School nurse-led educational interventions for sexual and reproductive health promotion in adolescents in high-income countries: a mixed-methods systematic review protocol

INTRODUCTION: As educators and health professionals, school nurses are in an optimal position to improve and advocate for adolescent reproductive and sexual health. This report outlines a protocol for a systematic review to synthesize evidence on the effects of school nurse-led education interventions and barriers and facilitators to implementing the interventions to improve students' knowledge, attitudes and behaviours related to sexual and reproductive health in high-income countries. METHODS AND ANALYSIS: . The search will be conducted in Ovid-MEDLINE, CINAHL, Cochrane Library, Ovid-Embase, PsycINFO, Koreamed and ScienceON using relevant Medical Subject Headings and text words to identify the literature on different types of studies examining school nurse-led sexual and reproductive health education interventions in April 2024. Two independent reviewers will select relevant studies and extract data using a predefined template. We will assess methodological quality using the risk-of-bias tools appropriate for study designs and will resolve discrepancies through discussion with the review team. Where appropriate, we will conduct meta-analyses to estimate the effectiveness of school nurse-led sexual and reproductive health education interventions. Additionally, a qualitative evidence synthesis will be performed for the qualitative research included in the review. Finally, both a quantitative synthesis and a qualitative synthesis will be combined into a secondary synthesis addressing the facilitators and barriers of sexual and reproductive health educational interventions provided by school nurses to adolescents. ETHICS AND DISSEMINATION: This review will synthesise publicly available resources and does not require ethical approval. The findings will provide insights into how school nurses can improve students' sexual and reproductive health. The results will be disseminated through peer-reviewed publications, reports and academic conferences. PROSPERO REGISTRATION NUMBER: CRD42022347625.