Introduction

This continuing education programme within the field of culture for health grew out of the pilot project, Culture as Prevention: Assisting Children and Youth. The Department of Humanities and Cultural Studies and the Department of Social Studies cooperated on the pilot project through capacity building, joint lectures and conferences aimed at enhancing knowledge among students and teachers and developing a culture / health perspective across faculties. Cooperative efforts were aimed at using cultural activities in health promotion work and the development of collaborative skills in an interdisciplinary perspective. The initiative for the pilot project developed from local interests in the field at Telemark University College, but also had regional and national roots. A series of public reports in recent years has increasingly addressed the relationship between culture and health, as well as the need for a multidisciplinary approach.

The curriculum for Culture for Health has been developed by a committee consisting of:

Professor Edvard Befring, University of Oslo

Professor Odd Steffen Dalgard, National Institute of Public Health

Chief Psychologist, Målfrid Grude Flekkøy, Nic Waals Institute

Assistant Professor, Gro Lorentzen, Telemark University College

Associate Professor, Sigrid Straand, Telemark University College

Initially, the implementation of the continuing education programme was to be a collaborative project between all the faculties at Telemark University College, with the Faculty of Arts and Sciences and the Faculty of Health and Social Studies bearing the main responsibility. The faculties were to contribute various aspects of expertise and competence in the form of teaching, guidance and idea generation. The Faculty of Health and Social Studies, and the Department of Social Studies specifically, is academically and administratively responsible for the study programme. At present, the Department of Social Studies is providing the content for the study programme, with other departments making only occasional contributions.

Culture of Health started as an experiment in autumn 1998, with financial support from the Norwegian Cultural Council and the Ministry for Health and Social Welfare, and from 2000 onwards has been offered as a study programme at Telemark University College.

The study programme was established in connection with the cooperation between the Ministry for Health and Social Welfare and the pilot project, Culture as Prevention, in which selected municipalities participated through various initiatives which took local and regional cultural life as their starting point. The main objective was to strengthen the local community’s efforts in health promotion and prevention of illness. After the project’s completion, culture and health networks were established involving the municipalities that had participated in the project, or those which connected to the networks at a later date.

In recent years the municipalities and local communities have acquired an ever greater responsibility for social development, and will in future probably be the main arena for the development of better health, greater cultural diversity and increased well being and welfare. This will lead to a need for new skills. The educational sector is a key player when it comes to qualifying, informing and adopting approaches. The study programme, Culture for Health, may be considered against this background.

A series of public reports also points to the need for interdisciplinary thinking and inter-agency cooperation from a culture and health perspective. Key documents in this context are:

- There is a use for everybody. Strengthening public health work in local government (NOU 1998:18): this document focuses on, amongst other things, the training of personnel in the public health sector. There is a need for a public health perspective in education and training, especially the development of the knowledge base to include empowerment and community development strategies in public health work. The university colleges in Tromsø, Bodø, Telemark and Lillehammer are challenged in this context to form networks with a focus on the interdisciplinary aspects within the health and social sciences.
- Rehabilitation document (Report no. 21 1998-1999): this document also addresses knowledge and skills, especially those relating to the rehabilitation field. In this context, the interdisciplinary study programme Culture for Health at Telemark University College may be relevant to the participants in rehabilitation work.

- The escalation plan for mental health from 1999 to 2006. Development of local initiatives. (Circular I-4/99 from the Ministry of Health and Social Welfare): this plan is based on a holistic view of humanity and a desire to develop a society with greater emphasis on cultural and human values, decentralization, family and community and a more equitable distribution of resources. The plan has a separate chapter on capacity building and recruitment of personnel, which focuses on interdisciplinary education. In the chapter Development of cultural and recreational initiatives, municipalities are encouraged to integrate people with mental illnesses into existing cultural and leisure activities; in this context, the efforts of the Norwegian Cultural Council and the Ministry of Health and Social Welfare are referred to.

- Local Agenda 21 (LA 21) is one of several final documents produced by the UN Conference on Environment and Development in Rio 1992. Local authorities in this context are encouraged to enter into dialogue and interaction with citizens, organizations and private enterprises to initiate processes for sustainable development. In Norway the Rio process was followed up locally, regionally, nationally and internationally by the Ministry of the Environment. As part of the follow-up, the Ministry signed a four-year agreement with the Norwegian Association of Local and Regional Authorities for the creation and testing of the regional centres for LA 21 in some counties; one of the sub-goals is to mobilize citizens, organizations and social partners for active participation in Local Agenda 21 processes and establish suitable meeting places and networks. Telemark is one of the counties participating in this trial.

