Northern Dimension Partnership in Public Health and Social Well-being

Secretariat

NDPHS Seed Money Project Winter 2013-14

With recognition of the generosity of the Ministry of Health, the NDPHS Secretariat is pleased to offer up to 45,000€ to one or a short list of projects under development that contribute to the NDPHS Strategy.

Awarded funds must be spent and reported on by the end of February 2013.

To receive this funding, you may complete one or a combination of the following four tasks: develop a report on the state of play in the respective field; develop the work plan, composition of the partnership, and budget for the main project; submit a report on funding possibilities and next steps; other. Please be realistic about what you can accomplish in this short amount of time.

Please read the instructions and rules as presented throughout the application form carefully.

Applications must be submitted no later than 30 Nov 2013 to [email protected].

Please contact [email protected] with questions regarding the application and the application process.

Application Form Index 1. Project information 2 2. Partner details 3 3. Main project 9 4. Work plan of the seed money project 12 5. Budget 14 6. Extra partner details 14

NDPHS Seed Money Application – Winter 2013-14 1

1. Project information

1.1 Project Name: Developing a model of empowerment for children’s healthy choices in order to tackle the NCD epidemics in the Region

1.2 Project Acronym: EmpowerKids

1.3 Project duration: 15 December 2013 - 28 February 2014 Note: the funds must be spent and reported on by February 2014.

1.4 Issue addressed and contribution to the NDPHS Strategy (max 300 words): The EmpowerKids project addresses the increasing problem of non-communicable diseases and health inequities found within and between European states, including Northern Dimension area. Data from Northern Dimension countries show the aggravating spread of obesity among children and young people. The project tackles directly the interrelated problems of obesity, deficit of physical activity, and unhealthy diet among the schoolchildren (7 – 15 years).

According to the WHO’s projections for year 2030 (NOPA II project, 2013), the obesity may grow considerably in all NDPHS and BSR countries. Around 30% of the population in the WHO EURO zone will be obese by then. This will create a huge burden to the health systems, social services and labor market.

Available evidence shows that heathy lifestyles root in deeper and sustainably when learnt from early childhood. Also, health inequalities often start growing at school age and easily lead to increased risk of developing obesity, cancer, cardiovascular diseases and other medical conditions. Ultimately, this may lead to social exclusion, unemployment and bigger health problems.

Promotion of physical activity and healthy nutrition are the central aims of the health promotion in Europe among younger generations. It is in line with the EUSBSR Action Plan, PA Health and contributes to flagship project proposal: "Promotion of physical activity and healthy food among schoolchildren". It is in line with the UN 2011 Declaration on Prevention and Control of Non-communicable Diseases, the WHO Regional Strategy and Action Plan for the Prevention and Control of NCDs 2012-2016, and NDPHS Strategy's Goal 12: “The impact of all main causes / risk-factors of lifestyle related NCDs in the ND countries are addressed (in addition to alcohol and tobacco targeted through Goals 7-9): overweight, low fruit and vegetable intake, trans fat avoidance, high salt-intake, insufficient vitamin-D intake, high blood pressure, high blood cholesterol, low physical inactivity (sedentary lifestyle), and factors related to mental health problems” as well as operational target 12.1 with the reference to the Flagship A project: “Prevention of over-weight of schoolchildren (ages 7-15) in Northern Dimension geographical area.’’ Last but not least, EmpowerKids project contributes to the delivery of the Europe 2020 Strategy.

Children empowered to take healthy decisions will become healthier adults with the lower risk of being marginalized in the social and working life.

Moreover, promoting physical activity by empowering people to make healthy decisions leads to increased physical, emotional and social wellbeing and instrumentally prevents health inequality.

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2. Partner details

On the following pages, please specify the required details of the project partners and the role of each in the project. You may have fewer than four project partners. If you have more than four please use the attached Extra Partner Details document to create as many additional sheets as needed.

