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This chapter proposes the House of Care model as an integrative framework for advancing person-centered brain health care through systemic evaluation and community-clinical partnerships. Building on realist evaluation principles, it argues that effective care requires understanding individuals’ lived experiences while addressing structural inequities like those described in the inverse care law, where health care services are inversely distributed with population needs. The House of Care framework emphasizes four interdependent pillars: (1) system-level problem-solving capacities to address root causes of disparities, (2) empowered patients/caregivers engaged as care co-creators, (3) organizational processes enabling cross-sector collaboration, and (4) integrated clinical-community partnerships providing continuous, anticipatory support. The model is applied to critical challenges, including implementing Canada’s Truth and Reconciliation Commission health recommendations through culturally safe evaluations and developing iterative learning through Problem-Driven Iterative Adaptation (PDIA). By combining neurological insights with community wisdom, the approach advocates for epistemic fluency—bridging Western medical and Indigenous knowledge systems to redefine thriving. The chapter positions evaluation as both a diagnostic tool and intervention catalyst, arguing that sustained improvements require dismantling evidence-generation asymmetries between clinical and community sectors while fostering trust through collaborative design. The role of evaluation in building adaptive brain health systems that transcend project-based thinking to help individuals and communities thrive is described.

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Building a House of Care: Movements Toward an Integration of Neuroscience and Community Solutions

  • 章节

  • 出版模式：

    开放获取

  • 发表日期：

    2026年

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  • Sanjeev Sridharan,
  • Jane Whynot,
  • Jordan Antflick,
  • Nikhil Shah,
  • Ian Macdougall,
  • April Nakaima

摘要

This chapter proposes the House of Care model as an integrative framework for advancing person-centered brain health care through systemic evaluation and community-clinical partnerships. Building on realist evaluation principles, it argues that effective care requires understanding individuals’ lived experiences while addressing structural inequities like those described in the inverse care law, where health care services are inversely distributed with population needs. The House of Care framework emphasizes four interdependent pillars: (1) system-level problem-solving capacities to address root causes of disparities, (2) empowered patients/caregivers engaged as care co-creators, (3) organizational processes enabling cross-sector collaboration, and (4) integrated clinical-community partnerships providing continuous, anticipatory support. The model is applied to critical challenges, including implementing Canada’s Truth and Reconciliation Commission health recommendations through culturally safe evaluations and developing iterative learning through Problem-Driven Iterative Adaptation (PDIA). By combining neurological insights with community wisdom, the approach advocates for epistemic fluency—bridging Western medical and Indigenous knowledge systems to redefine thriving. The chapter positions evaluation as both a diagnostic tool and intervention catalyst, arguing that sustained improvements require dismantling evidence-generation asymmetries between clinical and community sectors while fostering trust through collaborative design. The role of evaluation in building adaptive brain health systems that transcend project-based thinking to help individuals and communities thrive is described.