an E, Gedikaslan E, Y?lmaz HY. The effect of structured health promotion education given to adolescents on health literacy and health-promoting behaviors. (2023). J Pediatr Nurs, 73, 579-585. https://doi.org/10.1016/j.pedn.2023.10.036.
Port, L., Public, B. M. C., Port, A. Le, Seye, M., Heckert, J., Peterman, A., Tchamwa, A. N., Dione, M., Fall, A. S., & Hidrobo, M. (2022). A community edutainment intervention for gender-based violence , sexual and reproductive health, and maternal and child health in rural Senegal: a process evaluation. BMC Public Health, 22(1165), 1–15. https://doi.org/10.1186/s12889-022-13570-6
Ramadan, Y., Elkoofy, N., Sabry, S., Mansour, G., & Anwar, N. El. (2023). Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V. Egyptian Pediatric Association Gazette. 71(3).https://doi.org/10.1186/s43054-022-00155-6
Riyami, M. S. Al. (2025). Anemia in children with chronic kidney disease. Asian Journal of Pediatric, 7(2), 34–39. https://doi.org/10.4103/ajpn.ajpn
Siswati, T., Olfah, Y., Kasjono, H. S., & Paramashanti, B. A. (2022). Improving adolescent knowledge and attitude toward the intergenerational cycle of undernutrition through audiovisual education: findings from RESEPIN study in Yogyakarta Indonesia. Indian Journal of Community Medicine, 47(2), 196–201. https://doi.org/10.4103/ijcm.ijcm_1229_21
Önal HG, Önal M, Nalçacio?lu H, Tekcan Karali D. (2025). Growth and puberty development in pediatric chronic kidney disease patients. Medicine, 104(16). https://doi.org/10.1097/MD.0000000000042159
Taryzafitri, N., Meihartati, T., & Astutik, W. (2025). The effect of audiovisual educational media on adolescent girls’ knowledge of anemia at SMAN 1 Berau. Journal of Sosial Science Research, 5(2), 3752–3764.
Todisco, T., Ubertini, G. M., Bizzarri, C., Loche, S., & Cappa, M. (2024). Chronic kidney disease and growth failure in children. Children, 11(7), 808. https://doi.org/10.3390/children11070808
Wang, T. (2025). An epidemiological trend of chronic kidney disease due to hypertension among adolescents and young adults: global burden and future 2035 projections. Front Public Health, 4(13):1618416. https://doi.org/10.3389/fpubh.2025.1618416
Wang, Z., You, Q., Wang, Y., Wang, J., & Shao, L. (2025). Global, regional, and national burden of chronic kidney disease among adolescents and emerging adults from 1990 to 2021. Renal Failure, 47(1). https://doi.org/10.1080/0886022X.2025.2508296
Zhao, W., & Li, X. (2024). Global , regional and national burden of CKD in children and adolescents from 1990 to 2019. Nephrology Dialysis Transplantation, 39(8), 1268–1278. https://doi.org/10.1093/ndt/gfad269
Zhong, Y., Patel, N., Ferris, M., & Rak, E. (2019). Health literacy, nutrition knowledge, and health care transition readiness in youth with chronic kidney disease or hypertension: A cross- sectional study. Journal of Child Health Care. 24(2): 246-259. https://doi.org/10.1177/1367493519831493
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References
Adesope, O., & Proença, L. (2024). Video-based approaches in health education?: a systematic review and meta-analysis. Scientific Report, 14(1), 23651. https://doi.org/10.1038/s41598-024-73671-7
Bas, F., Kleden, S., & Hamu, A. (2024). The Effect of audiovisual health education on early detection and prevention of cervical cancer on female students’ knowledge. Journal of Tropical Disease and Health Science, 4(1), 1–5. https://doi.org/10.31965/jtdhs.v4i1.2181
Billany, R. E., Thopte, A., Adenwalla, S. F., March, D. S., Burton, J. O., & Brown, M. P. M. G. (2023). Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease?: a systematic review. Journal of Nephrology, 36(5), 1267–1281. https://doi.org/10.1007/s40620-022-01537-0