The following legal entities are considered as eligible project partners: a) national (governmental), regional and local authorities; b) ‘bodies governed by public law’ as defined in Article 1(9) of Directive 2004/18/EC; this means any body: i. established under public or private law for the specific purpose of meeting needs in the general interest, not having an industrial or commercial character; ii. having legal personality; and iii. financed, for the most part, by the State, regional or local authorities, or other bodies governed by public law; - or subject to management supervision by those bodies; - or having an administrative, managerial or supervisory board, more than half of whose members are appointed by the State, regional or local authorities, or by other bodies governed by public law. All legal entities applying for funding in category b) must fulfil criteria i), ii) and iii); c) associations formed by one or several regional or local authorities; d) associations formed by one or several bodies governed by public law as defined under b); e) bodies established under public or private law for the specific purpose of meeting needs in the general interest, not having an industrial or commercial character, and having legal personality.

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2.1 Lead partner – Details and Role in the project

Name of the organisation in the original language: Itämeren alueen Terveet Kaupungit ry Name of the organisation in English: Healthy Cities Association - WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Legal status: Non-governmental, non-for-profit organization Address: Vanha Suurtori 7 Postal Code: 20500 City: Turku Country: Website: www.marebalticum.org Organisation Identification Number: 174.156

Contact person: Name: Karolina Mackiewicz Position: Development Manager Phone: +358 40 5075 069 Email: [email protected]

Organisation’s competence relevant to this proposal: The Lead Partner is a WHO Collaborating Centre, an active member of WHO HEPA (Health Enhancing Physical Activity) Europe Network and partner of TAFISA - International Sport for All Association and UBC Commission on Sport. One of the Lead Partner's stategic goals is to promote the physical activity/active living and this is done by facilitating the strategic planning process in the cities, coordination and participation in the HEPA-oriented projects (e.g. Promotion of Nordic Walking), organization of the seminars on HEPA (in Finland and BSR countries), dissemination of practices and information (e.g. publishing a book ''Active Living in Turku'') and strong cooperation with City of Turku, University of Turku and Turku University of Applied Sciences (all are members of the Association). The expertise of the universities will be used in this project. Moreover, Association has an experience in coordination of international, EU-financed projects and staff experienced in project management, network building and communication.

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2.2 Project partner 2 – Details and Role in the project

Name of the organisation in the original language: Fraunhofer-Institut für Graphische Datenverarbeitung (IGD) Name of the organisation in English: Fraunhofer Institute for Computer Graphics Research Legal status: Non-profit research organization Address: J.-Jungius-Str.11 Postal Code: D-18059 City: Rostock Country: Germany Website: www.igd.fraunhofer.de Organisation Identification Number: AT Tax Act: DE 129515865 EU.No: 35124436517-75

Contact person: Name: Gerald Bieber Position: Certified Engineer Phone: +49 381 4024 125 Email: [email protected]

Organisation’s competence relevant to this proposal: The partner is an expert in e-health sector and possesses diverse expertise in the information and communication technology design with focus on application in the health and wellbeing spheres. The contribution to our project would be targeted into two areas: biometrics in the context of using up-to-date and non-obtrusive innovation in lifestyle changing, particularly in promotion of physical activity among young generations. Secondly, the expert will contribute in shaping the future of ICT-based supporting solutions to encourage healthy choices by the young generations. The organisation has accumulated evidence and information about quality and effectiveness of health-related and health- enhancing computer-assisted technology, hardware, and software.

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2.3 Project partner 3 – Details and Role in the project

Name of the organisation in the original language: Tervise Arengu Instituut Name of the organisation in English: National Institute for Health Development (NIHD) Legal status: Government established research and development body Address: Hiiu 42 Postal Code: 11619 City: Country: Website: www.tai.ee Organisation Identification Number: 70006292

Contact person: Name: Tiia Pertel Position: Head of the Health Promotion Department Phone: +372-6593974 Email: [email protected]

Organisation’s competence relevant to this proposal: National Institute for Health Development: 1/ coordinates the international survey on school- aged children health behaviour (HBSC) in Estonia, 2/ creates and spreads health knowledge by developing recommendations and information materials, as well as trainings in the areas of nutrition and physical activity, 3/ develops various guidelines and tools for use in educational settings to assist in the evaluation, analysis, planning and implementing of activities in the areas of nutrition and physical activity, 4/ coordinates Health Promoting Kindergartens and Health Promoting Schools networks in Estonia, 5/ organises campaigns and carries out projects involving youth, 6/ conducts studies to evaluate the effectiveness of these activities and to monitor the health behaviour of youth. The Institute is the coordinator of Health Promoting Schools Network in Estonia and a member of Schools for Health (SHE, http://www.schoolsforhealth.eu/).

