Mary M Hoke

University of Southern Nevada, Las Vegas, Nevada, United States

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Publications (19)10.46 Total impact

  • Mary M Hoke, Leslie K Robbins
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    ABSTRACT: Numerous training and education programs have evolved to address culturally competent health care delivery. This article describes an exemplar educational approach used to teach cultural competency to beginning graduate psychiatric mental health nursing students. Using interactive strategies delivered within the 4 phases of the curriculum, the approach has been shown to facilitate students' ongoing journey to cultural competence. Building on baccalaureate nursing competencies, the course addresses attitudes, knowledge, skills, and cultural humility to strengthen cultural self-assessment, cross-cultural clinical practice expertise, and the use of culturally appropriate research for graduate students.
    Nursing Clinics of North America 06/2011; 46(2):201-5, vi. · 0.43 Impact Factor
  • Mary M. Hoke, Marilyn Pase
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    ABSTRACT: Purpose: The purpose of this study was to explore changes in competencies as perceived by RN to BSN graduates from initiation of a completion program to post graduation professional practice using the Pew Health Professions Commissions 21 Competencies for the 21st Century. Background: The Pew Health Professions Commission has recommended several changes in the education of the professional healthcare workforce. These include: 1) training to meet the demands of the new healthcare system; 2) that the workforce reflect the nation’s diversity; 3) requiring interdisciplinary competency; 4) continuing to move education into ambulatory sites; and 5) encouraging public services of all students and graduates. While an increasing amount of professional literature speaks to the improvements in patient-care possible with increasing levels of nursing education, little is known about BSN completion graduates’ perceptions of changes in their professional practice competencies after graduation. Methods: Using Survey Monkey, BSN Competition graduates completed an investigator-developed questionnaire using the Pew Health Professions Commissions “21 Competencies for the 21st Century.” The ratings of the competencies were based on the work of Dreyfus and Benner using an investigator developed 5-point Likert instrument. Participants were asked to compare their perceived competencies for 21 items at time of entrance to BSN Completion Program and their current post graduation practice. Descriptive and correlations statistical methods were used in data analysis. Results:­ Of the 21 competencies, an increase was found in all competencies for the study sample (N=40). The three competencies which showed the largest increase were: 1) continue to learn and help others learn; 2) contribute to continuous quality improvement of the health care system, and 3) work in interdisciplinary teams. The three competencies with the least amount of change were: 1) ensure care that balances individual, professional, system and society needs; 2) exhibit ethical behavior in all professional activities; and 3) improve access to health care for those with unmet health needs. Implications: The findings of this study support previous clinical research studies that have demonstrated difference in patient outcomes based on the educational level of the nurse. The growth in professional competencies as perceived by the BSN completion graduate speaks to their recognition of a positive change in professional practice competencies following completion of their baccalaureate education. These views support the need for ongoing baccalaureate completion programs for associate degree educated registered nurses.
    2012 Western Institute of Nursing Annual Communicating Nursing Research Conference; 04/2011
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    ABSTRACT: Although promising research is developing related to promotores and the Chronic Care Model (CCM), studies of the effectiveness of the integration of these two system innovations in addressing health disparities are limited. This article reports on an organizational assessment and analysis of promotores working in a system of federally-sponsored community health clinics along the United States-Mexico border where the CCM has been operationalized. The work of promotores was found to be largely invisible within the CCM. This highlights the need for further investigation if the potential of these combined system innovations to address health disparities among Hispanics is to be realized.
    Journal of Community Health Nursing 04/2011; 28(2):70-80. · 0.63 Impact Factor
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    ABSTRACT: This study examined the relationship between spirituality and health-promoting behaviors in a convenience sample of 90 sheltered homeless women using the Health Promotion Lifestyle Profile II, the Spiritual Well-Being Scale, and a demographic questionnaire. A moderate positive correlation was found between spiritual well-being and overall health promoting lifestyle (r = .426). Moderate to strong positive correlations were found between the Spiritual Well-Being Scale and the Health Promotion Lifestyle Profile II dimension subscales (physical activity, nutrition, spiritual growth, interpersonal relations, and stress management). The results support the importance of spirituality in relation to health-promoting behaviors among sheltered homeless women.
