Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy
IntroductionTransgender and gender-diverse (TGD) individuals face significant health disparities, often due to healthcare providers’ (HCPs) insufficient training and awareness. Comprehensive educational interventions are essential to improve both cultural competence and medical knowledge. While prev...
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Frontiers Media S.A.
2025-07-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1550470/full |
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| author | Matteo Marconi Ughetta Maria Favazzi Pietro Carbone Debora Guerrera Angela Ruocco Martina Manoli Martina Manoli Cristiana Barbati Francesca Molinaro Federica Maria Regini Andrea Vittozzi Alfonso Mazzaccara Marina Pierdominici |
| author_facet | Matteo Marconi Ughetta Maria Favazzi Pietro Carbone Debora Guerrera Angela Ruocco Martina Manoli Martina Manoli Cristiana Barbati Francesca Molinaro Federica Maria Regini Andrea Vittozzi Alfonso Mazzaccara Marina Pierdominici |
| author_sort | Matteo Marconi |
| collection | DOAJ |
| description | IntroductionTransgender and gender-diverse (TGD) individuals face significant health disparities, often due to healthcare providers’ (HCPs) insufficient training and awareness. Comprehensive educational interventions are essential to improve both cultural competence and medical knowledge. While previous evaluations of training programs have shown short-term benefits, evidence on long-term outcomes remains scarce. This study extends the findings of an earlier evaluation of a distance learning course on TGD healthcare, exploring the sustainability of its effects over time.ObjectivesTo assess changes in self-reported attitudes, skills, practices, and knowledge retention 6 months after course completion.MethodsA longitudinal design was used with assessments at baseline (T0), post-course (T1), and six-month follow-up (T2). Participants completed the Attitudes, Skills, and Practices Questionnaire (ASPQ) and a 10-item knowledge test at all time points. Paired t-tests were used to compare mean scores for attitudes and skills. Knowledge retention was analyzed with McNemar tests. Changes in practice items were evaluated using Cochran’s Q and Friedman tests for paired categorical data.ResultsA total of 3,102 participants (17% of the original cohort) completed the follow-up. All self-reported skills and most attitudes improved significantly from baseline to follow-up (p < 0.001 for skills; p ≤ 0.02 for attitudes), with modest declines from T1. Practice items showed significant variation over time (Cochran’s Q and Friedman tests, p < 0.001), though without a consistent increase in engagement. Knowledge improved in 8 of 10 items from baseline to follow-up (McNemar, p < 0.001), particularly in sexual identity, hormone therapy, and legal rights, despite partial declines from post-course levels.ConclusionThis study highlights sustained improvements in self-reported attitudes, skills, and knowledge following a national TGD healthcare training, reinforcing its value in addressing health disparities. The findings underscore the need for structural support and integrated reinforcement to embed gender-affirming care into routine practice. |
| format | Article |
| id | doaj-art-997cb7536989467f93c2f3c4f4a26ce8 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-997cb7536989467f93c2f3c4f4a26ce82025-08-20T03:31:11ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-07-011310.3389/fpubh.2025.15504701550470Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in ItalyMatteo Marconi0Ughetta Maria Favazzi1Pietro Carbone2Debora Guerrera3Angela Ruocco4Martina Manoli5Martina Manoli6Cristiana Barbati7Francesca Molinaro8Federica Maria Regini9Andrea Vittozzi10Alfonso Mazzaccara11Marina Pierdominici12Reference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyReference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, ItalyReference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, ItalyDepartment of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyTraining Office, Istituto Superiore di Sanità, Rome, ItalyReference Centre for Gender Medicine, Istituto Superiore di Sanità, Rome, ItalyIntroductionTransgender and gender-diverse (TGD) individuals face significant health disparities, often due to healthcare providers’ (HCPs) insufficient training and awareness. Comprehensive educational interventions are essential to improve both cultural competence and medical knowledge. While previous evaluations of training programs have shown short-term benefits, evidence on long-term outcomes remains scarce. This study extends the findings of an earlier evaluation of a distance learning course on TGD healthcare, exploring the sustainability of its effects over time.ObjectivesTo assess changes in self-reported attitudes, skills, practices, and knowledge retention 6 months after course completion.MethodsA longitudinal design was used with assessments at baseline (T0), post-course (T1), and six-month follow-up (T2). Participants completed the Attitudes, Skills, and Practices Questionnaire (ASPQ) and a 10-item knowledge test at all time points. Paired t-tests were used to compare mean scores for attitudes and skills. Knowledge retention was analyzed with McNemar tests. Changes in practice items were evaluated using Cochran’s Q and Friedman tests for paired categorical data.ResultsA total of 3,102 participants (17% of the original cohort) completed the follow-up. All self-reported skills and most attitudes improved significantly from baseline to follow-up (p < 0.001 for skills; p ≤ 0.02 for attitudes), with modest declines from T1. Practice items showed significant variation over time (Cochran’s Q and Friedman tests, p < 0.001), though without a consistent increase in engagement. Knowledge improved in 8 of 10 items from baseline to follow-up (McNemar, p < 0.001), particularly in sexual identity, hormone therapy, and legal rights, despite partial declines from post-course levels.ConclusionThis study highlights sustained improvements in self-reported attitudes, skills, and knowledge following a national TGD healthcare training, reinforcing its value in addressing health disparities. The findings underscore the need for structural support and integrated reinforcement to embed gender-affirming care into routine practice.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1550470/fulltransgender and gender diversehealthcare professionalsdistance learningcontinuing medical educationknowledge retentiongender-affirming care |
| spellingShingle | Matteo Marconi Ughetta Maria Favazzi Pietro Carbone Debora Guerrera Angela Ruocco Martina Manoli Martina Manoli Cristiana Barbati Francesca Molinaro Federica Maria Regini Andrea Vittozzi Alfonso Mazzaccara Marina Pierdominici Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy Frontiers in Public Health transgender and gender diverse healthcare professionals distance learning continuing medical education knowledge retention gender-affirming care |
| title | Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy |
| title_full | Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy |
| title_fullStr | Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy |
| title_full_unstemmed | Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy |
| title_short | Evaluating the long-term impact of a distance learning course on attitudes, skills, practices, and knowledge in gender-affirming healthcare among healthcare professionals in Italy |
| title_sort | evaluating the long term impact of a distance learning course on attitudes skills practices and knowledge in gender affirming healthcare among healthcare professionals in italy |
| topic | transgender and gender diverse healthcare professionals distance learning continuing medical education knowledge retention gender-affirming care |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2025.1550470/full |
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