TELEMARK

FYLKESKOMMUNE

The Telemark Model

Nordic Public Health Conference

Finland 2011

Anne Karin Andersen

Leader for the Public Health Program inTelemark

Jorunn Borge Westhrin

Leader for Health promoting initiatives for

kindergartens and schools

Her er Telemark fylke!

We

mak

e T

elem

ark

str

on

ger

!

Here is Telemark County!

Population: 169,000

Challenges

• Population

• Level of education

• Social/economic status

• Health

Target Group

1. Children and youth

2. The elderly (65+)

3. Adults – risk groups

We

mak

e T

elem

ark

str

ong

er!

Background

- St.meld. Nr. 16

- Folkehelseprogram 2006-2009

- Evaluering

- Lovfesting

The Public Health Program’s

strategy note 2010-2012 kindergartens and schools

The Public Health perspective is founded in

the plans for the County Councils own

schools and in the Municipalities

kindergartens and schools.

Promote health and reduce differences in

health by carrying out non-stigmatizing

initiatives in kindergartens and schools, jfr

paragraph 2 in the Kindergarten Law and

paragraph 9a in the Education Law, as well as

the Learning Decree.

Main Initiatives 2010 - 2012

Everything with relevance to the Interaction reform

1. Foundation of public health

2. Health overviews and health monitoring

- The “Telemark barometer”

3. Health promoting kindergartens and schools

4. Healthier living and increased daily activity

5. Active Senior Telemark

6. Health promoting workplaces with focus on

availability

7. Communication and professional competence

Telemark fylkesting/-utvalg

The Telemark Model – HEFRES

Chief

Executive Staff Public Health

Regional

partnership

County

Edu. Reg. com. Transport

HS

14

TIK

FK

FM

LO

TT

NHO

RK

AiR

BK

HIT

STHF

NAV

TIK

Network for

Public Health

Coordin.

Municipali-

ties

18 10 w/

partnership

agreements

Other

cooper.

Partners: - Safe Traffic

– All

children

bicycle

and so on

Resource

group HEFRES

Network for

school health

service

Dentistry

Other

resource

groups/

network

HEFRES

Student

and

trainee

rep.

Objective

“A healthy lifestyle and

good health for all

children in kindergartens

and schools”

Why should kindergartens and

schools be used as health promoting arenas?

Kindergartens and schools reach everyone

Establish healthy habits early on

Good investment, also in relation to absence

Satisfies health and education objectives

“Preventative initiatives start

in kindergarten”

* The General Secretary of the Norwegian Cancer Association

describes the health promoting work being done in the kindergartens

and schools as “sykt gode tiltak” (sickly good initiatives).

* “Absence does not begin in High School – focus needs to be in place already

in kindergarten”

Håvard Tjora a teacher who made this statement to the Norwegian

Minister of Education

.

Has this been successful?

“Kindergartens and schools seem generally to be a good arena to work

with Public Health as there are many in the target groups here.

The school arena has also its limitations as there are limits to how much

capacity Public Health can be part of the daily school program. At the same

time, this is a good example of how one has reached out to integrate Public

Health into another sector,

the education sector.”

From Telemark Research’s evaluation of the Public

Health Program in Telemark

1. Holistic approach

2. Foundation – “Health in plans”

-Systematic and long-term focus

3. Conscious choices by key stakeholders

and arenas

4. Follow up on national initiatives

5. Increased availability

6. Make aware in the schools about the link

between health, well-being and education

What has been the most

important success factors?

What is unique?

Holistic approach from kindergartens to high-schools

Physical activity

Diet

Mental health

“The good school health service”

Tobacco and snuff

Alcohol and drug prevention

Foundation – “Health in Planning”

Root in plans and management (administrative and political)

All groups in kindergarten and in the school sector should

be informed and involved

“If the principle is not an active contributor, it will not be likely

that the Health promoting school will be a prioritized area over

time.” – quote from the HEMIL centre.

Founding Telemark - High Schools “Health in Planning”

Quality control the objective of health promoting schools:

The school nurse is more readily available and present at the schools, as

well as that the schools have an operative school health service.

