The Temporal Evolution of Digital Learning: A Longitudinal Quasi-Experimental Study of Web-Based Versus Conventional SRH Education Among Adolescents.
- 1Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences Universiti Malaysia Sarawak Kota Samarahan Malaysia.
- 2Faculty of Computer Science and Information Technology Universiti Malaysia Sarawak Kota Samarahan Malaysia.
- 3Faculty of Cognitive Sciences and Human Development Universiti Malaysia Sarawak Kota Samarahan Malaysia.
Abstract
Background
Adolescents in rural indigenous communities often lack culturally appropriate sexual and reproductive health (SRH) education. This study compared the short-term effectiveness of a web-based SRH intervention versus conventional face-to-face education among 260 rural Bidayuh adolescents aged 16-19 in Sarawak.Methods
Using a non-randomized, two-district quasi-experimental design (one district assigned to each arm to minimize contamination), knowledge was assessed via a validated questionnaire at baseline, 1 month, and 3 months. All 260 enrolled participants were analyzed under an intention-to-treat approach using a repeated-measures ANCOVA (arm × gender × time); 15 participants (5.8%) were lost to follow-up by 3 months.Results
Knowledge scores did not differ between arms at baseline or 1 month, but diverged significantly by 3 months, favoring the web-based arm (68.12% vs. 59.13%; adjusted difference = -8.67 percentage points, 95% CI = [-12.61 to -4.74] (conventional minus web-based; the web-based arm scored higher), p < 0.001), reflected in a significant Arm × Time interaction, F(2, 747) = 7.47, p = 0.001. This advantage was numerically larger among females (Δ = -11.48, p < 0.001) than males (Δ = -5.87, p = 0.050), though the three-way interaction did not reach conventional significance (p = 0.053). Sensitivity analyses (per-protocol; multiple imputation) produced consistent estimates.Discussion
Knowledge retention over 3 months was better in the web-based arm, with a numerically larger effect among females. These findings may be associated with digital SRH education promoting longer-lasting knowledge among rural indigenous adolescents, but should be interpreted cautiously given the non-randomized, two-cluster design, which cannot fully separate intervention effects from district-level differences.Conclusion
Self-regulated digital platforms may be a promising addition to school- and community-based SRH programs in conservative rural settings, alongside strategies to promote engagement and reinforcement, pending confirmation in a randomized, multi-site trial.
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BibTeX
@article{rahman2026temporal,
title = {{The Temporal Evolution of Digital Learning: A Longitudinal Quasi-Experimental Study of Web-Based Versus Conventional SRH Education Among Adolescents.}},
author = {Md Mizanur Rahman and Gerraint Gillan Ahi and Rafazila Ramli and Rasitasam Safii and Jacey Lynn Minoi and Stephanie Chua Hui Li and Ahmad Sofian Bin Shminan and Lee Jun Choi},
journal = {Health science reports},
year = {2026},
month = oct,
doi = {10.1002/hsr2.73452},
url = {https://europepmc.org/article/MED/42948519},
note = {CC BY},
}
RIS
TY - JOUR
TI - The Temporal Evolution of Digital Learning: A Longitudinal Quasi-Experimental Study of Web-Based Versus Conventional SRH Education Among Adolescents.
AU - Md Mizanur Rahman
AU - Gerraint Gillan Ahi
AU - Rafazila Ramli
AU - Rasitasam Safii
AU - Jacey Lynn Minoi
AU - Stephanie Chua Hui Li
AU - Ahmad Sofian Bin Shminan
AU - Lee Jun Choi
PY - 2026
DA - 2026/10/27
JO - Health science reports
DO - 10.1002/hsr2.73452
UR - https://europepmc.org/article/MED/42948519
AB - Background Adolescents in rural indigenous communities often lack culturally appropriate sexual and reproductive health (SRH) education. This study compared the short-term effectiveness of a web-based SRH intervention versus conventional face-to-face education among 260 rural Bidayuh adolescents aged 16-19 in Sarawak.Methods Using a non-randomized, two-district quasi-experimental design (one district assigned to each arm to minimize contamination), knowledge was assessed via a validated questionnaire at baseline, 1 month, and 3 months. All 260 enrolled participants were analyzed under an intention-to-treat approach using a repeated-measures ANCOVA (arm × gender × time); 15 participants (5.8%) were lost to follow-up by 3 months.Results Knowledge scores did not differ between arms at baseline or 1 month, but diverged significantly by 3 months, favoring the web-based arm (68.12% vs. 59.13%; adjusted difference = -8.67 percentage points, 95% CI = [-12.61 to -4.74] (conventional minus web-based; the web-based arm scored higher), p < 0.001), reflected in a significant Arm × Time interaction, F(2, 747) = 7.47, p = 0.001. This advantage was numerically larger among females (Δ = -11.48, p < 0.001) than males (Δ = -5.87, p = 0.050), though the three-way interaction did not reach conventional significance (p = 0.053). Sensitivity analyses (per-protocol; multiple imputation) produced consistent estimates.Discussion Knowledge retention over 3 months was better in the web-based arm, with a numerically larger effect among females. These findings may be associated with digital SRH education promoting longer-lasting knowledge among rural indigenous adolescents, but should be interpreted cautiously given the non-randomized, two-cluster design, which cannot fully separate intervention effects from district-level differences.Conclusion Self-regulated digital platforms may be a promising addition to school- and community-based SRH programs in conservative rural settings, alongside strategies to promote engagement and reinforcement, pending confirmation in a randomized, multi-site trial.
SN - 2398-8835
ER -