Clinic-based Model

  • Clinic-based Model

California State University San Marcos (CSUSM) and
Vista Community Clinic (VCC) REACH Higher Program
Vista, California

The REACH Higher Program is a joint venture between two major partners — California State University San Marcos (CSUSM) and the Vista Community Clinic (VCC). CSUSM is a federally-designated, Hispanic-serving institution of higher learning, and the home of the National Latino Research Center (NLRC). NLRC’s mission is to promote research, training, and the exchange of information that contributes to the understanding of the rapidly growing Latino population.69 The VCC is a local community health center that serves the needs of the underserved. Through its Health Promotion Center, the VCC has delivered youth development programs since the 1990’s. Accordingly, CSUSM and the VCC are a natural fit to partner in an OMH-funded Youth Empowerment Program.

“Our goal was to marry health and education,” says Dr. Arcela Nuñez-Alvarez, Director of NLRC. “Using evidence that shows a direct correlation between the two, we wanted to provide comprehensive educational and prevention services designed to promote healthy behaviors and significantly increase future orientation.” As Latino populations continue to grow, it is clear that better education is necessary if healthy and safe communities are to result. For the YEP, CSUSM has partnered with the Vista Unified School District, Vista High School, the Vista Townsite Community Partnership, the City of Vista, and North County Lifeline. Each partner’s role is identified in the REACH Higher partnership diagram (p. 30). The key partner that makes REACH Higher unique is the Vista Community Clinic (VCC), which gives the program a rich health promotion focus. Moreover, the VCC provides the day-to-day programming for REACH Higher students. “The Vista Community Clinic provides services to underinsured families who often lack access to health promotion services,” says Dr. Arcela Nuñez-Alvarez. “Through the YEP, the VCC has the ability to reach youth and their families, thereby increasing access to much-needed health resources.” Detailed below, the VCC is a dynamic partner within this clinic-based model for youth empowerment.

Vista Community Clinic (VCC)

The Vista Community Clinic (VCC) is a federally- funded community health center serving underserved residents in Vista, CA, home of the REACH Higher Program. The mission of the VCC is to provide comprehensive primary health care and prevention services to the community, focusing on those who face economic, social, or cultural barriers. Nearly half the VCC’s patients are age 18 or younger, 65% are uninsured, and 32% have Healthy Families or Medi-Cal coverage for low-income or disabled residents. The VCC has been offering after-school programs since the mid-1990s, focusing first on preventing teen pregnancy and evolving to provide a full range of services to disadvantaged youth. The NLRC at CSUSM is an ideal partner for youth empowerment, combining the VCC’s focus on after-school prevention programs and the NLRC’s focus on improving educational outcomes. The REACH Higher Program serves high-risk, primarily Latino youth, ages 12-17, in Vista, California. Specifically, the REACH Higher Program provides educational and prevention services designed to reduce risky behaviors, while improving protective factors and increasing academic success and college readiness.

Ms. Nannette Stamm serves as Assistant Director of the VCC’s Health Promotion Center, which oversees the REACH Higher Program.

“The goal of Healthy People 2020 for adolescent health is to improve the healthy development, health, safety, and well-being of adolescents,” says Ms. Stamm.

“The VCC is reaching this goal in our community through comprehensive programs like the REACH Higher Program,” Ms. Stamm continues. “We’re not just an academic achievement program, nor just a teen pregnancy prevention program. We’re a teen program, focusing on the teen as a whole and tailoring our interventions to fit teens and the environment in which they live.”

The VCC staff is responsible for providing and overseeing daily operations of the after-school programming, including the health prevention and life skills curricula. The health prevention curriculum includes content on reducing violence, cyber bullying, substance abuse, obesity, and chronic diseases. The VCC uses a curriculum designed to help youth develop positive life skills, such as risk assessment, decision making, and drug resistance, while enhancing anti-drug norms and attitudes. Streetwise to Sexwise is a comprehensive curriculum model for a basic series of human sexuality education for high-risk teens to prevent STDs and pregnancy.

In addition to the health-related prevention activities, the VCC is also leading the implementation of employment readiness programming. “The VCC is a prime example of a community health center leveraging the social determinants of health,” says Ms. Stamm. “By developing life skills in youth and improving academic performance, we know REACH Higher students will have better health outcomes. The primary goal of REACH Higher is prevention. On the verge of potentially becoming a pregnant teen, abusing drugs, or joining a gang, the REACH Higher Program shows students they have other options.” In addition to these comprehensive prevention programs, the VCC also addresses poor access to primary care services. Obstetrics, gynecology, pediatrics, dentistry, immunizations, reproductive health, and pre-natal services are just some of the health services provided. The VCC also offers a teen clinic to address specific concerns of Vista youth. In other words, the VCC provides a direct link to clinical services for REACH Higher youth and their families, including assistance with health insurance issues and direct referral to clinic providers.


The VCC’s partnership in REACH Higher brings firsthand experience in the effects of health disparities and the social determinants of health to empower youth. Their in-depth insight into health promotion is borne from direct observations in this population. Its ability to deliver youth empowerment programs is matched by its unique capability to also deliver health care to underserved and impoverished families, giving REACH Higher a truly comprehensive clinic-based approach. “The REACH Higher program is a perfect partnership between the Vista Community Clinic and the National Latino Research Center,” says Ms. Stamm. “VCC brings 15 years of experience in youth development programming related to teen pregnancy, violence, and substance abuse prevention, while the NLRC brings its own experience in applied research, youth empowerment, cultural sensitivity, parent engagement, and college readiness. The partnership allows REACH Higher youth to gain both the life skills needed to navigate through adolescence and the preparation and guidance needed to reach their higher education goals.”