The schools carry out at least one program for mental health.

The schools offer the students healthy food with grains and vegetables and

that they gradually remove sugar filled food and drinks.

The schools’ athletic facilities are open for the students during breaks and

recess.

The schools are tobacco free (cigarette and chewing tobacco, etc.) in

relevance to the County Council’s decision.

Quality control the students school environment:

The committees for the school environment is functioning properly and is

active

The students environment is in agreement with the Education Law §9a

Key cooperating stakeholders

and arenas

Cooperating stakeholders in the school:

Head of Department for County Education, Student and Trainee Representative, Principle collegiate

in the High Schools, County Governor, Administrative leaders in the kindergartens and schools in the

Municipalities, School Health Service, Dentistry Service, Public Health Coordinators

Cooperating stakeholders in the voluntary and private sector:

TIK, TTF, All children bicycle, BAMA

Arenas:

County Council, Committee for Competence,

Principle meetings in the High Schools,

County Governor’s meetings with the school and

kindergarten leaders in the municipalities, resource group

HEFRES, network groups, Committee for the school environment

Followed up national initiatives

“Fiskesprell”

(kindergarten and before/after school programs)

MER

Mental health in the school

FRI (middle school)

Love and boundaries

“The Key”

Making aware/competence about the link between health,

well-being and education

How to influence children and

youth to a health promoting lifestyle?

According to an EU report:

• Offer healthy food and drinks

• Time and facilities for physical activity

• Both families and the local society needs

to be involved

• Student influence

What can be gained with a

healthy diet and physical activity?

Educational

• Learning ability and concentration is improved

• Better school results and learning environment

• Less behavioral problems

Social

• Initiatives in the school can level out

health differences

Health

• Few illnesses and ailments on the short and long term

TELEMARK

FYLKESKOMMUNE

Good examples

of what has

been done

“Fiskesprell” kindergarten example of a national initiative

Telemark – pilot county

Objective for the kindergartens

-Provide for healthy meals and good habits

-Increase the consumption of fish and seafood

-Include cooking/meal preparation in educational activities

-Root the initiatives in the kindergartens and municipal plans

an example of cooperation with the voluntary sector

Objective

Education of young leaders/resource students and more physical activity in the recess

period at middle schools – low threshold

Concept

The schools choose 10 resource students

in the 9th grade

Course

2-day course

Follow-up course (4-6) at own school

A gathering for summing up

At many schools, the resource students are

also used at the elementary school level

and in before/after school programs as activity

leaders

Telemark Research

about health promoting dialog

“Previously, communication with the

schools was more of an evaluation of the

schools practice in various areas.

Dialog has proven to be more effective in

relation to creating change at the

schools.”

Health promoting dialog -An example of tool developed in Telemark

Cooperation with HEFRES and the student representative

Meet the resource persons for 1.5 hours dialog

Principle and some others from the school’s management

Student Council Leader

School nurse/other in the school health service

Contact persons in different fields, for ex. the cafeteria manager

Objective

Give the school’s leaders good overview and reasoning to make

holistic plans

Ensure systematic and coordinated health promoting work

Collect and distribute good tips and ideas

Help with the start up of initiatives

Arena at the school: Committee for the school environment

Gode tiltak –

Action Plan 2011

Further develop the Telemark Model

Rooting and implementation of the criterias

for “the good school health service” in the

municipalities – 2 year project

Contribute to that the schools are tobacco,

alcohol and drug free, use at least one

program for mental health, follow the

guidelines for food in kindergarten and

schools and provide activity during the school

day and on the school route

Contribute to a good functioning and

proactive committee for the school

environment

The High Schools quality control/question and

report on the objective of HEFRES and the

students school environment

Dialog and competence exchange contributes

to rooting and implementation of HEFRES in

Telemark.

Jorunn Borge Westhrin,

jorunn-borge.westhrin@t-fk.no

Anne Karin Andersen,

anne-karin.andersen@t-fk.no

www.telemark.no/folkehelse