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18. Teaching by texting to promote positive health behaviours in pregnancy: a protocol for a randomised controlled trial of SmartMom

Author

Janssen, Patricia, primary, Lecke, Sara, additional, Renner, Regina, additional, Zhang, Wei, additional, Vedam, Saraswathi, additional, Norman, Wendy V, additional, Bayrampour, Hamideh, additional, Tough, Suzanne, additional, Murray, Jennifer, additional, Muhajarine, Nazeem, additional, and Dennis, Cindy Lee, additional

Published
2024
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20. Perspectives Among Canadian Physicians on Factors Influencing Implementation of Mifepristone Medical Abortion: A National Qualitative Study

Author

Munro, Sarah, Guilbert, Edith, Wagner, Marie-Soleil, Wilcox, Elizabeth S., Devane, Courtney, Dunn, Sheila, Brooks, Melissa, Soon, Judith A., Mills, Megan, Leduc-Robert, Genevieve, Wahl, Kate, Zannier, Erik, and Norman, Wendy V.

Subjects
Physicians -- Beliefs, opinions and attitudes, Mifepristone -- Usage -- Laws, regulations and rules, Family planning services -- Laws, regulations and rules -- Analysis, Abortion services -- Laws, regulations and rules -- Analysis, Medical care quality -- Analysis, Government regulation, Health, Science and technology
Abstract

PURPOSE Access to family planning health services in Canada has been historically inadequate and inequitable. A potential solution appeared when Health Canada approved mifepristone, the gold standard for medical abortion, in July 2015. We sought to investigate the factors that influence successful initiation and ongoing provision of medical abortion services among Canadian health professionals and how these factors relate to abortion policies, systems, and service access throughout Canada. METHODS We conducted 1 -on-1 semistructured interviews with a national sample of abortion-providing and nonproviding physicians and health system stakeholders in Canadian health care settings. Our data collection, thematic analysis, and interpretation were guided by Diffusion of Innovation theory. RESULTS We conducted interviews with 90 participants including rural practitioners and those with no previous abortion experience. In the course of our study, Health Canada removed mifepristone restrictions. Our results suggest that Health Canada's initial restrictions discouraged physicians from providing mifepristone and were inconsistent with provincial licensing standards, thereby limiting patient access. Once deregulated, remaining factors were primarily related to local and regional implementation processes. Participants held strong perceptions that mifepristone was the new standard of care for medical abortion in Canada and within the scope of primary care practice. CONCLUSION Health Canada's removal of mifepristone restrictions facilitated the implementation of abortion care in the primary care setting. Our results are unique because Canada is the first country to facilitate provision of medical abortion in primary care via evidence-based deregulation of mifepristone. Key words: abortion; family planning; health policy; health services accessibility; implementation; qualitative research; interview, INTRODUCTION Approximately 40% of pregnancies in Canada are unplanned, and 1 in 3 Canadian women will have at least 1 abortion in their lifetime. (1-4) Access to health services in [...]

Published
2020
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26. Inequalities in access to prenatal care during the COVID‐19 pandemic: Analysis of a population‐based cohort.

Author

Hetherington, Erin, Darling, Elizabeth, Harper, Sam, Nguyen, Francis, Schummers, Laura, and Norman, Wendy V.

Subjects
COVID-19 pandemic, PRENATAL care, COHORT analysis, CONFIDENCE intervals, RURAL geography
Abstract

Background: Before the COVID‐19 pandemic, access to prenatal care was lower among some socio‐demographic groups. This pandemic caused disruptions to routine preventative care, which could have increased inequalities. Objectives: To investigate if the COVID‐19 pandemic increased inequalities in access to prenatal care among those who are younger, live in rural areas, have a lower socio‐economic situation (SES) and are recent immigrants. Methods: We used linked administrative datasets from ICES to identify a population‐based cohort of 455,245 deliveries in Ontario from January 2018 to December 2021. Our outcomes were first‐trimester prenatal visits, first‐trimester ultrasound and adequacy of prenatal care. We used joinpoint analysis to examine outcome time trends and identify trend change points. We stratified analyses by age, rural residence, SES and recent immigration, and examined risk differences (RD) with 95% confidence intervals (CI) between groups at the beginning and end of the study period. Results: For all outcomes, we noted disruptions to care beginning in March or April 2020 and returning to previous trends by November 2020. Inequalities were stable across groups, except recent immigrants. In July 2017, 65.0% and 69.8% of recent immigrants and non‐immigrants, respectively, received ultrasounds in the first trimester (RD −4.8%, 95% CI −8.0, −1.5). By October 2020, this had increased to 75.4%, with no difference with non‐immigrants (RD 0.4%, 95% CI −2.4, 3.2). Adequacy of prenatal care showed more intensive care as of November 2020, reflecting a higher number of visits. Conclusions: We found no evidence that inequalities between socio‐economic groups that existed prior to the pandemic worsened after March 2020. The pandemic may be associated with increased access to care for recent immigrants. The introduction of virtual visits may have resulted in a higher number of prenatal care visits. [ABSTRACT FROM AUTHOR]

Published
2024
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27. Intersectionality in Developing a Virtual Community of Practice Platform on Abortion.

