Marylyn M McEwen

Interests

Research

Health disparities/health equity in US-MX border region; diabetes Self-Management in Mexican American families; the influence of undocumentedness, migration on health; health-illness transitions

Teaching

Substantive: Health Equities; Methods: Qualitative Design and Mixed Methods; Community/Public Health Nursing

Courses

Scholarly Contributions

Journals/Publications

• Hilfinger Messias, D. K., McEwen, M. M., & Boyle, J. S. (2015). Undocumented migration in the United States: an overview of historical and current policy contexts. Nursing outlook, 63(1), 60-7. doi:https://doi.org/10.1016/j.outlook.2014.11.004
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  The aims of this overview are to provide a brief historical review of federal, state, and local immigration policies and to examine the historical origin and current constructions of the undocumented immigrant. We discuss how past and current policies promote, regulate, restrict, and deter immigration into the United States and access to health services and draw implications for the profession of nursing.
• Hilfinger Messias, D. K., McEwen, M. M., & Clark, L. (2019). The impact and implications of undocumented immigration on individual and collective health in the United States. Nursing outlook, 63(1), 86-94.
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  A nation of immigrants, the United States currently has more foreign-born residents than any other country; approximately 28% of these foreign-born residents are undocumented immigrants--individuals who either entered or are currently residing in the country without valid immigration or residency documents. The complex and constantly changing social, political, and economic context of undocumented migration has profound effects on individuals, families, and communities. The lack of demographic and epidemiologic data on undocumented immigrants is a major public health challenge. In this article, we identify multiple dimensions of vulnerability among undocumented persons; examine how undocumentedness impacts health and health care access and utilization; and consider the professional, practice, and policy issues and implications for nurses.
• Hooker, S. P., McEwen, M. M., Hingle, M. D., Humphrey, K., Bell, M. L., Valdez, L. A., & Garcia, D. O. (2017). A Gender- and Culturally-Sensitive Weight Loss Intervention for Hispanic Males: The ANIMO Randomized Controlled Trial Study Protocol and Recruitment Methods. Contemporary Clinical Trials Communications.
• McEwen, M. M., & Garcia, D. (2018). "A Gender- and Culturally-Sensitive Weight Loss Intervention for Hispanic Men: Results from The ANIMO Pilot Randomized Controlled Trial". Health Education and Behavior. doi:https://doi.org/10.1177/1090198119853011
• McEwen, M. M., Baird, M., Pasvogel, A., & Gallegos, G. (2019). Health-illness transition experiences among Mexican immigrant women with diabetes. Family & community health, 30(3), 201-12.
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  Multiple and complex health-illness transitions are required for successful diabetes self-management. Diabetes health-illness transitions influence the daily lives and interactions of Mexican immigrant women with diabetes. This article reports the findings from an intervention study designed to facilitate the health-illness transition in Mexican immigrant women with type 2 diabetes who reside in the Arizona-Sonora region of the US-Mexico border. There was a significant (P
• McEwen, M. M., Boyle, J. S., & Hilfinger Messias, D. K. (2019). Undocumentedness and public policy: the impact on communities, individuals, and families along the Arizona/Sonora border. Nursing outlook, 63(1), 77-85.
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  The focus of this article is the health impact and implications of undocumentedness along the U.S.-Mexico border, particularly the Arizona/Sonora region. We describe the direct and indirect influences of immigration policies on the health of individuals, families, and communities. The Arizona border region maintains close social, cultural, and linguistic ties to Mexico, and the amplified efforts to secure the border have been dramatic on the region and on the people who live there. The 261-mile stretch across the Arizona-Sonora Desert is the most deadly corridor for immigrants crossing into the United States because they are at risk of being killed, kidnapped, and coerced into smuggling drugs or dying in the desert. Gang-related violence is pushing more Central Americans, including unaccompanied minors, to the United States. The impact on individual migrants and their families has been devastating. We examine the health implications of policy and applaud the actions of the Arizona Nurses Association and the American Academy of Nursing to address the health needs of border communities.
• McEwen, M. M., Breathett, K., Crist, J. D., & Pool, N. (2019). Does race influence decision making for advanced heart failure therapies?. Journal of the American Heart Association, 8(22). doi:https://doi.org/10.1161/JAHA.119.013592
• McEwen, M. M., González-Salazar, F., Pasvogel, A., Elizondo-Pereo, R., Meester, I., & Vargas-Villarreal, J. (2019). Diabetes self-management behaviors, health care access and health perception in Mexico-U.S. border states. Diabetes Educator, 45(2). doi:DOI: 10.1177/0145721719828952
• McEwen, M. M., Lin, P. C., & Pasvogel, A. (2019). Analysis of behavior risk factor surveillance system data to assess the health of Hispanics with diabetes in US-Mexico border communities. The Diabetes educator, 39(6), 742-51.
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  The purpose of this study is to describe and compare personal characteristics, health care access and utilization, and self-management behaviors of Hispanic American adults diagnosed with diabetes who reside in 3 US-Mexico border counties in Arizona, New Mexico, and Texas. This study also examines the status of this population in attaining Healthy People (HP) 2020 diabetes target goals.
• McEwen, M. M., Murdaugh, C., & Pasvogel, A. (2019). Effects of a Family-based Diabetes Intervention on Family Social Capital Outcomes for Mexican American Adults.. Diabetes Educator, 45(3), 272-286. doi:DOI: 10.1177/0145721719837899
• McEwen, M. M., Nguyen, A. P., & Loescher, L. J. (2019). Systematic Review: Perceived Risk of Developing Diabetes in the General Population and Asian Americans.. Journal of Transcultural Nursing., 1-14. doi:https://doi.org/10.1177/1043659619876685.
• McEwen, M. M., Pasvogel, A., Gallegos, G., & Barrera, L. (2019). Type 2 diabetes self-management social support intervention at the U.S.-Mexico border. Public health nursing (Boston, Mass.), 27(4), 310-9.
