After the loss of her father during freshman year, Cherelle Vanbrakle began studying biology and exercise physiology to better understand the science behind various health issues. That determination, along with the guidance of mentor and former TLU Professor William Squires, helped her process what happened to her father. Under the direction of Dr. Squires, Vanbrakle developed an interest in public health, pediatric obesity, and an overall passion for helping her community.
As a kinesiology major and a biology minor, the Austin native went on to earn a Master of Education in Exercise Science at Texas State University where she completed a study titled, “The Effect of Environmental Factors and Socioeconomic Status on Body Mass Index, and Physical Activity in a Sample of Adolescents from Austin, Texas.”
Currently, Vanbrakle is the director of health promotions and community advocacy at People’s Community Clinic (PCC), a federally qualified health center in Austin. At PCC, she leads a department focused on upstreaming prevention work ranging from strengthening individual skills and knowledge to policy change. Her work has also led to the creation of an integrated Community Health Worker Program. The clinic, located in the St. Johns neighborhood (78752), is where Vanbrakle grew up.
Prior to joining PCC, she was an adjunct professor at Austin Community College and the coordinator of the Pediatric Obesity Center at Dell Children’s Medical Center. Vanbrakle is also a very active member of her community serving as a commissioner on the African American Resource Advisory Commission for the City of Austin, a board member for Open Door Preschools, and a member of the Community Strategy Team for Dell Medical School. Enhancing health resources and access in local communities is rooted in her TLU education.
“My mother connected me with the Texas Center for Treatment and Prevention of Childhood Obesity when I was working on a presentation with Dr. Squires,” she said. “They presented data that showed that this would be the first generation of children who wouldn’t outlive their parents. That really stuck with me. I always had the mindset that whatever I learn, I want to put it back into my community. My dad was very much like that with his air conditioning and heating business where he would often fix things for people who needed it but couldn’t pay for it. My mom was the same way as an RN and taught classes.”
While researching her graduate thesis, Vanbrakle actually went back to her own high school, LBJ Early College High School and the Liberal Arts And Science Academy, to complete a Neighborhood Environment Walkability Survey (NEWS).
“Obesity, a chronic multifactorial disease has become highly prevalent in the United States in the past few decades, and the incidence is predicted to continue to increase,” she said. “The purpose of this study was to investigate the associations among the walkability characteristics of neighborhoods, as measured using the NEWS survey, with physical activity and body mass index (BMI) in a sample of adolescents from LBJ High School. Participant packets were sent home and height and weight were obtained to calculate BMI.”
Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS). Results found that several factors correlated with the adolescents’ BMI, including the parent’s perceptions of neighborhood aesthetics, the students’ perception of pedestrian and automobile traffic safety in their neighborhood, and distance to hike/bike trails and recreation facilities. Neighborhood walkability appeared to be moderately related to adolescents’ BMI.
Her work at the Pediatric Obesity Center at Dell Children’s Medical Center functioned under a model called the spectrum of prevention—a systematic tool that promotes a range of activities for effective prevention.
According to the Prevention Institute, the spectrum identifies six levels of intervention and helps people move beyond the perception that prevention is merely education. The levels include Strengthening Individual Knowledge and Skills, Promoting Community Education Reaching, Educating Providers, Fostering Coalitions and Networks Bringing, Changing Organizational Practices Adopting and Influencing Policy and Legislation.
At PCC, Vanbrakle says their priority is treating patients with dignity and respect. Under the Spectrum of Prevention, the Health Promotions and Community Advocacy Department works collaboratively to do just that.
“We want to develop relationships with our patients to create a network of support,” she said. “That also includes educating medical providers and sharing the community knowledge we have. As a clinic, we also have a role in providing patients with other health professionals like dieticians and lactation consultants. We have formed coalitions and the goals of this collaborative work is to make a larger impact. PCC is also a member of Central Texas Interfaith, so we’re able work collaboratively with other sectors like churches and schools on institutional organizing and policy change.”
PCC created a social determinant of health screening tool that includes an eight-question survey about factors like transportation, housing, and access to technology. The tool was piloted with about 2,000 patients and preliminary data showed that ESL classes were a big concern. They also found that many patients prefer going places they are comfortable or familiar with, so Vanbrakle’s department worked to with Austin Community College to set up ESL classes on site.
The ultimate goal of PCC and the Prevention Institute is to integrate clinical service delivery with community prevention to reduce demand for resources and services, improve health, safety, and equity outcomes, and equip medical providers with skills and strategies to change the social circumstances that shape the health of their patients.
“We want to bring everyone together for policy change,” she said. “It’s not normal for health care organizations to be involved in this realm or to have medical professionals at the table. Our patients and community should get whatever they need to achieve their optimal health outcomes. That’s equity. Healthcare functions under a system that isn’t equitable. The Prevention Institute’s Spectrum of Prevention Model helps my department align our work in way that is proven to have a larger impact. My hope is that our department can align the work that benefits our patients greatly and that starts with simply asking them what they need.”
This work has become even more challenging amid a global pandemic. From access to COVID-19 testing and transportation, Vanbrakle says clients need support now more than ever with basic necessities like paying for utilities.
“As a clinic, we recognized that social determinants of health contribute significantly to our patients’ health, and under our ‘new normal,’ felt we must continue this work by actively reaching out to our patients,” she said. “After conversations with some of our community partners, we modified our Social Needs Tool in a way that made it more responsive to the community’s needs during COVID-19, focusing on the top calls seen by 2-1-1. We sent both text messages and emails to our active patients, while our nurses screened our patients with positive COVID-19 results via phone.”
The team followed up with clients who indicated they needed assistance and also worked with the Aunt Bertha nonprofit network to launch an internal resource navigation tool, The People’s Resource Hub. This tool allowed quick searches for resources being updated in real-time.
According to the hub, the top needs were: Utilities (Gas, Water, Electricity), Housing, or Rent/Mortgage Assistance, Computer or Tablet for Online Learning, and SNAP/Emergency Food. PCC used this information for individual resource interventions and coordinated efforts to address some of those top needs.
PCC partnered with Austin Urban Technology Movement to increase access, their Community Health Workers advocated at the city level for increased RISE funds, and their Medical Legal Partnership team organized a coalition of legal and medical experts to draft a state-wide petition for emergency rule-making on utility protections.
For Vanbrakle, all of these experiences solidified the importance of helping people at the individual level. One of the things she appreciates most about her TLU education is that she wasn’t just a number.
“I actually visited a large Texas university first but I didn’t get that feeling of belonging,” she said. “At TLU, I felt like I was home. The personal relationships you develop make you feel comfortable going to professors when you need help or guidance. While one-on-one attention does hold you more accountable for your work, it allows students to learn while being innovative. And that sparks passion.”