How school-community cultural norms shape young people’s reproductive health behaviors: Evidence from educational and behavioral research in China

This study systematically examines how school-community cultural norms shape young people's reproductive health behaviors in China. Using the PRISMA 2020 framework, a systematic review of empirical studies published between 2010 and 2022 was conducted to synthesize evidence from educational and behavioral research. Multiple international and Chinese databases were searched to identify qualitative, quantitative, and mixed-methods studies examining the influence of cultural norms within school and community settings on youth reproductive health knowledge, attitudes, and behaviors. Thematic synthesis, guided by the Social Ecological Model, was employed to integrate findings across studies. The review reveals that school-community cultural norms-particularly norms of silence, stigma, and gendered expectations-play a critical role in shaping reproductive health behaviors and in moderating the effectiveness of school-based interventions. Schools function both as reinforcers of prevailing community norms and as potential agents of change when culturally sensitive education is implemented. The findings underscore the need for context-specific, community-engaged reproductive health interventions tailored to the Chinese socio-cultural environment.