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  To pilot test the efficacy of a culturally tailored diabetes self-management social support intervention for Mexican American adults with Type 2 diabetes (T2DM) living in the U.S.-Mexico border region and to test the feasibility of recruiting and training promotoras to participate in intervention delivery.
• Rentfro, A. R., McEwen, M., & Ritter, L. (2010). Perspectives for practice: translating estimated average glucose (eAG) to promote diabetes self-management capacity. The Diabetes educator, 35(4), 581, 585-6, 588-90 passim.
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  The purpose of this article is to facilitate translation of the Consensus Statement to practice for diabetes educators and other professionals who contribute to the care of individuals with diabetes.
• Vincent, D., McEwen, M. M., & Pasvogel, A. (2019). The validity and reliability of a Spanish version of the summary of diabetes self-care activities questionnaire. Nursing research, 57(2), 101-6.
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  Translation of data collection instruments, paying careful attention to equivalency between the source and the target language, is important to obtain valid data collection instruments.
• Vincent, D., McEwen, M. M., Hepworth, J. T., & Stump, C. S. (2019). Challenges and success of recruiting and retention for a culturally tailored diabetes prevention program for adults of Mexican descent. The Diabetes educator, 39(2), 222-30.
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  The purpose of this article is to describe methods used to recruit and retain high-risk, Spanish-speaking adults of Mexican origin in a randomized clinical trial that adapts Diabetes Prevention Program (DPP) content into a community-based, culturally tailored intervention.
• Vincent, D., McEwen, M. M., Hepworth, J. T., & Stump, C. S. (2019). The effects of a community-based, culturally tailored diabetes prevention intervention for high-risk adults of Mexican descent. The Diabetes educator, 40(2), 202-13.
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  This article reports the results of a community-based, culturally tailored diabetes prevention program for overweight Mexican American adults on weight loss, waist circumference, diet and physical activity self-efficacy, and diet behaviors.
• Bowles, J. R., McEwen, M. M., & Rosenfeld, A. G. (2018). Acute Myocardial Infarction Experience Among Mexican American Women. Hispanic health care international : the official journal of the National Association of Hispanic Nurses, 16(2), 62-69.
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  Health disparities in cardiovascular disease risk factors affect a burgeoning segment of the U.S. population-Mexican American (MA) women. MAs experience disparities in the prevalence of heart disease risk factors. However, there are no studies describing acute myocardial infarction (AMI) symptoms unique to this Hispanic subgroup. The aim of the study was to describe MA women's AMI symptom experience.
• Breathett, K., Allen, L. A., Helmkamp, L., Colborn, K., Daugherty, S. L., Blair, I. V., Jones, J., Khazanie, P., Mazimba, S., McEwen, M., Stone, J., Calhoun, E., Sweitzer, N. K., & Peterson, P. N. (2018). Temporal Trends in Contemporary Use of Ventricular Assist Devices by Race and Ethnicity. Circulation. Heart failure, 11(8), e005008.
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  The proportion of racial/ethnic minorities receiving ventricular assist devices (VADs) has previously been less than expected. It is unclear if trends have changed since the broadening of access to insurance in 2014 and the rapid adoption of VAD technology.
• Breathett, K., Jones, J., Lum, H. D., Koonkongsatian, D., Jones, C. D., Sanghvi, U., Hoffecker, L., McEwen, M., Daugherty, S. L., Blair, I. V., Calhoun, E., de Groot, E., Sweitzer, N. K., & Peterson, P. N. (2018). Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: a Qualitative Meta-Synthesis. Journal of racial and ethnic health disparities, 5(6), 1215-1229.
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  Clinical decision-making may have a role in racial and ethnic disparities in healthcare but has not been evaluated systematically. The purpose of this study was to synthesize qualitative studies that explore various aspects of how a patient's African-American race or Hispanic ethnicity may factor into physician clinical decision-making. Using Ovid MEDLINE, Embase, and Cochrane Library, we identified 13 manuscripts that met inclusion criteria of usage of qualitative methods; addressed US physician clinical decision-making factors when caring for African-American, Hispanic, or Caucasian patients; and published between 2000 and 2017. We derived six fundamental themes that detail the role of patient race and ethnicity on physician decision-making, including importance of race, patient-level issues, system-level issues, bias and racism, patient values, and communication. In conclusion, a non-hierarchical system of intertwining themes influenced clinical decision-making among racial and ethnic minority patients. Future study should systematically intervene upon each theme in order to promote equitable clinical decision-making among diverse racial/ethnic patients.
• Garcia, D. O., Valdez, L. A., Bell, M. L., Humphrey, K., Hingle, M., McEwen, M., & Hooker, S. P. (2018). A gender- and culturally-sensitive weight loss intervention for Hispanic males: The ANIMO randomized controlled trial pilot study protocol and recruitment methods. Contemporary clinical trials communications, 9, 151-163.
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  Hispanic men have the highest rates of overweight and obesity when compared to men of other racial/ethnic groups, placing them at increased risk for obesity-related disease. Yet, Hispanic men are grossly underrepresented in weight loss research. Tailored intervention strategies to improve obesity treatment programs for this vulnerable racial/ethnic subgroup are needed. This manuscript describes recruitment strategies, methodology, and participant characteristics of the ANIMO study, a 24-week randomized controlled pilot trial testing the effects of a gender- and culturally-sensitive weight loss intervention (GCSWLI) on body weight in Hispanic men compared to a wait-list control condition. The ANIMO study included two phases. The first phase was a 12-week GCSWLI. Participants attended weekly in-person individual sessions guided by a trained bilingual Hispanic male lifestyle coach, were prescribed a daily reduced calorie goal, and 225 min of moderate-intensity physical activity per week. In the second phase, GCSWLI participants received bi-weekly phone calls across a 12-week follow-up. Wait-list control (WLC) participants from phase 1 received the GCSWLI plus mobile health technology support. Recruitment strategies included face-to-face efforts at a swap meet (outdoor marketplace), family/friend referrals, printed advertisements and social media. Recruitment, screening, and participant enrollment occurred over three months. Overall, 143 men expressed interest in participation. Of these, 115 were screened and 78% (n = 90) were eligible to participate; 45% of enrolled participants (n = 52) completed baseline assessments and 43% (n = 50) were randomized (mean age of 43.3 ± 11.4 years; BMI: 34.1 ± 5.3 kg/m; 58% Spanish monolingual). Parameter estimates from ANIMO will support future adequately powered trials for this health disparate population.
