Issue In Finland, municipalities are responsible for promoting public health on local level. However, there hasn’t been comparable nationwide information on health promotion processes and resources in different municipalities available. In order to enhance evidence-based management, a nationwide online database and user interface called TEAviisari (http://teaviisari.fi/en/) was released in 2010. Description TEAviisari is based on a generic health promotion capacity-building framework consisting of seven dimensions: commitment, management, monitoring and needs assessment, resources, common practices, participation, and other core functions. Each dimension consists of several indicators. TEAviisari aims to make measures taken by local authorities visible and to provide comparable and objective indicators for the management, planning, and evaluation of health promotion activities in different sectors of administration in all municipalities. Results Most of the data are collected biennially with an electronic form by municipal informants, and complemented with register data. Sectors covered are primary health care; comprehensive, upper secondary and vocational education; sport and physical activity; culture; and municipal management. Exceptionally high coverage (76%-97%) supports the quality of the follow-up data. In order to simplify the interpretation, all data are displayed as summary scores ranging from zero to 100, where 100 stands for a desirable quality. It is possible to drill down into more detailed information, all the way down to single indicators. Lessons Our work shows that it is possible to collect comparable data on health promotion practices and resources in municipalities. TEAviisari offers access to relevant, interpreted information for decision-makers on all levels, serving as an assessment and planning tool for the local government, making their actions transparent to the residents, and providing information for national policy-making.

The aim of this study was to analyse and test a theoretical generic health promotion capacity-building framework with empirical data on primary health care. The framework consists of seven dimensions: commitment, management, monitoring and needs assessment, resources, common practices, participation and other core functions. The data were collected in 2014 from all the health centres in Finland, of which 156 (99%) submitted their data. The data were scored by the quality of activities on a scale from 0 to 100, where 100 stands for desirable quality. Individual indicators were nested into subdimensions, which in turn were nested into the dimensions of the theoretical framework. Variables were clustered using the dimensions and subdimensions as initial partitions. The internal consistency of dimensions and subdimensions was tested with standardized Cronbach's alpha both before and after the clustering analysis. The results showed that although the internal consistency of the dimensions was high in the initial classification, it is possible to get even more consistent dimensions. The internal consistency of the initial classification varied from 0.62 in participation to 0.93 in common practices. In the clustering analysis, 45 out of 203 indicators were assigned to a dimension different from the initial partition. The biggest gain in internal consistency was achieved in the subdimension of systematic mass communications by relocating two indicators. This study suggests that it is possible to assess the health promotion capacity-building of organizations in a coherent way with comparable and objective indicators. These analyses also show that the number of indicators can be reduced. It would be interesting to see how the framework works in other governmental structures or political contexts.

Pitkittynyt työttömyys voidaan katkaista lyhytkestoisella tukityöllistämisellä, jolla voi olla vaikutusta työttömien hyvinvointiin, terveyteen ja toimintakykyyn. Työllistäminen voi vaikuttaa myös perusterveydenhuollon avopalvelujen käyttöön esimerkiksi tuomalla näkyväksi piilevää palvelutarvetta. Artikkelissa tutkitaan harvaan asutun kunnan tukityöllistämistoimenpiteisiin osallistuneiden ja työllistämisen ulkopuolelle jääneiden perusterveydenhuollon avopalvelujen käyttöä viiden vuoden aikana (2 vuotta ennen ja jälkeen interventiovuoden). Tutkimusjoukkona olivat yli 500 päivää työttömänä olleet. Yksilötason tiedot poimittiin rekistereistä kokonaisotantana (ikä: 17–63 vuotta, sukupuoli: 61 % miehiä, 39 % naisia, N = 152). Tiedot perustuivat kolmeen eri rekisteriin: Kelan työttömyysturvatiedot, Pudasjärven kaupungin työllistämispalvelujen asiakastiedot ja Oulunkaaren kuntayhtymän potilasrekisteri. Tutkimusjoukosta muodostettiin kaksi pseudonymisoitua ryhmää: interventioryhmä eli tukityöllistetyt (n = 67) ja vertailuryhmä (n = 85). Aineisto analysoitiin kvantiiliregressiolla. Tulosten mukaan interventio- ja vertailuryhmien terveyspalveluiden käytössä oli eroja ja palvelujen käyttö jakautui epätasaisesti molemmissa tutkimusryhmissä. Interventioryhmässä käynnit lisääntyivät intervention jälkeisen vuoden loppuun asti, mutta vähenivät sitä seuraavana vuonna 2016. Vertailuryhmän käynnit lisääntyivät koko seuranta-ajan vuoteen 2016 saakka. Palvelujen käyttö ei jakaantunut tasaisesti, vaan 17 prosenttia käytti puolet kaikista palveluista. Paljon palveluja käyttäneiden osuudet erosivat interventio- ja vertailuryhmän välillä. Interventioryhmässä paljon palveluja käyttäneiden palvelujen käyttö oli tilastollisesti merkitsevästi matalampaa kuin vertailuryhmässä (p=0,000–0,002). Pitkäaikaistyöttömille kohdennetun tuen ja työllistämistoimenpiteiden arvioinnin näkökulmasta tietoa perusterveydenhuollon avopalveluiden käytöstä tarvitaan. Relevanttia rekisteritietoa on harvoin käytössä.

