Co-creating wellness promotion in sport a Health Community Lab to prevent feeding and eating disorders in adolescence

In recent years, there has been a worrying increase in eating disorders (EDs), as evidenced by regional data on emergency room visits, hospital admissions and discharges, with particularly significant consequences for adolescents involved in sports (Ministry of Health, 2024). Scientific literature highlights the crucial role of coaches in shaping the sporting environment and in preventing or amplifying risk factors related to FEDs. However, in Italy, training courses dedicated to this topic are still limited. In this context, the Tuscany Health Ecosystem (THE) – as part of the PNRR, Spoke 10 'Population Health' – has promoted a Health Community Lab (HCL) focused on District 2 of Florence, with the aim of co-creating, together with sports clubs, parents, coaches and health professionals, a prototype training course for the prevention of FEDs in sport. HCLs are co-creation initiatives developed in collaboration with local stakeholders in the Tuscany region. The objective of this HCL is to support the co-creation of a prototype training course aimed at sports associations and clubs with a focus on District 2 of Florence. The HCL is part of the programme of integrated prevention and early action to prevent FEDs, promoted by the Meyer IRCCS University Hospital, the Azienda USL Toscana Centro and the Società della Salute of Florence, in collaboration with the Regional and Territorial School Office of Florence, the Department of Health Sciences of the University of Florence and the Primary Care Pediatrician services. Through a review of the literature, interviews with experts and three workshops involving coaches, parents and sports managers, the HCL has enabled the co-creation of a training course specifically for coaches, which aimed to: help coaches recognise early signs of distress; promote educational relationships and positive communication; strengthen skills to create healthy and inclusive sporting environments. The main recommendations that emerged concern: the introduction of annual training courses for coaches and technical staff; the inclusion of guidelines on risk and protective factors in sports regulations; and the evaluation of coaches also based on the well-being of athletes. In line with the WHO model of the Health Promoting Sports Coach, it is also proposed to adopt shared operational tools (e.g. checklists) and periodic information sessions for athletes and families. The co-creation process has shown that the direct involvement of coaches, managers and parents promotes awareness, the sharing of experiences and the development of concrete solutions to promote well-being and prevention in sport.