THE INFLUENCE OF AUDIO-VISUAL VIDEO MEDIA ON KNOWLEDGE IN EFFORTS TO PREVENT SEXUAL VIOLENCE AGAINST ADOLESCENTS WITH DISABILITIES AT SLB SHANTI KOSALA NGANJUK

Background : In Indonesia, teenagers account for one-quarter of the population. The focus of national development is on teenagers. Teenagers with disabilities are of particular concern due to their numerous restrictions, particularly in reproductive health education. They often experience health problems, especially sexual and reproductive health. Reproductive health education is the right solution for people with disabilities so that they can increase their knowledge in sexual violance so that they can protect themselves from a person. The aim of this research is to determine the effect of audio-visual video media on knowledge in efforts to prevent sexual violence among disabled teenagers. Method: We included all of the student that attend the school on the day of data collection. We used questionnaire to collect the data and the analytical test used was the Wilxocon Rank Test. Result: there was an increase in knowledge before implementing health education using audio-visual media, primarily 13.6%, with the high knowledge group comprising 54.5%. Meanwhile, the low knowledge group dropped from 86.4% to 45.5%. The Wilxocon Rank Test value is p= 0.035, indicating that audio-visual media has a significant influence on knowledge. Conclussion: There is an influence of audio-visual media with information in attempts to prevent sexual violence against disabled youth at SLB. Shanti Kosala Nganjuk.


INTRODUCTION
WHO states that the age limit for teenagers is between 10 and 19 years.The number of teenagers in Indonesia according to 2020 census data is estimated to reach 67 million people or 24% of the total population of Indonesia.Making teenagers an importand subject in the country's development (Pusdatin, 2017).
According the type of age group, they are with disabilities are the group that need attention.
People with disabilities are often excluded structurally, culturally and socially.There are relatively few reproductive health education activities that were given in the special need schools.Ignorance about the reproductive health of people with disabilities often causes them to face reproductive health problems such as genital infections, unsafe sex, unwanted pregnancies, addiction to pornography and sexual crimes.Discriminatory acts against children with special needs often occur because the perpetrator considers them to be asexual creatures or by labeling them as people who have excessive sexual needs and therefore so it's reasonable for them to experience sexual crimes (Apsari, 2018).Apart from that, teenagers with disabilities are vulnerable to health problems, especially those related to sexual and reproductive health (Houtrow et al. 2021).
According to the Disability Act No. 8 of 2016, section 1, paragraph 1, on persons with disabilities, disability is any person who has physical, intellectual, mental and sensory limitations for a long period of time experiencing obstacles and difficulties in fully interacting with society.Physical disabilities are divided into several types: visually impaired, hearing impairs, speech impaires, physically disabled, mentally retarded, healing impairing AND emotionally dysregulated.
They are who is blind or blurred is a disabled.So that the senses of the vision can no longer function like the watchmen in general (Nafi'ah and Khairi 2023).
Deafness is a disorder with difficulty speaking or commonly called speech disability, which is a condition where a person experiences the inability to hear and difficulty speaking.Deaf children's limitations in hearing and speaking slightly hinder the learning process (Al Irsyadi, Puspitassari, and Kurniawan 2019).Mental retardation is a term applied to children with special needs who experience problems regarding intelligence and adaptability in meeting basic daily needs.In Indonesia, the term mentally retarded is a grouping of several children with special needs, but in the field of education they have the same obstacles due to intelligence problems.In foreign languages, children who experience intelligence problems have several terms, including mental retardation, mental defective and mental deficiency (Al Irsyadi, Puspitassari, and Kurniawan 2019;Amanullah 2022).In this study, we analyzed differences in knowledge in these three types of disabilities, namely visually impaired, hearing impaired-speech impaired and mental retardation.

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The sexual behavior of people with disabilities is widely misunderstood by most people.It is the internal factor that makes them engage in inappropriate sexual behavior in public such us low internal control and a lack of understanding of the concept of sex (Farakhiyah, Raharjo, and Apsari 2018).Their limited ability to hear, see and think creates obstacles for adolescents with disabilities, especially in learning the principles of reproductive health.Apart from that, adolescents with disabilities are also vulnerable to sexual violence.This sexual violence often involves people closest to them or people in their immediate environment (Hermawan, 2020).Reproductive health education is one of the efforts that can be made to raise the understanding and awareness of disabled people about their protection from acts of sexual violence (Uyun, 2013).
Knowledge about gender in adolescents can prevent sexual deviations in adolescents (Gerda et al, 2022).Sexuality education for teenagers can also help avoid becoming victims of sexual harassment, thanks to being equipped with knowledge about sex, teenagers will understand what behavior is included in sexual harassment and know how to prevent sexual harassment (Ratna & Alias, 2016).Sex education is an important foundation in preventing sexual violence against children and increasing sexual protection and safety.Sex education helps children better understand their own bodies, know their authority over their bodies and respect the rights and bodies of others (Rahmawati, 2020).
The solution to this problem is to provide reproductive health education about sexual safety and security for the purpose of protecting against sexual violence.This can be done through learning media.Learning media is anything that can be used to convey messages from the sender to the recipient, to stimulate students' thoughts, emotions, attention and interest in learning (Agustin, 2020;Tafonao, 2018).We use audio visual media because in other studies this media has been proven to be able to create active student responses.when participating in learning activities using audio-visual media they are very interested and very concerned about what they see and hear (Anggraini,Himawanto,and Salim 207AD).Based on the description above, the aim of this research is to see the influence of information media, especially through audio-visual videos, on the knowledge of disabled teenagers in preventing sexual violence, so that teenagers can be more aware of their surroundings and minimize sexual violence against people with disabilities.

