title: Reasons for the use and non-use of school sexual health services: a systematic review of young people's views.
abstract: BACKGROUND
  The potential for sexual health services to influence the sexual health and behaviour of school-aged young people is only likely to be realised if these services are accessed. This review and synthesis seeks to explore children and adolescents' views and experiences of school-based and school-linked sexual health services to identify barriers to and facilitators of service use.
  
  
  METHODS
  The study design is a systematic review of studies focusing on the views of children and adolescents (11-18 years) about relevant services. Sixteen databases were searched, titles and abstracts were screened against the inclusion criteria, data extraction and quality assessment of included studies were performed and thematic synthesis was undertaken.
  
  
  RESULTS
  Nineteen relevant studies were identified, but only studies from the USA and the UK satisfied the inclusion criteria. The principal themes to emerge from the analysis were awareness and need, confidentiality and disclosure, perceptions of staff, service location, physical environment, costs and types of services on offer. These findings were consistent across country and type of service.
  
  
  CONCLUSIONS
  In the view of young people, school-linked sexual health services need to guarantee and promote the ideas of privacy, confidentiality and approachability if they are to be accessed and have an impact on behaviour.
authors.affiliation: School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield S1 4DA, UK. c.carroll@sheffield.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Carroll
authors.forename: M
authors.initials: M
authors.lastname: Lloyd-Jones
authors.forename: J
authors.initials: J
authors.lastname: Cooke
authors.forename: J
authors.initials: J
authors.lastname: Owen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001364:Awareness; D002648:Child; D002652:Child Behavior; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D000297:Psychology, Adolescent / Q000379:methods*; D036301:Qualitative Research; D060728:Reproductive Health; D012309:Risk-Taking; D012572:School Health Services / Q000706:statistics & numerical data*; D019529:Sexuality; D012938:Social Perception; D006113:United Kingdom; D014481:United States