Author

ABDULAI, Abdul-Fatawu, CZERNIAK, Efrat, DUONG, Cam, MEHTA, Aashay, CHIU, Rachel, STROULIA, Eleni, and NORMAN, Wendy V.

Abstract

Abortion is an essential healthcare service in many countries including Canada. The number of people who seek abortion is disproportionately higher among equity-deserving populations. Yet the knowledge needed to provide evidence-based, culturally safe, and gender-affirming abortion services remain limited among healthcare professionals. Using an intersectional lens, we conducted focus group discussions with 14 healthcare professionals to understand how an abortion web-based platform, which is currently under development, can be adapted to meet the needs of equity deserving populations. The findings revealed the need for multi-lingual resources on abortion, information on funding coverage for undocumented migrants, educational resources on Indigenous cultural safety and gender-affirming practices, and a mapping tool to locate providers or pharmacists. Beyond presenting clinical guidelines on web platforms, this study revealed important considerations for the design of web platforms that can help advance access to abortion for equity-deserving populations. [ABSTRACT FROM AUTHOR]

Published
2024
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35. User-Centered Development of a Patient Decision Aid for Choice of Early Abortion Method: Multi-Cycle Mixed Methods Study (Preprint)

Author

Wahl, Kate J, primary, Brooks, Melissa, additional, Trenaman, Logan, additional, Desjardins-Lorimer, Kirsten, additional, Bell, Carolyn M, additional, Chokmorova, Nazgul, additional, Segall, Romy, additional, Syring, Janelle, additional, Williams, Aleyah, additional, Li, Linda C, additional, Norman, Wendy V, additional, and Munro, Sarah, additional

Published
2023
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37. Avortement médical

Author

Costescu, Dustin, Guilbert, Édith, Bernardin, Jeanne, Black, Amanda, Dunn, Sheila, Fitzsimmons, Brian, Norman, Wendy V., Pymar, Helen, Soon, Judith, Trouton, Konia, Wagner, Marie-Soleil, and Wiebe, Ellen

Published
2016
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38. Medical Abortion

Author

Costescu, Dustin, Guilbert, Edith, Bernardin, Jeanne, Black, Amanda, Dunn, Sheila, Fitzsimmons, Brian, Norman, Wendy V., Pymar, Helen, Soon, Judith, Trouton, Konia, Wagner, Marie-Soleil, and Wiebe, Ellen

Published
2016
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44. Can youth-engaged research facilitate equitable access to contraception in Canada? The qualitative study protocol for the Ask Us project

Author

Munro, Sarah, primary, Di Meglio, Giuseppina, additional, Williams, Aleyah, additional, Barbic, Skye Pamela, additional, Begun, Stephanie, additional, Black, Amanda, additional, Carson, Andrea, additional, Fortin, Michelle, additional, Jacob, Kaiya, additional, Khan, Zeba, additional, Martin-Misener, Ruth, additional, Meherali, Salima, additional, Paller, Victoria, additional, Seiyad, Hajar, additional, Vallée, Carol-Anne, additional, Wahl, Kate, additional, and Norman, Wendy V, additional

Published
2023
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45. Improving rural and regional access to long-acting reversible contraception and medical abortion through nurse-led models of care, task-sharing and telehealth (ORIENT): a protocol for a stepped-wedge pragmatic cluster-randomised controlled trial in Australian general practice

Author

Mazza, Danielle, primary, Shankar, Mridula, additional, Botfield, Jessica R, additional, Moulton, Jessica E, additional, Chakraborty, Samantha Paubrey, additional, Black, Kirsten, additional, Tomnay, Jane, additional, Bateson, Deborah, additional, Church, Jody, additional, Laba, Tracey-Lea, additional, Kasza, Jessica, additional, and Norman, Wendy V, additional

Published
2023
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50. Canadian Contraception Consensus (Part 2 of 4)

Author

Ferguson, Carrie, Fortin, Claude, Kielly, Maria, Mansouri, Shireen, Todd, Nicole, Black, Amanda, Guilbert, Edith, Costescu, Dustin, Dunn, Sheila, Fisher, William, Kives, Sari, Mirosh, Melissa, Norman, Wendy V., Pymar, Helen, Reid, Robert, Roy, Geneviève, Varto, Hannah, Waddington, Ashley, Wagner, Marie-Soleil, and Whelan, Anne Marie

Published
2015
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