Introduction School age children are strategic targets for the implementation of health improvement programs in Indonesia. This study to determine the effect of  snakes, cards, and ladders board game with peers modeling approach to improve clean and healthy living behaviour of school-age children.

Method The design is quasi experiment pre-post test with control group. The calculated sample size was 126 school age chidren. School age children 6-12 years old who had a problem of lack of clean and healthy living behaviour. Community The researchers used simulation of snakes, cards, and ladders board game in four sessions over 1 months, staging each session for 45 minutes. Data collection tool was a questionnaire consisting of variable knowledge, attitudes, and clean and healthy living behaviour skills of school-age children. Data was analysed using the paired t-test.

Results The results showed snakes, cards, and ladders board game significantly affects knowledge (p = 0.003), attitudes (p = 0.04), and prevention skills (p = 0.007) of clean and healthy living behaviour.

Conslucion Simulation of snakes, cards, and ladders board game significantly increases knowledge, attitudes, and skills of clean and healthy living behaviour in school age children. The study recommends that used simulation of snakes, cards, and ladders board game be applied to enhance clean and healthy living behaviour and prevent diarrhoea among school-age children. It should also be integrated into school nursing services.

Keywords : School-age children, Snakes, cards, and ladders board game, clean and healthy living behaviour