Cirillo, L., De Chiara, L., Innocenti, S., Errichiello, C., Romagnani, P., & Becherucci, F. (2023). Chronic kidney disease in children: an update. Clinical Kidney Journal, 16(10), 1600–1611. https://doi.org/10.1093/ckj/sfad097
Dryjanska, N., & Kili, K. (2023). Depression in children and adolescents with chronic kidney disease-review of available literature. Journal of Clinical Medicine, 12, 3554. https://doi.org/10.3390/jcm12103554
Eghbal, S. B., Kenari, Z. A., Ashouri, A., Tonekaboni, N. R., & Kasmaei, P. (2023). The effectiveness of educational program based on health belief model on promotion of puberty health concepts among teen girls: a cross?sectional study in north of Iran. BMC Women’s Health, 1–9. https://doi.org/10.1186/s12905-023-02391-3
Fashafsheh N, Chui P, Danaee M, Ayed A, Lai L. (2025). Enhancing knowledge in adolescents undergoing hemodialysis in palestine: the Impact of a video-assisted educational program. Hemodialysis International, 30(1), 215-223. https://doi.org/10.1111/hdi.70015
Ishpuz, M. (2019). Association of adolescent hypertension with future end-stage renal disease. JAMA International Medication, 179(4), 517-523. https://doi.org/10.1001/jamainternmed.2018.7632
Khairunnisa, Y., Jeki, A. G., Wulansari, A., & Indrawati, I. (2025). The effect of nutrition education via video on adolescents’ knowledge of balanced nutrition at SMAN 7 Batang Hari. Jurnal Akademika Baiturahim Jambi, 14(2), 307–313. https://doi.org/10.36565/jab.v14i2.939
Kuma, A., & Kato, A. (2022). Lifestyle-related risk factors for the incidence and progression of chronic kidney disease in the healthy young and midle age population. Nutrients, 14(18), 3787. https://doi.org/10.3390/nu14183787
Kementerian Kesehatan Republik Indonesia. (2024). Kasus Gagal Ginjal Akut Pada Anak Meningkat, Orang Tua Diminta Waspada. 021, 2024–2026.
Li, Z., He, R., Wang, Y., Qu, Z., Liu, J., Yu, R., & Yang, S. (2025). Global trends of chronic kidney disease from 1990 to 2021: a systematic analysis for the global burden of disease study 2021. BMC Nephrology, 26(385). https://doi.org/10.1186/s12882-025-04309-7
Mackowiak, K., Danuta, L., Nowicka, O., & Zaorska, K. (2022). Chronic kidney disease predictors in obese adolescents. Pediatric Nephrology, 37(1), 2479–2488. https://doi.org/10.1007/s00467-021-05403-2
Meidiana, R., Simbolon, D., & Wahyudi, A. (2018). The effect of education through audiovisual media on the knowledge and attitudes of overweight adolescents. Jurnal Kesehatan, 9(3), 478–484.
Mi, A., Luh, N., Ariastuti, P., Ayu, K., Sari, K., & Sawitri, A. S. (2025). The influence of audiovisual media on increasing knowledge about chronic kidney disease in diabetes mellitus patients at RSUD Dr. Soedomo Trenggalek Regency. Jurnal Medika Udayana, 14(01), 57–65. https://doi.org/10.24843/MU.2025.V14.i1.P12
Muthmainnah, M., Salim, L. A., Nurmala, I., Nadia, A., & Salsabila, A. C. (2025). Enhancing health education using edutainment: a quantitative study in Malang Regency, Indonesia. Media Publikasi Promosi Kesehatan Indonesia, 8(5), 326-336. https://doi.org/10.56338/mppki.v8i5.7134
Nakamura, J., Kaseda, R., Takeuchi, M., Kitabayashi, K., & Narita, I. (2024). Adolescents and parents’ knowledge of chronic kidney disease: the potential of school-based education. Clinical and Experimental Nephrology, 29(3), 292–300. https://doi.org/10.1007/s10157-024-02574-8
Neto, V., Martins, B., Branquinho, A., Figueiras, A., & Teresa, M. (2025). Educational interventions for the adoption of healthy lifestyles and improvement of health literacy: a systematic review. Public Health, 245(1). https://doi.org/10.1016/j.puhe.2025.105788
Öztürk FÖ, Do?an E, Gedikaslan E, Y?lmaz HY. The effect of structured health promotion education given to adolescents on health literacy and health-promoting behaviors. (2023). J Pediatr Nurs, 73, 579-585. https://doi.org/10.1016/j.pedn.2023.10.036.
