InterWell: an integrated school-based primary care model


The Intergenerational School is an innovative, high-performing public school in Cleveland, Ohio, that fosters lifelong learning and individual and community health. Narrative approaches, information technology enhancements, art and music enrichments, and nature-based programming foster brain health in the service of purposeful and healthy living in the community. 

A newly designed integrated primary and public healthcare model, called InterWell, which was planned to be based in the school, had the potential to transform conceptions and practices of health. I wrote about this in the London Journal of Primary Care (Peter J Whitehouse  InterWell: an integrated school-based primary care model, London Journal of Primary Care, 2013; 5:2, 106-110, DOI: 10.1080/17571472.2013.11493391)

 Interprofessional care supporting chronic disease self-management and transdisciplinary research were foundational to the model. Over the 13-year history of the school, barriers to acceptance of this model of education and health had been reduced and greater community support engendered, but challenges of priorities and funding remained. Our initial question was: Can this new model help support human flourishing in this time of global ecological and social disruption?

No clinic was built because of lack of will at the hospital, so we started working with mobile van as part of another hospital system, but our school was excluded because it was a charter state-supported school (viewed as competitive with dysfunctional metropolitan public schools). Also we also still discussing health programming  at the school and have had challenges developing innovative intergenerational programming because of financial reasons and lack of imagination. Conclusion: unhealthy health care systems are sad; unlearned educational systems are tragic. 

Our current question is: How can we gain political support for health improvement initiatives, especially involving schools, which others view with skepticism? 

Peter J. Whitehouse, Case Western Reserve University:


One Reply to “InterWell: an integrated school-based primary care model”

  1. Thank you Peter for a very thought-provoking article, particularly in the light of the recent COIN blog on Adverse Childhood Experiences (ACEs). You finished your article on Interwell by asking how can you gain political support for health improvement initiatives especially within schools. I wonder whether one place to start is with employers and the corporate world more generally. They will see their future employees not fulfilling their potential because of early poor health practices, or indeed ACEs, which are not addressed, just as they might with those who have suffered difficult experiences as young adults in the workplace. Perhaps employers would more readily support an Interwell programme if they tried themselves more often to ask the question of their own employees….”What happened to you?” ( rather than “what is wrong with you?”), and perhaps, in particular, thought about what they could do to help on hearing the answer to that question. Government Departments such as Business Energy & Industrial Strategy and the Department for Work & Pensions might be interested in getting involved if they could see the benefit to work and welfare. Could Interwell be transposed or extended into the work place so that employees are linked into the local community and that involvement becomes part of their work-plan and remuneration. In essence, bringing into play your Interwell concept of “fostering adaptability and resilience in individuals and our community through a blend of learning, [employment] and health.” Your concept sounds a good one to me in the current context of COVID-19.

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