    Journal of Community Health Nursing 04/2011; 28(2):81-91. · 0.63 Impact Factor
  • Mary M. Hoke, Gayle M. Timmerman
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    ABSTRACT: Overweight rural Mexican American women have received limited research attention despite their high prevalence of being overweight and obese. The purpose of this descriptive study was to describe participants' readiness or stage of change, the processes or strategies of change being used, and the decision balance (i.e., pros and cons) to losing weight among overweight rural Mexican American women. Based on the transtheoretical model's (TTM) stages of change, most participants (60%) were in contemplation, 26.7% were in precontemplation, and 13.3% were in preparation/action. Consciousness raising was the cognitive process used most frequently by those in the precontemplation stage. Self-reevaluation was the most frequently used process for those in the contemplation stage, whereas dramatic relief was highest for those in the preparation/action stages. For behavioral processes of change (POC), all participants identified self-liberation as the most frequently used process of change. Weight Decision Balance pro scores were highest for participants in the preparation/action stages. Spanish Las mujeres rurales México Americanas con sobrepeso han recibido atención limitada de investigación a pesar de la alta incidencia de su sobrepeso y obesidad. El propósito de este estudio descriptivo fue describir la disposición o la etapa de cambio de las participantes, los procesos o estrategias de cambio que están utilizando, y la balanza decisiva (pros y contras) de perder peso entre mujeres México Americanas con sobrepeso en zonas rurales. Basándose en las etapas de cambio del modelo transteórico, la mayoría de las participantes (60%) estaban en contemplación, el 26.7% estaban en precontemplación, y el 13.3% en preparación/acción. La concientización fue el proceso utilizado más frecuentemente por las que se encontraban en la etapa de precontemplación. La reevaluación personal fue el proceso más frecuentemente utilizado por aquellas en la etapa de contemplación, mientras que el alivio dramático fue el más alto para las que se encontraban en la etapa de preparación/acción. Para los procesos de cambio conductuales, todas las participantes identificaron la auto-liberación como el proceso de cambio más frecuentemente utilizado. Los puntuaciones a favor en la Balanza Decisiva en relación al Peso fueron las más altas entre las participantes en la etapa de preparación/acción.
    Hispanic Health Care International 02/2011; 9(1):41-49.
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    ABSTRACT: The Association of Community Health Nursing Educators (ACHNE) has developed a number of documents designed to delineate the scope and function of community/public health nursing (C/PHN) educators, researchers, and practitioners. Consistent with the mission of ACHNE, this position paper entitled Academic Faculty Qualifications for Community/Public Health Nursing has been developed by the Faculty Qualifications Task Force. The shortage of qualified nursing faculty has been well documented. In particular, this shortage has increased the difficulty in having sufficient numbers of faculty who are educationally and experientially qualified to teach in the C/PHN specialty. ACHNE is addressing this concern by setting forth preferred qualifications for faculty to teach C/PHN at both the graduate and undergraduate level. While we recognize that the current faculty shortage may require schools to use faculty to teach in areas in which they do not have appropriate formal preparation, the paper outlines best practices for teaching C/PHN, a goal we urge all schools of nursing to work toward. Task Force members developed an earlier draft of the document in fall 2008, and input was solicited and received from ACHNE members and considered in the final document, which was approved by the ACHNE Executive Board in July 2009.
    Public Health Nursing 01/2010; 27(1):89-93. · 0.78 Impact Factor
  • Leslie K. Robbins, Mary M. Hoke
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    ABSTRACT: Perceptions of counselors from Hispanic serving high schools regarding professional nursing as a career have received limited study. A cross-sectional descriptive study of a convenience sample of 55 guidance counselors from Hispanic serving institutions identified the number of requests/referrals to nursing programs and perceptions of prospective nursing student and registered nurse attributes. Hispanic counselors rated caring and professional leadership skills higher than did White non-Hispanic counselors. Recommendations for academic nursing and counselor partnerships are provided.
    Journal of Hispanic Higher Education 01/2010; 9(4):272-280.
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    ABSTRACT: To identify risk factors for excessive or inadequate gestational weight gain and associated morbidities among Hispanic women in a U.S.-Mexico border state. Case-control design. New Mexico. Hispanic women responding to the New Mexico Pregnancy Risk Assessment Monitoring System 2000 to 2003; 1,597 women in final excessive versus adequate gestational weight gain analyses and 1,351 in final inadequate versus adequate gestational weight gain analyses. Information from birth certificates and Pregnancy Risk Assessment Monitoring System questionnaires were use in logistic regression analyses to identify risk factors and associated events. Prevalence of excessive gestational weight gain was 35.7%, while inadequate gestational weight gain was 30.4%. Among factors associated with increased risk of excessive gestational weight gain were overweight (odds ratio [OR]=2.87, 95% confidence interval [CI]=2.11, 3.90) or obese status (OR=1.82, 95% CI=1.38, 2.39), whereas residing in a U.S.-Mexico border county reduced such risk (OR=0.75, 95% CI=0.59, 0.97). Among risk factors for inadequate gestational weight gain were gestational diabetes (OR=1.58, 95% CI=1.05, 2.37) and inadequate prenatal care (OR=2.17, 95% CI=1.56, 3.02). After adjusting for confounders, inadequate gestational weight gain increased risk of low birth weight (OR=l.92, 95% CI=1.11, 3.29), while excessive gestational weight gain reduced this risk (OR=0.29, 95% CI=0.12, 0.68) but increased risk of macrosomia (OR=2.07, 95% CI=1.32, 3.25). Prepregnant overweight and obese status were among factors associated with excessive gestational weight gain among Hispanic women, whereas inadequate prenatal care was among factors associated with increased risk of inadequate gestational weight gain.