- Prescription for a healthier Norway (Report no. 16:2002 - in 2003): this report discusses factors that contribute to creating health problems, or that help prevent disease. Health promotion is concerned with how an individual may gain “increased energy to cope with the demands of daily life.” It explores how culture and health efforts exemplify the use of cultural activities in promoting public health. The report also emphasizes that public awareness raising concerning the relationship between physical activity and health is ensured amongst other things by continuing education programmes for health professionals.

- Cultural policy to 2014 (Report no. 48:2002 - 2003): this report outlines the central aspects of cultural policy priorities that lie ahead. The report focuses in particular on professional art/artists, but also addresses the importance of an active and engaging cultural life at the level of the individual and the community. In a separate chapter on Culture and health, the importance of participation in meaningful cultural activities is emphasised, as well as how this may contribute to improving quality of life and a better ability to cope with an individual’s life situations.
In 2000, Porsgrunn municipality was selected to be a culture and health community. The municipality has developed and implemented a number of measures within the area, especially concerning cultural efforts in psychiatry. The municipality’s Cultural Office collaborates with the District Psychiatric Centre in Porsgrunn and the Faculty of Health and Social Studies at the University College concerning research and development efforts in culture and mental health. Amongst other things this involves an annual conference, the Porsgrunn Conference for Mental Health, Culture and Research.

The study programme’s duration, scope and level

The study programme comprises 60 credits and is a part-time course of studies taught over two years. The instruction will be carried out in units, usually 3-4 units per semester, during the day and primarily on weekdays. The study programme is structured so that students may combine their studies with full time employment. This requires that employers provide leave in connection with workshops, and that students set aside time for self study / work in regional groups.

Target Group and Admission Requirements

There are a variety of professions that work with general health promotion, or with people who are in exposed or vulnerable situations - permanently or temporarily. The work is carried out in the public and private sector and by NGOs.
The study programme is therefore aimed at different professions, cultural workers, health and social workers, teachers, pre-school teachers, the police, planners and others working within the relevant areas.
In order to be admitted to the study programme, students must meet the minimum requirement: a completed 3-year course of studies at university or university college.

Aim of the Programme

The aim of the study programme is to provide students with knowledge of the central areas within culture and health so they can gain insight into the various aspects of interaction between culture and health at individual and community levels. Students will also gain knowledge of globalisation and its consequences.
Another aim is that students individually and in groups develop expertise in creative and interdisciplinary interaction.
The study programme seeks to meet society’s demands for knowledge concerning the relationship between culture, well-being and health. This also implies knowledge of the responsibilities and division of labour between NGOs, and the public and private sectors. Moreover, emphasis is placed on conditions for and the use of cultural activities and creativity in working with various groups, organizations and local communities. Through the study programme, students will gain skills in communication, teamwork and project work.
Knowledge of interdisciplinary collaboration is emphasized in all parts of the study programme. The fact that the students will have different professional backgrounds will provide them with the opportunity to discuss and interact across disciplines.

Curriculum and structure

The study programme consists of four major course units of 15 credits each. The first year is structured with a major course unit each semester. In the second year students will work with two major course units in parallel. The major course units build on each other. In order to study in the second year, it is therefore essential that the first year of study is completed, or that the student has equivalent qualifications.

Major course unit 1: Culture, Health and Quality of Life, 15 ECTS

The culture and health concept is analysed from different theoretical approaches and the relationship between culture and health will be emphasized. The relationship is also discussed and illustrated by examples from cultural and health projects.

Students will gain an overview of the most common traditional and contemporary artistic and cultural expressions. Furthermore, the importance of cultural and social capital will be discussed. The central concept within the sociology of culture will be addressed.
The relationship between culture and nature will be discussed, especially based on the body, body experiences and bodily expressions.
Physical activity and outdoor activities are also presented as a means to maintain and improve mental and physical health.
Students should be familiar with different strategies within health care such as treatment, prevention, rehabilitation and health promotion. The study programme will address both the culture of health when it comes to prevention and health promotion at individual and community level, and the use culture to cope with illness and disabilities at the individual and societal level.

Major course unit 2: Modernity, Globalization and Identity, 15 ECTS

Students will acquire knowledge and understanding of modernity’s basic institutional dimensions and globalisation in the broadest context. Furthermore, how globalisation has national and local consequences and can lead to increased marginalisation will be emphasised.

Modernity and globalisation means that distances and territorial borders have less meaning and cultural elements are shared by more people. Globalisation of culture can lead to homogenisation, but also to the creation of new inequalities through local articulation of global phenomena. Modernity implies increased individualisation and a trend towards more sophisticated and complex conditions. The study programme will examine how modernity and globalisation has major consequences for ways of life, lifestyles and identity formation.
In most cultures religious traditions and beliefs influence people’s lives and affect their values, attitudes, norms and practices. Students will learn about perceptions of health, illness and life styles in different cultures.
Network theory and methods are considered from both individual and community perspectives. At the level of the individual, factors that affect an individual during the course of their life, and the relationship between social networks, identity and quality of life will be emphasized. How societies create different types of networks and provide various opportunities for integration and local mobilization at the community level will also be discussed. An understanding of the importance of networking will also point out the necessity of cooperation between formal, informal and voluntary networks.

