The document summarizes Telemark County's public health program, known as the Telemark Model. The model aims to promote health and reduce health differences among the population of Telemark through initiatives in kindergartens and schools. It focuses on children, youth, and the elderly. The program establishes health as a priority in planning and uses a holistic approach. Key aspects include healthy eating, physical activity, and mental health programs. Cooperation with stakeholders and national initiatives helps drive implementation. Evaluation found the school setting effective for reaching people and establishing healthy habits early.

1. 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

3. We make Telemark stronger!
Her er Telemark fylke!

4. Here is Telemark County!
We make Telemark stronger!
 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

5. Background
- St.meld. Nr. 16
- Folkehelseprogram 2006-2009
- Evaluering
- Lovfesting

6. 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.

7. 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

8. The Telemark Model – HEFRES
Telemark fylkesting/-utvalg
Regional Chief
Staff Public Health
partnership Executive
NAV HEFRES
Dentistry Municipali-
STHF ties Other
Network for 18
FM cooper.
Public Health 10 w/
County Partners:
Reg. com. Transport Coordin. partnership - Safe Traffic
HIT Edu. agreements
– All
children
BK Student Resource
HS bicycle
and group HEFRES
AiR
14 trainee
TIK and so on
rep.
NHO Network for
school health
LO service
TIK
Other
TT resource
groups/
RK network
FK

9. Objective
“A healthy lifestyle and
good health for all
children in kindergartens
and schools”

10. 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

11. “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
.

12. 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

13. What has been the most
important success factors?
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

14. 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

15. 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.

16. 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

17. 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

18. Followed up national initiatives
 “Fiskesprell”
(kindergarten and before/after school programs)
 MER
 Mental health in the school
 FRI (middle school)
 Love and boundaries

19. “The Key”
Making aware/competence about the link between health,
well-being and education

20. 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

21. 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

22. TELEMARK
FYLKESKOMMUNE
Good examples
of what has
been done

23. “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

24. 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

25. 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.”

26. Health promoting dialog
-Anexample 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

27. Gode tiltak –

28. 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.

29.  Jorunn Borge Westhrin,
jorunn-borge.westhrin@t-fk.no
 Anne Karin Andersen,
anne-karin.andersen@t-fk.no
www.telemark.no/folkehelse