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Controlled trials of sex education or sexual health services and qualitative studies focusing solely on attitudes to and knowledge of sexual health or sex education were excluded.We hand searched American Journal of Public Health (from January 1999 to January 2004), Journal of Adolescent Health (from January 1999 to February 2004), Journal of Adolescence (from February 1999 to April 2004), and Perspectives on Sexual and Reproductive Health (from issue 1, 1999, to issue 1, 2004). We also reviewed the reference lists of all studies that met our inclusion criteria and contacted experts in the field who suggested further studies to pursue.Quality assessmentWe assessed the extent to which controlled trials had minimised bias and error in their findings by using a set of criteria developed in previous health promotion reviews.27 28 29 “Sound” trials were those that reported data on each outcome measure indicated in the study aims; used a control or comparison group equivalent to the intervention group on relevant sociodemographic measures (or, in cases with non equivalent groups, adjusted for differences in the analysis); provided pre intervention data for all individuals in each group; and provided post intervention data for all individuals in each group.The criteria we used to assess the methodological quality of the qualitative studies were built on those suggested in the literature on qualitative research.26 30 31 32 33 Each study was assessed according to 12 criteria designed to aid judgment on the extent to which study findings were an accurate representation of young people’s perspectives and experiences (box). A final assessment sorted studies into one of three categories on the basis of quality: high quality (those meeting 10 or more criteria), medium quality (those meeting between seven and nine criteria), and low quality (those meeting fewer than seven criteria).Criteria used to assess the quality of qualitative studiesQuality of reportingWere the aims and objectives clearly reported?Was there an adequate description of the context in which the research was carried out?Was there an adequate description of the sample and the methods by which the sample was identified and recruited?Was there an adequate description of the methods used to collect data?Was there an adequate description of the methods used to analyse data?Use of strategies to increase reliability and validityWere there attempts to establish the reliability of the data collection tools (for example, by use of interview topic guides)?Were there attempts to establish the validity of the data collection tools (for example, with pilot interviews)?Were there attempts to establish the reliability of the data analysis methods (for example, by use of independent coders)?Were there attempts to establish the validity of data analysis methods (for example, by searching for negative cases)?.