• Hooker, S. P., McEwen, M. M., Hingle, M. D., Humphrey, K., Bell, M. L., Valdez, L. A., & Garcia, D. O. (2018). A Gender- and Culturally-Sensitive Weight Loss Intervention for Hispanic Males: The ANIMO Randomized Controlled Trial Study Protocol and Recruitment Methods. Contemporary Clinical Trials Communications.
• Mcewen, M. M., Bowles, J., & Rosenfeld, A. G. (2016). The acute myocardial symptom experience of Mexican American women with coronary heart disease in the U.S.-Mexico border region.. Journal of Cardiovascular Nursing.
• Kindarara, D. M., McEwen, M. M., Crist, J. D., & Loescher, L. J. (2017). Health-Illness Transition Experiences With Type 2 Diabetes Self-management of Sub-Saharan African Immigrants in the United States. The Diabetes educator, 43(5), 506-518.
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  Purpose The purpose of this study was to describe Sub-Saharan African immigrants' health-illness transition experiences associated with type 2 diabetes mellitus (T2DM) self-management. Methods A qualitative description methodology was used in this study. Face-to-face semi-structured in-depth interviews lasting 60 to 90 minutes were conducted with 10 Sub-Saharan African immigrant men and women with T2DM recruited using purposive and snowball sampling. Each interview was audio-taped, transcribed, and analyzed using qualitative content analysis. Results Participants' mean age was 60.3 years (range, 44-76 years), 5 men and 5 women; most had lived in the US for more than 10 years (70%) and with T2DM for more than 5 years (60%). Four overarching domains described the health-illness transition experiences the participants had with T2DM self-management: (1) knowledge of T2DM self-management behaviors, (2) current T2DM self-management behaviors, (3) inhibitors of T2DM self-management, and (4) facilitators of T2DM self-management. Conclusions Health professionals should be equipped with an understanding of the properties and conditions of health-illness transition. This understanding is necessary to build a foundation that facilitates healthy adaptation to the T2DM transition requiring the development and mastery of new skills consistent with gaining control of T2DM. Culturally tailored interventions need to be developed to decrease inhibitors of and encourage self-management in daily T2DM care for Sub-Saharan African immigrants with T2DM.
• McEwen, M. M., Elizondo-Pereo, R. A., Pasvogel, A. E., Meester, I., Vargas-Villarreal, J., & González-Salazar, F. (2017). A Modified Behavior Risk Factor Surveillance System to Assess Diabetes Self-management Behaviors and Diabetes Care in Monterrey Mexico: A Cross-sectional Study. Frontiers in public health, 5, 97.
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  Type 2 diabetes mellitus (T2DM) is one of the leading causes of death from worldwide non-communicable diseases. The prevalence of diabetes in the Mexico (MX)-United States border states exceeds the national rate in both countries. The economic burden of diabetes, due to decreased productivity, disability, and medical costs, is staggering and increases significantly when T2DM-related complications occur. The purpose of this study was to use a modified behavioral risk factor surveillance system (BRFSS) to describe the T2DM self-management behaviors, diabetes care, and health perception of a convenience sample of adults with T2DM in Monterrey, MX. This cross-sectional study design, with convenience sampling, was conducted with a convenience sample ( = 351) of adults in the metropolitan area of Monterrey, MX who self-reported a diagnosis of T2DM. Potential participants were recruited from local supermarkets. Twenty-six diabetes and health-related items were selected from the BRFSS and administered in face-to-face interviews by trained data collectors. Data analysis was conducted using descriptive statistics. The mean age was 47 years, and the mean length of time with T2DM was 12 years. The majority was taking oral medication and 34% required insulin. Daily self-monitoring of feet was performed by 56% of the participants; however, only 8.8% engaged in blood glucose self-monitoring. The mean number of health-care provider visits was 9.09 per year, and glycated hemoglobin level (HbA1c) was assessed 2.6 times per year. Finally, only 40.5% of the participants recalled having a dilated eye exam. We conclude the modified BRFSS survey administered in a face-to-face interview format is an appropriate tool for assessing engagement in T2DM self-management behaviors, diabetes care, and health perception. Extension of the use of this survey in a more rigorous design with a larger scale survey is encouraged.
• McEwen, M. M., Pasvogel, A., Murdaugh, C., & Hepworth, J. (2017). Effects of a Family-based Diabetes Intervention on Behavioral and Biological Outcomes for Mexican American Adults. The Diabetes educator, 43(3), 272-285.
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  Purpose The purpose of the study was to investigate the effects of a family-based self-management support intervention for adults with type 2 diabetes (T2DM). Methods Using a 2-group, experimental repeated measures design, 157 dyads (participant with T2DM and family member) were randomly assigned to an intervention (education, social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated measures ANOVAs were used to test the hypotheses with interaction contrasts to assess immediate and sustained intervention effects. Results Significant changes over time were reported in diet self-management, exercise self-management, total self-management, diabetes self-efficacy for general health and total diabetes self-efficacy, physician distress, regimen distress, interpersonal distress, and total distress. There were likewise sustained effects for diet self-management, total self-management, diabetes self-efficacy for general health, total self-efficacy, physician distress, regimen distress, and interpersonal distress. Conclusions Results support and extend prior research documenting the value of culturally relevant family-based interventions to improve diabetes self-management and substantiate the need for intensive, longer, tailored interventions to achieve glycemic control.
