InterWell: an integrated schoolbased primary care model

A newly designed integrated primary and public healthcare model, called InterWell, which is planned to be based in the school, has the potential to transform conceptions and practices of health. Inter-professional care supporting chronic disease self-management and transdisciplinary research are foundational to our model. Over the 13-year
history of the school, barriers to acceptance of this model of education and health have been reduced and greater community support engendered, but challenges of priorities and funding remain. Can this new model help support human flourishing in this time of global ecological and social disruption?

The Intergenerational School (TIS) is a high-performing public school located in Cleveland, Ohio that meets the educational needs of over 200 urban elementary school students and hundreds of adults, including elders and some with dementia (www.tisonline.org). In existence for more than a dozen years it is a learning community that celebrates lifelong learning and spirited citizenship. It has been recognised by the state of Ohio as being ‘excellent with distinction’ and is currently the highest ranking charter public school in our state, as measured by standardised tests. The term charter is used in the USA for a state-funded, open access school where the bureaucratic rules of usual public schools are relaxed (somewhat) to foster innovation. Moreover, it provides learning opportunities for high school, college, graduate and professional students, as well as adults developing encore careers and elders interested in legacy. Quantitative and qualitative research have demonstrated its value for older people with cognitive impairment. Broadly defined conceptions of health have been at the centre of its programmes since its founding by Peter Whitehouse, a geriatric neurologist, and Catherine Whitehouse, a developmental psychologist, as well as others.

In the USA in particular, but other countries as well, educational and healthcare systems are in a state of disarray. They are not seen as providing value for money, based on poor outcomes as well as excessive costs. TIS is a response to this critical social need to create new organisational forms that address, in a cost-effective fashion, boundary spanning activities that serve multiple community purposes.5 In this paper, we describe specific programmes that highlight certain aspects of our lifelong learning model before describing specific health related programmes, including our concept of brain health. We then outline our newly designed integrated primary and public health practice
being developed at the school. Finally, we end with an analysis of factors that have helped and hindered our work in creating the school and its health practices.

Paper written by Peter John Whitehouse

Please find the full paper below.