Projects: Collaborate.Health

Island Health Care

Addressing the Social Determinants of Health

Agency Partner
Island Health Care
Program Design for Global Health
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Island Health Care (IHC) is a Federally Qualified Health Center (FQHC) and an accredited Patient-Centered Medical Home (PCMH) that provides primary care to approximately 3,000 patients on Martha’s Vineyard annually.


IHC has partnered with the Martha’s Vineyard Boards of Health to address social determinants of health and improve wellness for all residents across the island.


How can we address social determinants of health and improve wellness among the residents of Martha’s Vineyard through chronic disease prevention and management?


Our program creates a coordination hub supported by a mobile application to connect and uplift existing and new community initiatives targeted towards nutrition, fitness, and stress management to provide a collaborative chronic disease management and prevention initiative. The cluster package of wellness services that is facilitated, administered, and monitored by IHC and its community partners has the following core elements:

  • Partner with local initiatives to curate a menu of local services that target SDOHs related to chronic diseases
  • Create an app that links community members to local initiatives with discounts and other incentives
  • Advertisement to increase both referral and use of local initiative services

Services include but are not limited to:

  • Access to free and/or discounter exercise classes
  • Access to free and or discounted stress management resources (yoga and art therapy classes)
  • Access to free and or reduced local fruits and vegetables
  • Access to free meeting with a personal trainer to develop a fitness plan


A comprehensive community wellness collaboration to improve chronic disease management and prevention services provided outside the clinical setting to improve overall the wellness of the entire Martha’s Vineyard community. This project was developed over the course of nine weekdays. and will be implemented over a course of 5 years with meaningful engagement expected before the end of year one.

Project Timeline

This project took four months to complete from kick-off meeting to presentation of final deliverables. Click the button below for a detailed timeline.

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