• Mcewen, M. M., Gonzalez-Salazar, F., Vargas-Villarreal, J., Pasvogel, A., Elizondo-Pereo, R., & Meester, I. (2016). Feasibility of Using the Behavior Risk Factor Surveillance System (BRFSS) Survey in a Face-to-Face Interview During Assessment of Diabetes Self-Management in Monterrey, Mexico. Frontiers in Public Health.
• Mcewen, M. M., Pasvogel, A., Murdaugh, C., & Hepworth, J. (2016). Effects of a family-based diabetes intervention on behavioral and biological outcomes for Mexican American Adults. Diabetes Educator.
• Mcewen, M. M., Murdaugh, C., & Pasvogel, A. (2016). Family efficacy for diabetes management: Psychometric testing.. Diabetes Educator, 24(1), 32-43. doi:10.1891/1061-3749.24.1.E32
• Mcewen, M. M., Pasvogel, A., & Murdaugh, C. L. (2016). Family Self-Efficacy for Diabetes Management: Psychometric Testing. Journal of nursing measurement, 24(1), E32-43.
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  Type 2 diabetes mellitus (T2DM) self-management among Hispanic adults occurs in a family context. Self-efficacy (SE) affects T2DM self-management behaviors; however, no instruments are available to measure family diabetes self-efficacy. The study's purpose was to test the psychometric properties of the Family Self-Efficacy for Diabetes Scale (FSE).
• McEwen, M. M., & Murdaugh, C. (2014). Partnering With Families to Refine and Expand a Diabetes Intervention for Mexican Americans. The Diabetes educator, 40(4), 488-495.
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  The purpose of this study was to refine and expand a culturally tailored individual-level diabetes self-management intervention to a family-level intervention.
• McEwen, M. M., Lin, P., & Pasvogel, A. (2013). Analysis of Behavior Risk Factor Surveillance System Data to Assess the Health of Hispanics With Diabetes in US-Mexico Border Communities. Diabetes Educator, 39(6), 742-751.
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  PMID: 24045333;Abstract: Purpose: The purpose of this study is to describe and compare personal characteristics, health care access and utilization, and self-management behaviors of Hispanic American adults diagnosed with diabetes who reside in 3 US-Mexico border counties in Arizona, New Mexico, and Texas. This study also examines the status of this population in attaining Healthy People (HP) 2020 diabetes target goals. Methods: Data were extracted from the 2005-2009 Selected Metropolitan/Micropolitan Area Risk Trends (SMART): Behavioral Risk Factor Surveillance System (BRFSS) to analyze behavioral and health system factors associated with diabetes management among Hispanic American adults who reside in the border counties (N = 600). Data were analyzed using descriptive statistics and compared using chi-square and one-way analysis of variance. Results: There were significant differences in health care access and utilization and in 1 self-management behavior (daily feet checks) across the counties. The majority of participants (83.4%) had a care provider, however the HP 2020 diabetes target goals for A1C monitoring or foot exams conducted by a care provider were not met. Participants in all counties met the target goal for dilated eye exams. Conclusions: Improvement of diabetes management among this population should focus on border health system barriers to attaining HP 2020 diabetes target goals. © 2013 The Author(s).
• Slack, M. K., & McEwen, M. M. (2013). Perceived impact of an interprofessional education program on community resilience: an exploratory study. Journal of interprofessional care, 27(5), 408-12.
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  The purpose of this study was to explore the perceived impact of an interprofessional education (IPE) program for health sciences students on two culturally diverse, underserved communities. A community resilience/capacity framework, consisting of catalysts (primarily the creation of awareness) and capital components: human (workforce development), social (networking and empowerment) and economic (volunteer labor and money spent by the program), provided the conceptual underpinnings for the study. Focus groups with stakeholders in two communities, one rural and one metropolitan, were audio-recorded, transcribed and analyzed by categorizing data according to each capital component. In addition to the concepts contained in the capacity framework a new category, informational capital (data specific to the community) emerged during the analysis. We suggest that by acting as a catalyst a community based interprofessional program can affect components of community resilience/capacity, primarily human, social, and informational capital. Using the community resilience/capacity framework facilitated exploration of the perceived impact of an educational program on one rural and one urban underserved community beyond assessing student outcomes or number of clients served.
• Hartweg, D., Isabelli-García, C., McEwen, M., & Piper, R. (2012). Being physically active: Perceptions of recent mexican immigrant women on the Arizona-Mexico border. Hispanic Health Care International, 10(3), 127-136.
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  Abstract: Mexican immigrant women report being physically active prior to arrival in the United States. However, with increased years of U.S. residency, this positive lifestyle behavior diminishes, increasing their risk of obesity and chronic disease. A qualitative descriptive design was used to elicit recent Mexican immigrant women's perceptions of "being physically active" and to describe how living in the United States has influenced their perceptions of being physically active. Three themes were inductively generated: (a) purposeful exercising, (b) being active, and (c) being active with purposeful exercising. Overall, being physically active was described within the context of daily living well below the recommended levels of intensity, duration, and frequency. These findings can be used to inform multilevel interventions delivered early in the immigration process to prevent sedentary behaviors. © 2012 Springer Publishing Company.
• DeLuca, L. A., McEwen, M. M., & Keim, S. M. (2010). United States-Mexico border crossing: experiences and risk perceptions of undocumented male immigrants. Journal of immigrant and minority health, 12(1), 113-23.
