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1 SISÄLTÖ 1 JOHDANTO...3 2 TERVEYDEN EDISTÄMINEN...4 2.1 Terveys...4 2.2 Terveyden edistämisen taustaa...6 2.3 Terveyden edistämisen käsite...7 2.4 Terveyden edistäminen prosessina...10 2.5 Kuntoutusohjauksen näkökulma terveyden edistämiseen...11 2.6 Kunnan velvoitteet edistää terveyttä...15 3 POLICY, HEALTH AND FAMILY LEARNING-HANKE...17 3.1 Policy, health and family learning-hankkeen pilottikunnat...18 4 OPINNÄYTETYÖN TARKOITUS JA TUTKIMUSTEHTÄVÄT...21 5 TUTKIMUKSEN TOTEUTUS...22 6 TULOKSET...24 6.1. Terveyden ja terveyden edistämisen määrittely pilottikunnissa...24 6.2 Terveyden edistämiseen liittyvät kehittämishaasteet pilottikunnissa...26 Hankasalmi 6.2.1 Päätöksenteko...26 6.2.2 Vaikuttavuuden arviointi...27 6.2.3 Resurssit...27 6.2.4 Asenteet...28 6.2.5 Yhteistyö muiden toimijoiden kanssa...29

2 6.2.6 Perheet...29 6.2.7 Liikunta...30 6.2.8 Sijainti...30 Jämsä 6.2.9 Päätöksenteko...32 6.2.10 Resurssit...33 6.2.11 Asenteet...34 6.2.12 Yhteistyö muiden toimijoiden kanssa...34 6.2.13 Liikunta...34 6.2.14 Elinkeinopolitiikka...34 6.3 Terveyden edistämiseen liittyvät kehittämisideat pilottikunnissa...37 6.3.1 Henkilöstö...37 6.3.2 Seuranta ja arviointi...37 6.3.3 Koulu...37 6.3.4 Päätöksenteko...38 6.3.5 Jo kehitettyä...38 6.3.6 Henkilöstö...42 6.3.7 Terveydenhuolto...42 6.3.8 Perheet...42 6.3.9 Käytännön järjestelyt palveluissa...43 6.3.10 Jo kehitettyä...43 6.4 Yhteenveto...44 7 POHDINTA...45 7.1 Tutkimuksen luotettavuus...45 7.2 Tutkimukseen liittyvät eettiset kysymykset...47 7.3 Tulosten tarkastelua...48 7.4 Johtopäätökset...50 LÄHTEET...53

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