Port, L., Public, B. M. C., Port, A. Le, Seye, M., Heckert, J., Peterman, A., Tchamwa, A. N., Dione, M., Fall, A. S., & Hidrobo, M. (2022). A community edutainment intervention for gender-based violence , sexual and reproductive health, and maternal and child health in rural Senegal: a process evaluation. BMC Public Health, 22(1165), 1–15. https://doi.org/10.1186/s12889-022-13570-6
Ramadan, Y., Elkoofy, N., Sabry, S., Mansour, G., & Anwar, N. El. (2023). Fatigue assessment and its predictors in pediatric patients with chronic kidney disease stages III to V. Egyptian Pediatric Association Gazette. 71(3).https://doi.org/10.1186/s43054-022-00155-6
Riyami, M. S. Al. (2025). Anemia in children with chronic kidney disease. Asian Journal of Pediatric, 7(2), 34–39. https://doi.org/10.4103/ajpn.ajpn
Siswati, T., Olfah, Y., Kasjono, H. S., & Paramashanti, B. A. (2022). Improving adolescent knowledge and attitude toward the intergenerational cycle of undernutrition through audiovisual education: findings from RESEPIN study in Yogyakarta Indonesia. Indian Journal of Community Medicine, 47(2), 196–201. https://doi.org/10.4103/ijcm.ijcm_1229_21
Önal HG, Önal M, Nalçacio?lu H, Tekcan Karali D. (2025). Growth and puberty development in pediatric chronic kidney disease patients. Medicine, 104(16). https://doi.org/10.1097/MD.0000000000042159
Taryzafitri, N., Meihartati, T., & Astutik, W. (2025). The effect of audiovisual educational media on adolescent girls’ knowledge of anemia at SMAN 1 Berau. Journal of Sosial Science Research, 5(2), 3752–3764.
Todisco, T., Ubertini, G. M., Bizzarri, C., Loche, S., & Cappa, M. (2024). Chronic kidney disease and growth failure in children. Children, 11(7), 808. https://doi.org/10.3390/children11070808
Wang, T. (2025). An epidemiological trend of chronic kidney disease due to hypertension among adolescents and young adults: global burden and future 2035 projections. Front Public Health, 4(13):1618416. https://doi.org/10.3389/fpubh.2025.1618416
Wang, Z., You, Q., Wang, Y., Wang, J., & Shao, L. (2025). Global, regional, and national burden of chronic kidney disease among adolescents and emerging adults from 1990 to 2021. Renal Failure, 47(1). https://doi.org/10.1080/0886022X.2025.2508296
Zhao, W., & Li, X. (2024). Global , regional and national burden of CKD in children and adolescents from 1990 to 2019. Nephrology Dialysis Transplantation, 39(8), 1268–1278. https://doi.org/10.1093/ndt/gfad269
Zhong, Y., Patel, N., Ferris, M., & Rak, E. (2019). Health literacy, nutrition knowledge, and health care transition readiness in youth with chronic kidney disease or hypertension: A cross- sectional study. Journal of Child Health Care. 24(2): 246-259. https://doi.org/10.1177/1367493519831493