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  Undocumented immigrants crossing the US-Mexico border face many hazards as they attempt to enter the United States, including heat and cold injury, dehydration, and wild animal encounters. In the Tucson sector of the US-Mexico border, there are over 100 deaths a year from heat-related injuries alone. Public awareness campaigns have been undertaken to disseminate information on the dangers inherent in crossing. Little is known, however, about the ways in which undocumented immigrants actually receive information regarding the risks of crossing the border, how such information impacts their preparation for crossing or how the journey itself effects their motivation to cross again in the future. A qualitative descriptive method was used to describe and analyze information from adult males who had attempted to illegally cross the US-Mexico Border and had recently been returned to Mexico. Semi-structured interviews were conducted, and responses were classified into several broad themes. Interviews were conducted and analyzed iteratively until thematic saturation was achieved. The responses validated the established risks as being commonplace. A total of eight (8) male undocumented immigrants participated in the interviews. Individuals sought information prior to crossing from the media, their families and friends, and acquaintances in border towns. They did not appear to value any particular information source over any other. New areas of risk were identified, such as traveling with others who might have new or existing medical problems. There was also substantial concern for the family unit as both a source of inspiration and motivation. The family emerged as an additional at-risk unit due to the destabilization and financial strain of having one of its members leave to attempt to immigrate to the US for work. While many planned to cross again, the majority of the men in our sample had no intention of seeking permanent residence in the US, instead planning to work and then return to their families in Mexico. This preliminary study found that individuals crossing the US-Mexico border appear willing to put themselves and their families at substantial perceived risk in order to seek economic opportunity. Future public awareness campaigns may choose to shift focus solely from the individual risk of the crossing to the additional risks to family and community.
• McEwen, M. M., Pasvogel, A., Gallegos, G., & Barrera, L. (2010). Type 2 diabetes self-management social support intervention at the U.S.-Mexico border. Public Health Nursing, 27(4), 310-319.
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  PMID: 20626831;PMCID: PMC2917267;Abstract: Objectives: To pilot test the efficacy of a culturally tailored diabetes self-management social support intervention for Mexican American adults with Type 2 diabetes (T2DM) living in the U.S.-Mexico border region and to test the feasibility of recruiting and training promotoras to participate in intervention delivery. Design and Sample: This study used a single-group pretest and posttest design. The convenience sample consisted of 21 Mexican American adults with T2DM. The setting for the study was a community in the Arizona-Sonora, Mexico border region. Interventions: A bilingual, bicultural certified diabetes educator (CDE) and a nurse researcher developed the intervention to improve T2DM self-management activities for Mexican Americans. Data were collected using self-report questionnaires, glycosolated hemoglobin (HbA1c), and anthropometric measures. Results: Intervention efficacy was demonstrated by an increase in participants' diabetes self-management activities and diabetes knowledge and a decrease in diabetes-related distress and sedentary behaviors. There were no significant changes in physiologic outcomes. Feasibility of recruitment and training of 2 promotoras who participated in intervention delivery was established. Conclusions: Promotoras, in collaboration with a CDE, successfully delivered a culturally tailored diabetes self-management social support intervention for Mexican American adults with T2DM. This intervention positively affected diabetes self-management behaviors. © 2010 Wiley Periodicals, Inc.
• Crist, J. D., McEwen, M. M., Herrera, A. P., Kim, S. S., Pasvogel, A., & Hepworth, J. T. (2009). Caregiving burden, acculturation, familism, and Mexican American elders' use of home care services. Research and theory for nursing practice, 23(3), 165-80.
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  Caregiving burden has been shown to predict use of home care services among Anglo Americans. In a previous study, only one of two dimensions of caregiving burden predicted such use among Mexican American caregivers. Because acculturation and familism may affect burden, we conducted analyses to test three hypotheses: increased acculturation decreases familism; decreased familism increases burden; and increased burden increases use of home care services. Among 140 Mexican American family caregivers, acculturation was positively correlated with familism; familism was not significantly correlated with burden; objective burden was positively correlated with use of home care services, and objective and subjective burden significantly interacted in their effect on the use of home care services. Targeted interventions may be needed to increase use of home care services and preserve the well-being of Mexican American elders and caregivers.
• McEwen, M. M., Rentfro, A., & Vincent, D. (2009). Diabetes care in the U.S.-Mexico border region. The Nurse practitioner, 34(3), 14-21.
• Michaels, C., McEwen, M. M., & McArthur, D. B. (2008). Saying "no" to professional recommendations: client values, beliefs, and evidence-based practice. Journal of the American Academy of Nurse Practitioners, 20(12), 585-9.
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  The purpose of this article is to explore the phenomenon of saying "no" to secondary prevention recommended by healthcare providers.
• McEwen, M. M., & Boyle, J. (2007). Resistance, health, and latent tuberculosis infection: Mexican immigrants at the U.S.-Mexico border. Research and theory for nursing practice, 21(3), 185-97.
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  Mexican immigrants living in the U.S.-Mexico border region are confronted with different national explanations about latent tuberculosis infection (LTBI) and preventive treatment. The purpose of this study was to explore how a group of Mexican immigrant women (N = 8) at risk of LTBI treatment failure interpreted and ultimately resisted LTBI preventive treatment. A critical ethnographic methodology, grounded in asymmetrical power relations that are historically embedded within the U.S.-Mexico border culture, was used to examine the encounters between the participants and the health care provider. The study findings are discussed from the perspective of women who experienced oppression and resistance in the U.S.-Mexico border region, providing an account of how Mexican immigrant women become entangled in U.S.-Mexico TB health policies and through resistance manage to assert control over health care choices. In the context of the U.S.-Mexico border region, health care professionals must be skilled at minimizing asymmetrical power relations and use methods that elicit immigrant voices in reconciling differences in health beliefs and practices.