NDPHS Seed Money Application – Winter 2013-14 6 The Institute coordinates healthy school-canteen project in Estonia and few other national projects on nutrition issues. The Institute is also a partner in Health Behaviour in School- Aged Children (HBSC) study.

NDPHS Seed Money Application – Winter 2013-14 7

2.4 Project partner 4 – Details and Role in the project

Name of the organisation in the original language: Sveikatos mokymo ir ligų prevencijos centras Name of the organisation in English: Center for Health Education and Disease Prevention Legal status: Budgetary institution subordinate to the Ministry of Health Address: Kalvarijų g. 153 Postal Code: LT-08221 City: Country: Website: www.smlpc.lt Organisation Identification Number: 191347976

Contact person: Name: Milda Andriunaite Position: Head of the Division of Noncommunicable Diseases Prevention Phone: +370 5 247 7324 Email: [email protected]

Organisation’s competence relevant to this proposal: At the national level, the Center for Health Education and Disease Prevention acts as a coordinator and methods writer for municipalities and public health bureaus, an implementing body of national strategies tackling the problems of obesity, physical inactivity and unhealthy diet among schoolchildren. Also, capacity building of public health specialists who work at schools is one of the central points of the activity, particularly in questions of healthy lifestyle improvements in school environment. Together with other relevant units of the Centre a comprehensive system for better NCD monitoring and response is being developed, and a big element of the system is focused on children and adolescents.

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3. Main project

3.1 Please describe (max 2 pages): - the regional need for the main project; - how the project ties into or responds to known current/past initiatives in the region (if applicable); - the foreseen activities of the main project; - the expected outcomes of the main project; - how the activities and the outcomes of the main project address the needs of the region and the priorities as listed in the NDPHS Strategy.

Make sure you clearly address each of the points above.

Childhood obesity is one of the biggest challenges today in Europe. According to statistics, today 25% of children are overweight or obese. It is assumed that an obese 12 year old child has 82% likelihood of being an obese adult. Childhood obesity is strongly associated with risk factors for cardiovascular disease, type 2 diabetes, orthopaedic problems, mental disorders, underachievement in school and lower self-esteem.

The causes for the overweight and obesity epidemic are few and well-known: calories intake prevails over calories spending; abundance of high-fat, high-sugar, high-salt foods; accessibility of unhealthy foods to chidren; scarce intake of vegetables and fruit; dominance of physically inactive lifestyles.

The project in question accords to the Action Plan for Implementation of the European Strategy for the Prevention and Control of Non-Communicable Diseases 2012-2016, which states promoting healthy consumption and promoting health in settings in the list of the priority interventions.

The countries and regions of the Northern Dimension area recognise the presence of the problem and are looking for the ways to effectively counter-act. The experience gained shows that childhood obesity must be tackled both at a societal and individual level. Individual responsibility cannot influence the activity-friendly environment, food production, labelling and marketing alone. A co-ordinated multi stakeholders approach can only address these determinants, which require a commitment to targeted education in areas for individual responsibility and focused regulations around the areas that are outside of individual control. The individual responsibility implies making an informed choice for healthy alternatives. The societal responsibility is to ensure that such alternatives for decision- making are available.

The proposed project accents on issues of individual responsibility and deals with the empowerment of school children to make healthy choices in terms of food and physical activity.

The EmpowerKids main project will consist of two parts: 1/ research and 2/ demonstration (piloting of interventions).

