Development and Pilot Evaluation of a Training-of-Trainers Model for School-Based Sexuality Education Within the ESPRIT Project

Background: Sexuality education is essential for adolescent health and well-being, yet in Italy it is not included in a mandatory national curriculum, resulting in heterogeneous implementation across regions. Within the ESPRIT project, a multidisciplinary training-of-trainers (ToT) model was developed to prepare professionals to support school-based peer-education pathways. This study aimed to describe the training model and perform a pilot evaluation of short-term knowledge outcomes among trained participants. Methods: A pilot non-randomized controlled comparative study was conducted within the ESPRIT project framework. A multidisciplinary Training Team developed a structured ToT pathway based on WHO guidance, national recommendations, and peer-education models. Ten advanced public health residents in Hygiene and Preventive Medicine attended a three-day residential training course. One month later, a 10-item knowledge questionnaire was administered to trained participants (n = 10) and untrained advanced public health residents (n = 10). Results: Trained participants achieved higher questionnaire scores than the comparator group (median score 8 [IQR 2] vs. 3.5 [IQR 2]; p < 0.0005). Conclusions: Structured ToT programmes may represent a promising approach for strengthening professional preparation in sexuality education. Larger studies with longer follow-up are needed to evaluate sustainability and real-world implementation.