    Journal of Obstetric Gynecologic & Neonatal Nursing 01/2009; 38(4):418-29. · 1.03 Impact Factor
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    ABSTRACT: Various populations experience health disparities related to risk factors such as gender, race or ethnicity, educational level, income level, and geographic location. These populations often experience barriers to access and utilization of services, which can lead to adverse health outcomes. Health promotion interventions developed within the context of communities represent resources that may offer protection to these populations. The purpose of this article is to describe the evolution of a conceptual model for the study of health disparities. The model, based on a review of literature, was developed to guide 19 pilot studies funded by the Texas-New Mexico P20 Southwest Partnership Center for Nursing Research on Health Disparities. Reflection on these studies, their respective methodologies, and findings resulted in a revised model to guide further studies of communities experiencing health disparities.
    Nursing outlook 01/2009; 57(3):132-42. · 1.54 Impact Factor
  • Leslie K Robbins, Mary M Hoke
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    ABSTRACT: This study aims to describe the use of modified objective structured clinical examinations (OSCEs) developed to address the identified educational need for formative advanced practice psychiatric mental health (PMH) student assessments and focused learning experiences within a modified nursing distance education program that serves advanced practice nurse PMH students from rural/underserved areas. OSCEs represent a practical solution to the challenges of clinical competency evaluation in psychiatric nursing distance education programs. OSCEs add a supportive evaluation layer to the precepted experience. This increases the availability of PMH nurse practitioner/clinical nurse specialist distance education programs focused on improving advanced PMH nursing services in rural and underserved areas.
    Perspectives In Psychiatric Care 05/2008; 44(2):81-8. · 1.04 Impact Factor
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    ABSTRACT: The limited supply of BSN nurses hinders efforts to increase patient care quality and address health disparities. In largely rural and economically disadvantaged areas, associate degree prepared nurses provide the majority of nursing services. To address a statewide need, a BSN Program and 3 ADN Programs formed a partnership to take BSN education to rural and medically underserved areas. This article describes the program planning, implementation, and evaluation using an adapted assessment framework with partnership principles as its foundation. Interactive television, internet education components, local clinical experiences, and distant nursing faculty liaisons were used. The nursing course sequence was completed by 101 of 102 students. Hall's Professionalism Scale, the California Critical Thinking Disposition Inventory, and the California Critical Thinking Skills Test measured the increases found in professional socialization and critical thinking. Use of the adapted theoretical framework represented a strategic approach to developing a distance delivered nursing education program.
    International Journal of Nursing Education Scholarship 02/2007; 4:Article25.
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    ABSTRACT: The concept of positive deviance (PD), which highlights uncommon practices that reduce risk in low-resource communities, has been effective in community mobilization and programming to improve health outcomes. We present a protocol for extending the concept to analysis of existing public health data. The protocol includes assessing whether PD fits the situation, identifying positive deviants, and identifying behaviors associated with positive deviants' healthy outcomes. Analyzing existing datasets from a PD perspective may aid public health nurses in efforts to reduce health disparities. The effectiveness of our protocol will be clarified in future research.
    Public Health Nursing 01/2007; 24(6):571-6. · 0.78 Impact Factor
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    ABSTRACT: Objective: A support model consisting of a local health educators' network, a technical assistance team with academic and practice experts, and an evolving sequence of professional continuing education activities supported health educators transitioning from community or school health education sites to health care sites as part of the Clinic Health Education and Life Style Promotion Project (Clinic HELP) designed to increase health education options for individuals within the Paso del Norte Region of the United States-Mexico Border. Methods: Focus groups, interviews and surveys were used to evaluate intervention activities designed to assist in the transition. Results/Conclusions: Lack of familiarity with health care settings and role delineation were identified as barriers while "expert" sounding boards, professional development activities, and advanced education assisted in the transition. Use of the professional network was less than anticipated. Practice Implications: Based on the Clinic HELP experience, recommendations are provided for professional education and support for health educators within clinical practice settings.