The first part will take 12 months and will be coordinated by the Turku University of Applied Sciences – Health Care Department and University of Turku Department of Nursing Science. The existing interventions that fulfill the criteria of: being targeted to the school children, being empowering, in the relation to the healthy lifestyles, physical activity and healthy diet will be screened and assessed according to the following criteria: being evidence-based, feasible in the Baltic Sea Region, cost effective and with high impact. The

NDPHS Seed Money Application – Winter 2013-14 9 protocol will be prepared and the demonstration phase will begin. It will also include the online based interventions, e.g. games (edutainment), smartphone applications and other relevant e-solutions and technology.

The demonstration phase will be piloting of the most promising interventions selected in the research phase. The piloting will take place in the schools invited and nominated to take part in the project. The demonstration phase will take 8 months which will be followed by the 4- month period of evaluation, assessment and reporting of the collected results. The schools, sport clubs, NGOs and most importantly the municipal workers and municipal decision makers will be invited to learn about the project, its activities, outcomes, results and impact on the every stage of EmpowerKids.

Specific objectives of the main project are: 1. To establish and strengthen the cooperation between the partners in order to better tackle the obesity, physical inactivity and unhealthy diet among school children; 2. To create an optimal educational intervention on healthy lifestyles for school children; 3. To reinforce the national and local policies for healthy lifestyle of school children; 4. To collect the evidence on the interventions for school children which empower them to take good decisions related to their healthy lifestyles; 5. To share the knowledge and experience between the partners;

The outcomes of the main EmpowerKids project will include: - established cooperation between schools, local and national administrators, sport clubs, NGOs in the area of healthy lifestyles interventions for school children, - educational framework paper on the healthy lifestyles interventions for school children - educational model of interventions that are empowering for school children, - paper on the potential of use of games, phone applications and other e-solutions for empowerment of school children to take healthy decisions; - policy papers for support the programmes targeted to school children which aim is to tackle obesity, physical inactivity and unhealthy diet; - evidence on the effective healthy lifestyle empowering interventions - system of knowledge sharing in the area of healthy lifestyle related interventions for school children in the Baltic Sea Region

3.2 Planned geographical scope of the main project and reactions among the relevant networks/locations to the project idea so far: Ideally the main project would spread out to all NDPHS countries and regions. All NDPHS and EU countries are covered by EUSBSR. The project partners will come from the national institutes of health promotion and disease preventions, universities and other research institutions, NGOs, schools, municipalities. So far the project idea was strongly supported by the Baltic States, Finland, , Germany. The main project will obviously include more countries or regions, as the problem is common to all of them.

3.3 Potential sources of funding for the main project: The funding for the main EmpowerKids project will be sought from from several sources, e.g. EU Baltic Sea Region Programme 2014-2020, Central Baltic Programme 2014-2020 (for the Swedish, Finnish, Latvian, Estonian and potentially Russian and partners), from Nordic Council of Ministers (NGO Funding for the projects with NGOs only or other funding for the broader

NDPHS Seed Money Application – Winter 2013-14 10 cooperation), EU Health for Growth programme, Sport programme, other programmes available in the area, national funding.

NDPHS Seed Money Application – Winter 2013-14 11

4. Work plan of the seed money project

To receive this funding, complete one or a combination of the following four tasks: develop a report on the state of play in the respective field; develop the work plan, composition of the partnership, and budget for the main project; submit a report on funding possibilities and next steps; other. Please be realistic about what you can accomplish in this short amount of time.

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4.1 Report on the state of play in the field by the projects including an overview of complementary projects. a. Description of the activities leading to the development of a state of play report - describe the tasks, explain what type of data and information sources you plan to use: 1. The Lead Partner, in close cooperation with all partners, prepares the stakeholder analysis - a map of actors relevant to the project proposals in the Baltic Sea Region.

