{
  "abstract": "Background Comprehensive sexuality education (CSE) is a priority area for health promotion in adolescence and a key strategy to prevent STIs, including HIV/AIDS. Scaling up effective interventions requires long-term sustainability and transferability to heterogeneous contexts. This study explores the feasibility of a CSE intervention (EduForIST) conducted in lower (LSS) and upper secondary schools (USS) in seven Italian regions during 2023/2024 and 2024/2025 school years, developed and implemented through a multi-sectoral collaboration.Methods The intervention consists of five two-hour sessions conducted by two educators. For each participating class, the composition of the educational team (Local Health Authority – LHA, Civil Society Organisations – CSO, teachers) and the context (e.g. type of school, location, deprivation) were collected. The intervention was evaluated using pre and post questionnaires to measure students’ knowledge (28-30 items) and satisfaction (19 items). An online survey investigating programme sustainability (P-SAT) was disseminated to adult stakeholders. Multilevel regression analyses explored the association between the team composition and the outcomes of the intervention. For each domain of the P-SAT questionnaire, a score was calculated as the arithmetic mean of the corresponding items.Results KnowledgeIn two years, the programme involved 2094 students. Overall, knowledge increased in all domains investigated, in particular STIs prevention. In LSS, post-test scores remained consistent across team compositions, with no statistically significant differences observed (p = 0.085). Conversely, USS results reported higher overall scores and significant variation based on team (p = 0.009), showing that students taught by mixed teams performed better than those taught by a single-sector team.SatisfactionOverall, students reported a high level of appreciation of the intervention (>80%). Both school levels showed a clear preference for external providers, while preference for own teachers as educators was higher when teachers were part of the educational team.SustainabilityAmong the project adult stakeholders, 26 completed the P-SAT, 9 of which had a managerial role. Perceived sustainability capacity was moderate (overall mean score 5.08). Programme adaptation scored higher (5.8), while funding stability scored lower (3.4).Conclusions The results of the study suggest that the integration of multi-sectoral, local health and educational expertise is a distinctive strength of the intervention. The improved performance, in USS, of mixed teams suggests that a multidisciplinary approach enhances knowledge acquisition. The capacity for program adaptation might help to mitigate resource shortages and improve its transferability across different local contexts. To ensure long-term impact, efforts must address the weakness in funding stability to allow the transition from a pilot study to a standardised public health practice.",
  "authors": [
    {
      "affiliations": [
        "Department of Translational Research and New Medical and Surgical Technologies, University of Pisa, Pisa, Italy"
      ],
      "name": "A Chinelli"
    },
    {
      "affiliations": [
        "Department of Translational Research and New Medical and Surgical Technologies, University of Pisa, Pisa, Italy"
      ],
      "name": "G Paparatto"
    },
    {
      "affiliations": [
        "Department of clinical and experimental medicine, University of Pisa, Pisa, Italy"
      ],
      "name": "P Giangrande"
    },
    {
      "affiliations": [
        "Italian National Association for the Fight Against Aids (ANLAIDS), Rome, Italy"
      ],
      "name": "M Farinella"
    },
    {
      "affiliations": [
        "Department of Prevention, General Directorate of Welfare, Regione Lombardia, Milan, Italy"
      ],
      "name": "C Celata"
    },
    {
      "affiliations": [
        "Department of Human Sciences, University of Verona, Verona, Italy"
      ],
      "name": "M Ubbiali"
    },
    {
      "affiliations": [
        "Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy"
      ],
      "name": "D Martinelli"
    },
    {
      "affiliations": [
        "Department of Translational Research and New Medical and Surgical Technologies, University of Pisa, Pisa, Italy"
      ],
      "name": "L Tavoschi"
    }
  ],
  "title": "OC56 Effectiveness and sustainability of organisational models for delivering comprehensive sexuality education in Italian secondary schools: a two-year analysis, 2023-2025",
  "uid": "2defa31a-f3df-505e-8163-ebd992cfaedf"
}