METHOD
This research is an observational analytical research.This research was carried out at SLB Shanti Kosala Nganjuk.Population in this study was all 22 students in grades 1, 2 and 3 of junior high school.The sampling technique used is total sampling.This independent variable is reproductive health education for the dependent variable is an effort to prevent sexual violence.Data collection used a questionnaire of 10 questions, to find out how to manage adolescents with disabilities, especially actions that should not be in sexual behaviour.To see whether this instrument can be used or not, a validity test is carried out first.The results of the validity test conducted by the researcher obtained a calculation of 0.461, where the calculation > 0.444 values from the table and interpreted as valid.
The analysis methods used are univariate and bivariate analysis.The analysis used used the Wilxocon Rank Test.Ethical tests are carried out first before research, ethical tests are used to see whether or not this research is feasible to be carried out on humans.Ethics is carried out at the Bhakti Wiyata Kediri Institute of Health Sciences with number 06/FTMK/EP/VII/2023.

RESULT AND DISCUSSION
From this study we collected information regarding the characteristics of respondents and the level of knowledge of participants both before and after education.The following are the results of data analysis of respondents based on age and gender.Total

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Table 1 shows the average age of participants.Most participants aged < 20 years were 15 (68.1%).The average age of respondents in this study was 8.91 years with the youngest participant was 13 years old and the oldest was 23 years old.Meanwhile, the most common gender is women with a percentage of 59.1% or around 13 people.Some participants in this study were deaf and speech impaired, some others mentally impaired.Especially for students with intellectual disabilities or mental disabilities, there is a difference in mental age from the actual age.The largest number of participants in this study were students with mental disabilities or intellectual disabilities, namely 13 people (59%), while the fewest were blind, namely 1 person (5%).
In terms of age, we can see a big difference between normal children and children with special needs.In normal children, the average age of junior high school children is 12-15 years.But in this school there are children whose age even reaches 20 years or more.SLB students often encounter physical and cognitive developmental delays that may take them longer to reach the level of development appropriate to normal high school students (Zablotsky et al. 2019).Especially for students with intellectual disabilities or mental disabilities, there is a difference in mental age from the actual (Chronological) age (Sambira, Rusminati, and Rafikayati 2022;Román et al. 2022).
Table 2 The data above shows that for the level of knowledge of children with disabilities before being given health education with a low category with a frequency of 19 or 86.4% and for those who have high knowledge with a frequency of 3 or 13.6%, it means that there are still many children with disabilities who have low knowledge.
Respondent's low knowledge of reproductive health knowledge can be caused by a number of obstacles.One is because of the obstacles to access to general healthcare services.For example, the present review identified lack of education and knowledge on sexual and reproductive health services and information by healthcare workers, and disability unfriendly healthcare facilities and services.Other studies showed barriers to general healthcare services that persons with disability faced included lack of information, limited mobility, stigmatization, and negative and poor staff attitude (Devkota et al. 2017;Ganle et al. 2020).
Table 2 shows that for the level of knowledge after being given reproductive health education with a high category with a frequency of 12 with a percentage of 54.5%.As for low knowledge, the frequency results were obtained 10 or 45.5%.We can see that before counseling, only 13.6% of children who had good knowledge.After counseling, the number of children with high understanding of sexual violence increased to 54.4%.This is quite encouraging.By understanding the importance of taking care of themselves from others, children understand what they should do in the event of sexual violence or sexual harassment.The significance of sexual health education for people with dissabilities cannot be overstated, as lack of information increases the risk of sexual abuse and sexually transmitted infections (Hole, Schnellert, and Cantle 2022).Facts show that people with disabilities are vulnerable to sexual harassment or violence due to their disabilities (Azhar, Hidayat, and Raharjo 2023) (Praptiningrum, 2010).
To be able to provide a significant increase in participants' knowledge, we chose to use song media with simple lyrics.The song was repeated up to 4 times and sung together for easy remembrance by participants.In a study conducted at the Dria Raba Education Foundation, the media used to increase the knowledge of blind students was using braille books (Juanita et al. 2023).Meanwhile, according to (Kelrey 2022), the principle of delivering education to children with mental disabilities is based on simplicity.Just a simple word is conveyed and easy to remember.

CONCLUSION, SUGGESTION
The conclusion of this study is that knowledge increases from pretest to postest.The hope is that the implementation of learning, especially reproductive health education for children with disabilities, is not only carried out once or twice but can be done regularly, so that the knowledge possessed can be sustainable.In addition, the school can also coordinate with local medical personnel or BKKBN to provide materials, including knowledge about reproductive health, so that it can be a provision of knowledge after children with disabilities leave school.

ACKNOWLEDGMENT
Thank you to the Bhakti Wiyata Kediri Institute of Health Sciences for its support in carrying out this research, so that it can be carried out smoothly.

Table 3 . Wilxocon Rank Test Results on Knowledge of Children with Disabilities With Audio-visual Media
As for the ties value is 0 which means there is no equal value between the pretest and postest values.A p value of 0.035 means a value less than < 0.05.So Ha is accepted and H0 is rejected, then it can be concluded that there is an influence of both variables.