BackgroundIn Finland, municipalities are responsible for promoting the health and welfare of their residents. Safety promotion and injury prevention are an integral part of health promotion on various fields of municipal action.Description of the problemUntil the launch of TEAviisari, a nationwide benchmarking tool for the management, planning and evaluation of health promotion capacity building (HPCB), there has been very little accurate and comparable nationwide information on health promoting activities in different sectors in Finnish municipalities.ResultsAiming to make measures taken by local authorities visible and to provide information on actions that promote better public health on local level, TEAviisari is based on a generic HPCB framework. The framework consists of seven dimensions: commitment, management, monitoring and needs assessment, resources, common practices, participation and core functions. Safety and injury related topics covered in TEAviisari include but are not limited to prevention of home and leisure accident injuries, inspection of health and safety at schools, home-school collaboration to promote safety, prevention and monitoring of accidents and injuries at school, compiling a local safety plan, evaluating older person’s housing safety and having expertise on health and safety technology and assistive devices. The results show that differences between municipalities and schools exist in all topics. The data can be viewed on municipal level or on various geographical or administrative levels. Data for single schools are shown with the permission of the school.ConclusionsTEAviisari shows that it is possible to assess the HPCB of municipalities, serving as a tool for the local government while making it transparent to the residents. Web-based user interface provides a quick access to relevant, interpreted information for decision-makers. TEAviisari is free of charge and available at in Finnish, Swedish and English.

Background Promoting well-being and health is a key policy instrument in municipalities. There are many ways to support the work ability of long-term unemployed people. Short term subsidized employment (300-500 €/person/month) being one widely used measure. The purpose was to study what kind of influence a short term employment has on the use of social and health care services of long-term unemployed people in sparsely populated area. Specifically, the aim was to investigate the use of primary health care services among people in subsidized employment, intervention (n = 67) and control group (n = 85) during five years period (2012-2016). Methods Individual-level data were extracted from registers (age: 19-65 years old, gender: 61 % men, 39 % woman, N = 152). The use of primary health care was examined in the case study by means of annual averages, cumulative percentages and regression analysis. Results According to preliminary results, there were differences in the prevalence of primary health care services use and how the use of services changed among intervention and control groups. The use of services in intervention group increased until the end of the intervention year, but decreased in the following year, 2016. The use of services in control group increased until 2016. Regression analysis was carried out to study the change; a year and an intervention for 2014-2016 were made as a predictor. It was found out that the number of visits increased each year by looking at both groups together (p = 0.012). The subsidized employment that started in 2014 had a statistically significant reducing effect on the use of services (p = 0.034) in intervention group in 2014-2016. Conclusions Municipalities’ health promotion and subsidized employment work can have positive impact on disadvantaged groups such as long-term unemployed people in sparsely populated area. Creating data for the use of services from local registers was very time consuming and challenging process, but possible. Key messages Promoting well-being and health is a key policy instrument in municipalities. Municipalities’ health promotion and subsidized employment work can have positive impact on disadvantaged groups such as long-term unemployed people in sparsely populated area.