• McEwen, M. M., Baird, M., Pasvogel, A., & Gallegos, G. (2007). Healthg-illness transition experiences among mexican immigrant women with diabetes. Family and Community Health, 30(3), 201-212.
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  PMID: 17563482;Abstract: Multiple and complex healthĝ€"illness transitions are required for successful diabetes self-management. Diabetes healthĝ€ "illness transitions influence the daily lives and interactions of Mexican immigrant women with diabetes. This article reports the findings from an intervention study designed to facilitate the healthĝ€"illness transition in Mexican immigrant women with type 2 diabetes who reside in the Arizona-Sonora region of the USĝ€"Mexico border. There was a significant (P < 0.001) increase from preintervention to postintervention in diabetes knowledge and diabetes self-efficacy and a significant decrease (P ĝ‰Currency sign 0.001) in psychosocial and health-related behavior problems. Copyright © 2007 Wolters Kluwer Health | Lippincott Williams and Wilkins.
• McEwen, M. M. (2005). Mexican immigrants' explanatory model of latent tuberculosis infection. Journal of Transcultural Nursing, 16(4), 347-355.
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  PMID: 16160197;Abstract: This article reveals how the multiple and disparate explanations of latent tuberculosis infection (LTBI) from the U.S. and Mexico professional health sectors and the popular sector are used to inform the explanatory model (EM) of LTBI for Mexican immigrants residing in the U.S.-Mexico border region. Fourteen immigrants, nine diagnosed with LTBI (n = 9) and their spouses (n = 5) participated in this critical ethnographic study. Because care seeking and treatment decisions are influenced by EMs, the results indicate that it is imperative that interventions for Mexican immigrants with LTBI are built on an understanding of their illness experience and are contextually meaningful. © 2005 Sage Publications.
• McEwen, M. M., & Slack, M. K. (2005). Factors associated with health-related behaviors in Latinos with or at risk of diabetes. Hispanic Healthcare International, 3(3), 143-152.
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  Abstract: The purpose of this study was to describe the types of health problems identified using the Omaha System and the relationship between those health problems for persons of Mexican origin (N = 56) who have or are at risk of diabetes and who reside at the U.S.-Mexico border. Sixty-four percent of the participants were diagnosed with diabetes; the majority (69%) with type 2. Three hundred and seventy-two problems were identified; the mean number of problems per participant was 6.6 (SD = 3.9). The most frequently identified problems were related to: income (71%), social contact (52%), communicating with community resources (50%), and nutrition (50%). Twenty-four significant correlations are reported; findings are discussed within the context of undocumentedness. © 2005 Springer Publishing Company.
• Mcewen, M., & Mcewen, M. M. (2005). Mexican immigrants' explanatory model of latent tuberculosis infection. Journal of transcultural nursing : official journal of the Transcultural Nursing Society / Transcultural Nursing Society, 16(4).
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  This article reveals how the multiple and disparate explanations of latent tuberculosis infection (LTBI) from the U.S. and Mexico professional health sectors and the popular sector are used to inform the explanatory model (EM) of LTBI for Mexican immigrants residing in the U.S.-Mexico border region. Fourteen immigrants, nine diagnosed with LTBI (n = 9) and their spouses (n = 5) participated in this critical ethnographic study. Because care seeking and treatment decisions are influenced by EMs, the results indicate that it is imperative that interventions for Mexican immigrants with LTBI are built on an understanding of their illness experience and are contextually meaningful.
• Slack, M. K., & McEwen, M. M. (1999). The impact of interdisciplinary case management on client outcomes. Family and Community Health, 22(3), 30-48.
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  Abstract: To assess impact, outcome data were analyzed from an interdisciplinary case management program based on the Omaha Systems model. The study population of 54 clients was 98 percent female and 98 percent Hispanic, with 65 percent having not completed high school. Clients averaged seven problems: 43 percent were psychosocial, 23 percent environmental, 19 percent physiological, and 15 percent health-related behaviors. Interventions (12.4/client) were primarily educational (53%) and case management (19%). Effect sizes for impact were moderate to very large (0.4 to 1.5; p ≤ 0.002) for knowledge, behavior, and status outcomes. The results indicate that interdisciplinary case management using the Omaha Systems model can affect significantly outcomes related to specific problems.
• Slack, M. K., & McEwen, M. M. (1997). An Interdisciplinary Problem-Based Practicum in Case Management and Rural Border Health. Family and Community Health, 20(1), 40-53.
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  Abstract: To illustrate the application of problem-based learning in a practicum, this article describes an interdisciplinary problem-based practicum in case management and rural border health. Students from pharmacy, nursing, social work, and public health live and work in a rural community located on the border between the United States and Mexico. They provide case management services to pregnant women. Students conduct home visits with lay health educators, then meet in weekly case management seminars. The seminar and the interdisciplinary database are structured to support the clinical reasoning steps of data gathering, problem synthesis, hypothesis generation, and diagnostic decision making. The problem-based learning approach appears to enhance student learning in a practicum setting.
• Slack, M. K., McEwen, M. M., Carter, J. T., & Bruekner, R. L. (1996). Case management delivery model for pharmacy. American Journal of Health-System Pharmacy, 53(23), 2860-2867.
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  PMID: 8957348;
• Sherman, J. B., Clark, L., & McEwen, M. M. (1989). Evaluation of a worksite wellness program: Impact on exercise, weight, smoking, and stress. Public Health Nursing, 6(3), 114-119.
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  PMID: 2813254;