    01/2007;
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    ABSTRACT: The Clinic Health Education and Lifestyle Promotion (Clinic HELP) Initiative, funded by the Paso del Norte Health Foundation, was designed to extend health education services to medically indigent residents along the US-Mexico border. This paper reports finding of an evaluation that examined the integration of health education into community clinics, and the quantity and quality of health education services delivered. We found that start-up funding, appropriate training, guidance from technical experts, clearly communicated expectations, and having a strong program champion combined with health educator/health agency "fit" can facilitate the integration process.
    01/2007;
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    ABSTRACT: This exploratory qualitative descriptive study describes the explanatory models (EMs) of rural Mexican American women regarding how eating behavior relates to weight and health based on interviews with a community-based sample of 15 overweight Mexican American women from a rural area of a southwestern state. Physical activity, limiting food intake, and use of diet pills were past and current practices identified. As a consequence of healthy eating, an improvement in self-esteem was the predominant theme identified. Having more energy, weight loss, and improved health were also noted. When asked how eating behaviors affect health, the participants identified increased risk for specific diseases such as diabetes, high blood pressure, and heart disease. Participants identified multiple barriers to healthy eating: (1) stress; (2) lack of self-control; (3) effort; (4) control by others now and in the past; (5) social influences; and (6) cultural influences. Spanish Este estudio descriptivo, cualitativo y exploratorio describe los modelos explicativos (EMs) de mujeres Mexico-Americanas rurales con respecto a cómo la conducta de comer relaciona el peso y la salud basada en entrevistas con una comunidad basada de 15 mujeres Mexico-Americanas y de peso excesivo de un área rural de un estado del sudoeste. La actividad física, limitando alimento, y el uso de píldoras de dieta fueron y las prácticas pasadas y corrientes identificadas. Como resultado de comer sano, una mejora en el auto estima era el tema predominante identificado. Teniendo más energía, la pérdida de peso, y la salud mejorada se notó también. Cuándo preguntadas cómo la conducta de alimentacion afectan la salud, las participantes identificaron el riesgo aumentado para enfermedades específicas como el diabetes, la hipertensión, y la enfermedad cardíaca. Las participantes identificaron múltiples barreras a comer sano: (1) énfasis; (2) la falta de auto control; (3) esfuerzo; (4) controle por otros ahora y en el pasado; (5) influencias socials; y (6) influencias culturales.
    Hispanic Health Care International 08/2006; 4(3):143-151.
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    Mary M Hoke, Leslie K Robbins
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    ABSTRACT: Active, cooperative learning is a method to teach the critical thinking skills necessary for the transfer and use of classroom-acquired knowledge in the clinical setting. Yet many nursing educators continue to use teacher-centered educational approaches while identifying an array of barriers for the voiced preference for student-centered education. Using holistic, active cooperative learning strategies (faculty role modeling, student interactive and group learning, and group testing) within a didactic class, the authors found differences in the average clinical grade (87.03) when compared to the average clinical grade for students who had been taught using a lecture approach (84.19).
    Journal of Holistic Nursing 10/2005; 23(3):348-55.
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    ABSTRACT: The authors share lessons learned from 5 community-based research studies involving rural Mexican-American women. The 10 lessons revolved around compensation, confidentiality, recruitment, crossing paths, mailings, locating people, participation/attendance, translation, children, and closure. Despite their clinical knowledge and previous experiences in service with this population, researchers found recruiting and retaining participants and data collection far more challenging than expected. This article is significant as it illustrates the extensive time, expense, and effort required to conduct research with a rural population experiencing health disparities. Recommendations are provided to assist in planning and designing community-based and culturally sensitive research that has realistic time and budget allowances.
    Nursing Outlook 05/2005; 53(3):141-6. · 2.36 Impact Factor
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    ABSTRACT: With the advent of the digital information age, schools of nursing are developing and using web-based programs, courses, and course materials to meet students' needs for access and high-quality learning experiences. In an attempt to maximize scant resources, including faculty, many schools are seeking grant funding, joining consortia, or forming partnerships that require sharing of web-based course materials. Entering such collaborative arrangements usually requires licensing agreements to transfer intellectual capital. This article explains licensing and the related concepts of intellectual property, copyright, and technology transfer. It also identifies the advantages and disadvantages of licensing and describes a licensing process.
    Journal of Professional Nursing 01/2005; 21(5):276-82. · 0.68 Impact Factor
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    ABSTRACT: Funding from a local conversion foundation was used to develop an initiative to extend health education services to medically indigent residents along the U.S.-Mexican border. The initiative included the direct funding of 10 clinic sites, the development of a technical assistance team, and the establishment of a health education network. Strengths, weaknesses, and lessons learned are discussed. Recommendations for collaboration between private funding agencies, universities, and practice sites include: developing a support system for health educators, providing ongoing training, and helping health educators develop measurable goals and objectives.
    Health Promotion Practice 01/2002; 3(4):477-484. · 0.55 Impact Factor