Re-Imagining Healthcare

Healthcare has long been focused primarily on fixing problems. While prevention has also been a buzzword for many years, the emphasis remains heavily on the idea of responding to a problem once the patient presents. Obviously, healthcare professionals will always need to be capable of dealing with problems after they occur. People will get sick.

But a new way of thinking about attacking problems long before they have a chance to take root is starting to get traction. It’s called the lifecourse approach. Its premise is that health is not static, but changes constantly and is influenced by biology, environment, and society (Halfon, Larson, Lu, Tullis & Russ, 2014). The trajectory of one’s health begins before conception, the lifecourse model suggests.

Nursing, in particular, may be a crucial lifecourse player. “Enriching our understanding of the mechanisms underlying health development across the lifespan offers significant potential for developing nursing interventions to ameliorate risk and enhance protective factors for individuals during early childhood,” wrote a team of scholars from The Ohio State University and the University of Rochester earlier this year in the Journal of Pediatric Health Care (Bates et al., 2018). The authors noted that health constantly develops over time, based on interactions between one’s physiology and the environment, starting at preconception and the fetal period.

Their thinking dovetails with the expanding emphasis on community-driven healthcare research and quality improvement. Dr. C. Daniel Mullins of the University of Maryland asserts that community engagement in the context of healthcare “works with individuals to conduct research that is meaningful to the community in which they reside. Patients and caregivers are involved as advisors at every step of the research process.”​ In short, a very different way of looking at healthcare research.

Which is precisely the point of a conference coming up in November called, “Re-Imagining Healthcare: A Life-Course Approach to Community Based Care,” at the UT Health San Antonio School of Nursing. This event will bring some of the leading voices in the community-based care movement together to share hands-on ways to connect with communities, guide families in finding community resources to help them flourish, and incorporate a grass-roots focus into local healthcare.

Dr. Mullins will be on hand to talk about a framework for community engagement and he will lead the Research Proposal Workshop on the second day of the conference. The workshop is designed to prepare conference attendees to identify why their “question” is important, why it is unique or innovative, and what the real question is in the voice of the patient and the community. Dr. Mullins will help attendees address potential research questions, quality improvement projects, and/or innovative practice changes.

The UT Health San Antonio School of Nursing conference is already putting into practice the community-based approach to lifecourse solutions, with an agenda developed in partnership with the school’s community partners. The first day of the conference will focus on listening to the stories and concerns of these community partners, including their experiences with violence, drugs, death, homelessness, teen pregnancy and parenting, and grandparents raising grandchildren.

The format of the agenda and the titles of the panel and working groups use the community’s own words. “Opioid crisis” and “teens in crisis” had no meaning to the teens, moms, and grandmothers that made up the conference planning committee.

The interaction between the community and conference attendees on the first day of the conference sets the stage for generating research questions and/or quality improvement projects on the second day. Also, working groups and the Knowledge Market will allow attendees and the community to learn from each other, turning the traditional approach to academia-driven research upside down.

Bringing it all together, Dr. Cindy Sickora and Dr. Diana Mason will lay the foundation for understanding the life-course approach and the need to shift the focus of healthcare to the health of families and communities.  Dr. Sickora is Vice Dean of Practice & Engagement at the UT Health San Antonio School of Nursing. Dr. Mason is Senior Policy Service Professor at the Center for Health Policy and Media Engagement at George Washington University School of Nursing.

Want to register for the conference? Click HERE.


  • Bates, R. A., Blair, L. M., Schlegel, E. C., McGovern, C. M., Nist, M. D., Sealschott, S., & Arcoleo, K. (2018). Nursing across the lifespan: Implications of lifecourse theory for nursing research. Journal of Pediatric Health Care, 32(1), 92-97.
  • Halfon, N., Larson, K., Lu, M., Tullis, E., & Russ, S. (2014). Lifecourse health development: Past, present, and future. Maternal and Child Health Journal, 18, ​344-365.

Posted by:

Joyce K. Borgfeld, DNP, RN, NE-BC

School of Nursing, Department of Lifelong Learning

UT Health San Antonio

Article Categories: Blog

Leave a Reply

XHTML: You can use these tags: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>