Proceedings Publications

• McEwen, M. M. (2019, November). HISPANIC FAMILY-CENTERED DIABETES INTERVENTION: RESPONDERS AND NON-RESPONDERS. In American Public Health Association.
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  Paper presentation from secondary analysis of NIH Diabetes study.
• McEwen, M. M., Pasvogel, A., Murdaugh, C., Crane, T., Sikorskii, A., & Hsu, P. (2019, november). Responders and Nonresponders to a Family-Centered Diabetes Intervention for Mexican Americans. In American Public Health Association.
• McEwen, M. M. (2017, March 29-April 1). A Gender- and Culturally-Sensitive Weight Loss Intervention for Hispanic Males. In Annual Meeting and Scientific Sessions of the Society of Behavioral Medicine,.
• McEwen, M. M., & Williams, D. (2016, October). Value of ethnographic methods for gaining refugees LTBI knowledge. In The American Public Health Association, October 31- November 04, 2016..
• McEwen, M. M., Crist, J. D., Rosenfeld, A. G., & Norria, B. (2016, November). Acute Coronary Syndrome and Native American Men: Symptom Experiences and Challenges to Healthcare Access. In American Heart Association Scientific Session 2016.
• McEwen, M. M., Overgaard, P., Lyles, A. A., & Caputo, G. L. (2016, Apr). Stakeholders’ Perceptions of Care Coordination: A Participatory Process. In 49th Annual Communicating Nursing Research Conference.
• McEwen, M. M., Pasvogel, A., Hepworth, J. T., & Murdaugh, C. (2016, November). Effects of a Family Intervention to Promote Health Equity on Behavioral and Biological Outcomes among Mexican Americans with Diabetes.. In American Public Health Association.
• Mcewen, M. M., Hepworth, J. T., Murdaugh, C., & Pasvogel, A. (2016, April). Intervention Effects on Gender in Self-Management in Hispanics with Type 2 Diabetes. In The Western Institute of Nursing 49th Annual Communicating Nursing Research Conference.

