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Table 2 Activities to promote health and prevent obesity and their main targets in the municipal administrative sectors during the period 2009–2016

From: A qualitative study on multisector activities to prevent childhood obesity in the municipality of Seinäjoki, Finland

Administrative sector Activities according to main targets
Management Physical activity
- Investments in PA-promoting environments
Obesity prevention
- Was included in Seinäjoki city strategy
- Implementation of the city Overcoming Obesity Program 2013–2020
Health and/or well-being
- Was included in Seinäjoki city strategy
- Director of Health Promotion (2009–2015)a)/Health promotion coordinator (2016)a)
- Objectives developed in accordance with the National Health Policy Program, and based on the Health in All Policies approach, with special emphasis on children’s health [41]
- The mayor and the health promotion management group as supporters of the sector-wise work
- Collaboration with NGOs and regular meetings between those working with families with children
- Strong commitment of the administrative sectors
- Auditing: yearly health overview document, i.e., the Electronic Health and Welfare Report, a nationally developed and obligatory evaluation and planning document [42] to support knowledge management, strategic work, and decision-making in municipalities [43]; surveys among school children
- Membership of the Director of Health Promotion in a national health promotion working group led by the Ministry of Health and Social Affairs (support to the work in a municipality)
Primary health care Healthy eating
- Dietary advice with dental care
Obesity prevention
- Early intervention and support in healthy lifestyles of children and families
- Systematic monitoring of children’s growth
- Yearly weight and height reports on the child population
- Implementation of the systematically used “Smart Family Method”, which includes a self-assessment tool for families and a motivational interview tool to be used by the professionals [44]
- A Child’s and Adolescent’s Weight Path tool for children at risk of obesity [36]
Health and/or well-being
- Preventive services in maternal and child health clinics and in schools
- Early support to families in their abilities to promote their children’s healthy development
- Systematic monitoring of child health and development during pregnancy (home visits by a nurse) and school age [45]
- The “Pilari” [The Pillar] support service for guidance on health and psychosocial problems of children, youth, and families [46]
Early childhood education and care Physical activity
- Construction of PA-friendly and inspiring courtyards and interiors, in collaboration with the technical services
- Guidance towards including PA as a natural part of the children’s daily life
- Introduction of the “Ilo kasvaa liikkuen” [Joy Grows through Motion] program [47]
- PA messengers circulating in the day-care centers to distribute information and new ideas
- Involvement of families in PA together with their children
- Raising awareness about children’s national PA recommendations [48]
- Advice given to private childminders
Healthy eating
- Three nutritionally balanced [49] and heart-friendly meals (The Heart Symbol of the Finnish Heart Association (https://www.sydanmerkki.fi/en/)) during full-time childcare
- Day-care centers became dessert-free (no sweets, biscuits, potato chips, juice)
- Theme weeks for learning HE (e.g., the “Kaappaa kasvis!” [Grab the Veggie!] campaign [50]
- Participation in the meal committee together with the mass catering services
- Advice given to private childminders
Health and/or well-being
- Comprehensive promotion of the children’s development, overall well-being, and learning [51]
Schools Physical activity
- Implementation of the “Finnish Schools on the Move programme” [52] to embed PA as an elementary part of daily life
- Construction of PA friendly courtyards and interiors in collaboration with the technical services
- Availability of both indoor and outdoor equipment for games and play
- Acquisition of new type of furniture (standing desks, etc.) to counteract too much sitting
- Breaks from lessons for gymnastics (older pupils trained to act as peer sports instructors)
- Restructuring of school days to have a longer break for PA (provided also by agencies outside the school; e.g. the Adult Education Center, congregations)
- PA theme days and events (also with families)
- PA-weighted curriculum. PA Academy in collaboration with the Kuortane Olympic Training Center (https://epuburheiluakatemia.fi/oppilaitokset/)b)
- A teacher as a PA coordinator (one day weekly, in collaboration and the cost shared with the sports services)
- Multisectoral teams and teacher collaboration to share ideas
- Bicycles provided for studentsb)
- Parents’ association used for communicating about PA opportunitiesb)
Healthy eating
- Nutritionally balanced [49], heart-friendly meals (The Heart Symbol of the Finnish Heart Association (https://www.sydanmerkki.fi/en/))
- Participation in the meal committee together with the mass catering services
- A principle of tasting everything and the observation of portion sizes by the teachers and mass catering personnel
- Energy drinks banned in schools
Health and/or well-being
- Restructuring of school days to have a longer break to be used for hobbies (also other than PA, provided also by agencies outside the school, e.g., the Adult Education Center, congregations)
- Handbook on well-being available (also describing how to combine PA with cultural experiences)
- Nomination of some pupils “responsible for” well-being in classesb)
- Adding to the sensitivity of the community for early detection and multiprofessional (teachers, student welfare services, school social workers, school nurses, other primary health care professionals) intervention in students’ problems
- Hiring of a professional youth worker called “school coach”
Sports services Physical activity
- Investments in sports areas, premises, and activities (playgrounds, winter sports areas, jogging tracks, sports halls, etc.)
- Investments in hiring PA instructors and financial support to sports clubs
- Swimming schools for children, parents, and other adults
- Introduction of new forms of PA
- Active communication about opportunities for PA to the public
- Adapted and targeted possibilities offered for special groups (e.g., children with asthma)
- Collaboration with the Adult Education Center in the organization of PA groups and events
- Organization of PA events for children and families
- A guidebook prepared for the public on opportunities for PA (and healthy lifestyles)
Health and/or well-being
- A guidebook prepared for the public on opportunities for (PA and) healthy lifestyles
Technical services Physical activity
- Planning, building, and maintenance of PA promoting and attractive areas (jogging tracks, parks, playgrounds, schoolyards, etc.) in collaboration with several other sectors and NGOs
- Construction of routes for light traffic (walking, cycling, etc.)
- Construction of the new plan for the city center to add to PA (and well-being) among the public
Health and/or well-being
- Construction of the new plan for the city center to add to (PA and) well-being among the public
Mass catering services Healthy eating
- National nutritional recommendations [49] followed for food preparation at early childhood education centers and schools
- The recipes and foodstuff complying with the criteria of The Heart Symbol of the Finnish Heart Association (https://www.sydanmerkki.fi/en/) and the consideration of sugar and fiber contents
- Less sugar in snacks, spices to compensate the reduced salt amount
- Participation in dessert-free early childhood education and care
- Staff training (e.g., Bachelor’s degree in Food and Hospitality)
- Feedback collected about meals and observation of meals at schools
- Participation in collaborative meal committees
  1. a) The posts were administered in primary health care. The mandate of the Director of Health Promotion was among the highest city management b) Mentioned in one school only