The NDPHS NCD Thematic Report 2012: Healthy Lifestyles - Cornerstone of Public Health and the NCD-Thematic-Report 2013: Short overview of Noncommunicable Diseases in Northern Dimension Geographical Area, especially factsheet on Nutrition, Overweight and Obesity will serve as a general baseline review for the project preparation. However, the closer look at the stakeholders is needed. b. Responsibilities of developing and executing each activity described above – describe how the responsibility for each task above will be shared among the partnership (be specific, “all responsibilities shared equally among the partners” is not specific enough): 1. Lead Partner in cooperation with all partners will map relevant stakeholders. There will be a mapping exercise during the project planning workshop. c. Budget justification – briefly describe the costs including in the attached budget consistent with the tasks described above. The accomplishment of the action requires working time input from the Lead Partner to search the web, conduct the interviews and prepare a questionnaire to be filled in by all partners. Moreover, the Lead Partner will prepare a mapping exercise concucted during the project planning workshop. The Lead Partner will also combine all the results in a comprehensive report.

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4.2 Development of the main project’s work plan, partnership, and budget a. Description of the activities leading to the development of the work plan, composition of the partnership, and budget plan for the main project - list, number and describe tasks to be carried out. 1. The Lead Partner prepares the project fiche and disseminates to the project partners; 2. The Lead partner organises a project planning crowdstorm for the partners to develop a problem tree and project tree of the project; revise goals and objectives, devise components/work packages; discuss the circle of the project partnership and ensure commitment from the partners; timetable; activites; budget lines; 3. The Lead Partner drafts version 1 of the project proposal and sends to the partners for comments;

NDPHS Seed Money Application – Winter 2013-14 12 4. The partners discuss the paper with relevant stakeholders/NCD EG to: 1) get expert comments, 2) inform about the initiative, 3) draw to partnership; 5. The partners send comments to the Lead Partner and provide other possible information needed for the workplan and budget (estimates of expenses, fees, possibilities for co- financing); 6. The Lead Partner finalises the project's documentation. b. Responsibilities of developing and executing each activity described above – describe how the responsibility for each task above will be shared among the partnership (be specific, “all responsibilities shared equally among the partners” is not specific enough): 1. The Lead Partner, NCD EG Secretariat 2. The Lead Partner and partners, NCD Secretariat 3. The Lead Partner 4. The Partners, NCD EG, other relevant experts 5. The Partners 6. The Lead Partner c. Budget justification – briefly describe the costs including in the attached budget consistent with the tasks described above. The accomplishment of the action requires working time input from the Lead Partner to conduct of desk study, draft the project fiche, organise the workshop, finalise the document. The Partners' costs are related to their working time needed to participate in the workshop, comment on the document, discuss the project proposal with other stakeholders/experts.

The workshop requires costs for travel, accommodation, meals and per diems of the partners. Besides, the consultation will require costs for the rent of premises. The project will also make use of the NDPHS NCD EG capacity.

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4.3 Report on funding possibilities and next steps a. Description of the activities leading to the development of a report on funding possibilities and next steps - list, number and describe tasks to be carried out. The funding opportunities for the main EmpowerKids project will most likely not be opened yet. However, the Lead Partner, as well as all partners, will regularly scan the funding programmes available in the area and relevant to the topic and share the findings with each other. b. Responsibilities of developing and executing each activity described above – describe how the responsibility for each task above will be shared among the partnership (be specific, “all responsibilities shared equally among the partners” is not specific enough):

c. Budget justification – briefly describe the costs including in the attached budget consistent with the tasks described above.

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NDPHS Seed Money Application – Winter 2013-14 13 4.4 Other a. Description of the activities leading to this output - list, number and describe tasks to be carried out. Include a description as to what benefit this output brings to the development of an eventual main project application.

b. Responsibilities of developing and executing each activity described above – describe how the responsibility for each task above will be shared among the partnership (be specific, “all responsibilities shared equally among the partners” is not specific enough):

c. Budget justification – briefly describe the costs including in the attached budget consistent with the tasks described above.

5. Budget

Fill out the attached budget excel sheet.

6. Extra partner details

If you have more than 4 project partners, please use the attached Extra Partner Details document to create as many additional sheets as needed.

NDPHS Seed Money Application – Winter 2013-14 14