Presentations

• McEwen, M. M., & Coats, H. (2017, April 20-22). Community based participatory research with ethnically diverse populations. The Western Institute of Nursing 50th Annual Communicating Nursing Research Conference. Denver, CO: Western Institute of Nursing.
• McEwen, M. M., Menon, U., Szalacha, L. A., & Loescher, L. J. (2016, Fall). Symposium Title: Translational Research: Dissemination and Implementation of Interventions From Research to Practice. 28th International Nursing Research Congress. Dublin, Ireland: Sigma Theta Tau International Conference 2017.
• McEwen, M. M., Pasvogel, A., Murdaugh, C., & Hepworth, J. (2017, July 26-30, 2017). Implementation of a Diabetes Self-Management Intervention for Mexican-American Families in the Arizona-Mexico Border Region. Sigma Theta Tau International Conference. Dublin, Ireland: Sigma Theta Tau International.
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  Symposium on Translation and Dissemination
• Kahn-John, M., McEwen, M. M., & Badger, T. A. (2017, Fall). Measuring Emotional Distress and Inflammation before and after a Diné Ceremony. Navajo Nation Human Research Review Board Research Conference. Window Rock, AZ.
• Crist, J. D., Brice, N., McEwen, M. M., & Rosenfeld, A. G. (2016, spring). Acute coronary syndrome and Native American men: Symptom experiences and challenges to healthcare access. AHA Scientific Sessions 2016/Resusciatation Science Symposium 2016American Heart Association.
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  Co-authored abstract for podium symposium presentation by graduated PhD student.
• McEwen, M. M. (2016, october). Community-based interventions to decrease diabetes health disparities for Mexican American adults with T2DM. UA CON Homecoming Research Panel. UA CON: UA CON Alumni Association.
• McEwen, M. M., Crist, J. D., & Reifsnider, E. (2016, Apr). CONDUCTING RESEARCH WITH LATINO INDIVIDUALS, FAMILIES, AND COMMUNITIES. 49th Annual Communicating Nursing Research Conference. Anaheim, CA: 49th Annual Communicating Nursing Research Conference.
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  Latino/a Research Symposium

Poster Presentations

• McEwen, M. M. (2019, Fall). What about the abuelos? T2DM self-management in caregiving Mexican American grandmothers. Arizona Health Equity Conference. Phoenix, AZ: Equality Health.
• Williams, D. K., & McEwen, M. M. (2017, February). THE MYSTIFYING APPEARANCE OF LATENT TUBERCULOSIS INFECTION. The Union-North America Region 2017 TB Conference. Vancouver, British Columbia: The Union-North America Region.
• Pace, T. W., Pace, T. W., McEwen, M. M., McEwen, M. M., Rosenfeld, A. G., Rosenfeld, A. G., Pace, T. W., McEwen, M. M., Rosenfeld, A. G., Pace, T. W., Rosenfeld, A. G., & McEwen, M. M. (2016, April). Symptom biomarkers in Mexican American women with diabetes & heart disease.. Western Institute of Nursing Communicating Nursing Research Conference. Anaheim CA: Western Institute of Nursing.
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  This was work from our Emmons grant.
• Rosenfeld, A. G., McEwen, M. M., & Hsu, C. (2016, April). Symptom experience of Mexican American women with diabetes & heart disease.. Western Institute of Nursing Communicating Nursing Research Conference. Anaheim CA: Western Institute of Nursing.
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  This was work from our Emmons grant.

Others

• McEwen, M. M., Rosenfeld, A. G., & Pace, T. W. (2016, October). Concept Paper: Innovative, biobehavioral, symptom self-management approach to filling the existing gap in knowledge for Mexican-American women with co-occurring T2DM and IHD.. NIMHD program officers meeting.
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  Concept paper: We proposed an innovative, bio-behavioral, symptom self-management approach to filling the existing gap in knowledge for Mexican-American women with co-occurring T2DM and IHD.
• Hooker, S. P., McEwen, M. M., Hingle, M. D., Loya, J. L., Campas, D., Aceves, B., Valdez, L. A., & Garcia, D. O. (2017, March). A Gender- and Culturally-Sensitive Weight Loss Intervention for Hispanic Males. [Abstract].
• Garcia, D. O., Valdez, L. A., Aceves, B., Campas, D., Lopez, J., Rodriguez, E., Hingle, M. D., Bell, M., Mcewen, M. M., & Hooker, S. (2016, November). Recruiting Hispanic Men for a Gender- and Culturally-Sensitive Weight Loss Intervention. [Abstract]..