Major course unit 3: Cooperation and Creative Skills to Take Action, 15 ECTS

The study programme provides a short introduction to organizational theory with special emphasis on what promotes and inhibits cooperation. Organizational culture and leadership issues will be discussed, and important frameworks for interdisciplinary and inter-agency cooperation will be examined.

The users of various services constitute important partners, both regarding information and in the creation of appropriate objectives and measures. They also constitute the basis for the work which is carried out. Coping and resilience will be addressed, because this involves the strengthening of people’s inherent skills and social networks. Empowerment is also an important approach so that users may attain control over their own lives and safeguard their rights.
Strong professional interests are often an obstacle to flexible cooperation. In addition to the knowledge of various professions, critical approaches towards the various professions will also be considered, and the problems that may arise in interdisciplinary and inter-agency cooperation.
In addition to services in the public sector, voluntary organisations and the market also play a major role. The study programme will also discuss various forms of cooperation and types of collaboration partners.
The study programme requires knowledge of appropriate cooperation methods. Included in this context is communication in groups, conflict resolution, various forms of meetings, project methods, etc. Creative therapies such as the use of music, art and expressive therapy will be examined, and knowledge of dissemination and facilitation of culture in health and care institutions will be stressed.

Major course unit 4: Interdisciplinary Project Work, 15 ECTS

In this part of the study programme, students will complete a project related to a culture and health perspective.

The project work and research methods will be based on students’ knowledge and from their experience with other projects, and builds on previous lectures. Problem formulation, data collection, analysis and report writing, evaluation methods and action research will also be discussed.
Students will establish project teams with an aim of including the representation of at least two professional groups; however, exemption from this requirement may be granted.
The project groups will be given the opportunity to present their work in class, and thus receive responses from fellow students and teachers. This work will provide insight into various aspects of culture and health issues, while students will practice critical reflection and constructive feedback. Each project team will also be appointed a supervisor.
Topics will also be addressed in lectures and field trips that will illustrate key areas concerning the relationship between culture and health. The topics may be linked to one or more of the projects, or refer to recent research in the area. The selection of topics will be done in collaboration with the students.

Teaching and Learning Methods

Teaching and learning methods will include lectures, seminars, group work, discussion groups, project work and student presentations, in addition to practical exercises with cultural forms of expression. The lectures will emphasise the use of lecturers and examples that are relevant in a cultural / health perspective. In addition, the study programme will include field trips and / or presentation of the various initiatives / projects.
Projects in the study programme will be selected to develop cross-disciplinary collaboration and implementation of systematic, innovative efforts.
The project work will contribute to the learning of practical skills in research-based work. Students will receive guidance.
The study programme’s integrated learning form requires continuity and participation. Individual students are responsible for their own learning, but they will also affect the learning environment of all the students, especially in group work. It is assumed therefore that students participate in the various teaching initiatives organized by the college. Some parts of the study programme are obligatory. This will be described in the study and the semester schedule.

Assessment Methods

Each academic year concludes with an examination. In order to take the examination, the mandatory assignments must receive passing marks. In order to continue with the second year of the study programme it is a requirement that students pass the 1st year examination.
The first year of study
Course code: 9841ÅR ST1; Study programme requirements first year, major course units 1 and 2
Study programme requirements consist of an individual written assignment relating to the first year major course units.
Graded as pass / fail.
Study programme requirements must be passed in order to take the examination.
Course Code: 000 9841ÅR Culture, Health and Quality of Life. Modernity, Globalization and Identity
Written examination under supervision, 8 hours, without examination aids.
The first year must be passed in order to continue to the second year of study.
Second year of study
Course code: 9842ÅR; ST2 Study programme requirements; second year: project outline
Study programme requirements are: project outline in groups.
Course Code: 9842ÅR 000 Interdisciplinary project; group work with individual oral examination
Project assignment in groups with oral individual examination. Written and oral examinations are equally weighted. The project must be approved before students may take the oral examination. The individual oral examination is based on the specialisation project and the individual student’s academic level at the time of the examination, and covers the study programme’s overall content, literature, teaching, field trips, exercises, etc.
Assessment is based on the college grading scale from A to F, where E represents the lowest passing grade. A grade is given for each year of study, and a final grade for the entire study programme.

Minor adjustments may occur during the academic year, subject to the decision of the Dean