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There is a need to ensure an environment for safe and supported disclosure of sexual violence in these clinical settings. The purpose of this research is to gain a deeper understanding of how, why, for whom and in what circumstances safe and supported disclosure occurs in sexual health services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>To understand how safe and supported disclosure of sexual violence works within sexual health services a realist review will be undertaken with the following steps: (1) Focussing of the review including a scoping literature search and guidance from an advisory group. (2) Developing the initial programme theories and a search strategy using context-mechanism-outcome (CMO) configurations. (3) Selection, data extraction and appraisal based on relevance and rigour. (4) Data analysis and synthesis to further develop and refine programme theory, CMO configurations with consideration of middle-range and substantive theories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data analysis<\/jats:title>\n                    <jats:p>A realist logic of analysis will be used to align data from each phase of the review, with CMO configurations being developed. Programme theories will be sought from the review that can be further tested in the field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study has been approved by the ethics committee at University of Birmingham, and has Health Research Authority approval. Findings will be disseminated through knowledge exchange with stakeholders, publications in peer-reviewed journals, conference presentations and formal and informal reports. In addition, as part of a doctoral study, the findings will be tested in multisite case studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration details<\/jats:title>\n                    <jats:p>CRD4201912998. Dates of the planned realist review, from protocol design to completion, January 2019 to July 2020.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-037599","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T06:34:04Z","timestamp":1592462044000},"page":"e037599","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["How, why, for whom and in what context, do sexual health clinics provide an environment for safe and supported disclosure of sexual violence: protocol for a realist review"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9246-2581","authenticated-orcid":false,"given":"Rachel J","family":"Caswell","sequence":"first","affiliation":[{"name":"Department of Sexual Health and HIV Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4152-9704","authenticated-orcid":false,"given":"Ian","family":"Maidment","sequence":"additional","affiliation":[{"name":"School of Life and Health Sciences, Aston University, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D C","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Sexual Health and HIV Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Bradbury-Jones","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"2025121510360649000_10.6.e037599.1","first-page":"1","article-title":"Sexual and reproductive health outcomes of violence against women and girls in Lower-Income countries: a review of reviews","author":"Grose","year":"2020","journal-title":"J Sex Res"},{"key":"2025121510360649000_10.6.e037599.2","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.amepre.2018.08.025","article-title":"Trauma exposure, DSM-5 post-traumatic stress disorder, and sexual risk outcomes","volume":"56","author":"Mota","year":"2019","journal-title":"Am J Prev Med"},{"key":"2025121510360649000_10.6.e037599.3","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.162.10.1157"},{"key":"2025121510360649000_10.6.e037599.4","doi-asserted-by":"publisher","DOI":"10.2307\/3030208"},{"key":"2025121510360649000_10.6.e037599.5","doi-asserted-by":"publisher","DOI":"10.1136\/sti.2007.026039"},{"key":"2025121510360649000_10.6.e037599.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60548-X"},{"key":"2025121510360649000_10.6.e037599.7","doi-asserted-by":"publisher","DOI":"10.1016\/S1054-139X(00)00096-3"},{"key":"2025121510360649000_10.6.e037599.8","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/S2352-4642(18)30202-5","article-title":"Mental and sexual health outcomes following sexual assault in adolescents: a prospective cohort study","volume":"2","author":"Khadr","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"key":"2025121510360649000_10.6.e037599.9","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000146641.98665.b6"},{"key":"2025121510360649000_10.6.e037599.10","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jogn.2016.04.002","article-title":"Factors That Influence Women to Disclose Sexual Assault History to Health Care Providers","volume":"45","author":"Berry","year":"2016","journal-title":"J Obstet Gynecol Neonatal Nurs"},{"key":"2025121510360649000_10.6.e037599.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.02.025"},{"key":"2025121510360649000_10.6.e037599.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-3797(00)00226-9"},{"key":"2025121510360649000_10.6.e037599.13","unstructured":"PHE . 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