Projects

Current

  • Cannabis in Pregnancy & Breastfeeding [2019-2022]

    I am leading a pan-Canadian study of how women make decisions about using cannabis products during pregnancy and breastfeeding.

     

    Cannabis is the most commonly used non-prescribed substance in pregnancy, but we know very little about the maternal and neonatal outcomes of use, have little evidence about motivations for cannabis use, and a clear prevalence of use in Canadian women has not been established. These gaps in information present a challenge of prenatal health care providers who seek to counsel women to make informed decisions about cannabis use during pregnancy and breastfeeding, and to facilitate harm reduction strategies.

     

    The project begins with a systematic review of evidence on women’s and health care providers’ experiences, opinions, and beliefs about this topic.

     

    Contact: Janelle Panday, pandayj@mcmaster.ca

     

    Funded by the Canadian Institutes of Health Research

  • Canadian Patient Partner Study (CPPS) [2019-2022]

    With  Dr. Julia Abelson , I am co-leading a pan-Canadian study of patient partners and advisors within the health system.

     

    This three year study will look at how the patient partner role has been conceptualized and operationalized across the health system. The aim of this study is to address a critical gap in the patient engagement field, which is our lack of understanding of the origins, motivations, defining features, anticipated contributions, and experiences of the patient partner and advisor role in the Canadian health system.

     

    This project begins with a critical interpretive synthesis of existing evidence on this topic.

     

    Project updates will be available through the:

    Public and Patient Engagement Collaborative

     

    Contact: Janelle Panday, pandayj@mcmaster.ca or Laura Tripp, mccamml@mcmaster.ca

     

    Funded by the Canadian Institutes of Health Research

  • Researching the Impact of Service provider Education (RISE)

    [2019-2023]

    With   Drs. Melissa Kimber and   Donna Stewart , I am co-leading an evaluation of the impact of Family Violence education materials.

     

    This cross-Canada project will implement and evaluate the   VEGA materials , which aim to help health and social service providers recognize and respond to people who have experienced Family Violence.

     

    We are currently completing an environmental scan of existing resources.

     

    Contact: Ilana Allice, allicei@mcmaster.ca

     

    Funded by the Public Health Agency of Canada

  • Impact of the Certificates of Added Competence on Family Medicine practice in Canada

    [2018-2020]

    With  Dr. Lawrence Grierson , I am co-leading an evaluation of the Certificates of Added Competence (CAC), an education credential provided by the College of Family Physicians of Canada (CFPC) to recognize Family Physicians with enhanced skills in particular clinical areas.

     

    This project focuses on the CACs for Palliative Care, Care of the Elderly, Sports and Exercise Medicine, and Family Practice Anesthesia. This research consisted of a multiple embedded case study of 6 different groups of Family Physicians across Canada, followed by a nation-wide survey of Family Physicians to confirm the propositions we developed in the qualitative work.

     

    Our report has been accepted by the CFPC and we are working on generating academic manuscripts for publication.

     

    Contact: Meredith Vanstone, vanstomg@mcmaster.ca

     

    Conducted in partnership with the College of Family Physicians of Canada

  • Mistreatment, Abuse & Power in the Clinical Learning Environment

    [2017-2020]

    In collaboration with colleagues and graduate students, I conduct a program of research examining the use of power within the clinical learning environment. This work has generated multiple theses and publications on the following issues in the clinical learning environment:

     

     

    “Power, Hierarchy, Mistreatment & Abuse in the clinical environment: Welcome to the dark side of medical education."

    Merit Rounds, October 2018

     

    "Tackling abusive behaviours in the clinical workplace."

    McMaster's Health Leadership Academy, September 2019

     

    Contact: Meredith Vanstone, vanstomg@mcmaster.ca

     

    Funded by the Health Leadership Academy and Canadian Association of Medical Education

Completed

  • Prenatal Testing for Disability: Women, Prenatal Care Provider, and Policy Perspectives

    [2012-2019]

    Non-Invasive Prenatal Testing (NIPT) is a morally complex technology that provides genetic information about a fetus as early as 10 weeks into gestation, by analyzing samples of cell-free fetal DNA obtained from maternal blood. It is a rapidly developing technology which has important ethical and organizational implications for health policy, health professional education and patient education.

     

    I’ve worked with policymakers, patients, and clinicians to generate social and ethics evidence about this technology for 5 years. This work came to fruition in 2018 when I participated in generating evidence to support a recommendation  to the Ontario Ministry of Health and Long-Term Care about the public funding of NIPT in Ontario. My work in this area has been supported by funding from the Government of Ontario and the Canadian Institutes of Health Research.

     

    With this funding, I conducted primary research about NIPT in Ontario, publishing papers about:

     

     

     

     

     

     

     

    I have also participated in research examining the implementation of NIPT in the Netherlands, Quebec, and Lebanon.

     

    I have actively engaged as an expert consultant with several decision-maker bodies including the Provincial Council of Maternal and Child Health, the Ontario Genetics Advisory Committee and the Ontario Health Technology Advisory Committee.

     

    This work built upon my doctoral work on counselling modelspatient education materials, and discursive implications of health professional counselling about Integrated Prenatal Screening. My final NIPT papers are currently under review.

  • Other Pregnancy Related Work

    Socially and morally complex decisions during pregnancy have long been of interest to me. Beyond my work about prenatal testing and cannabis use during pregnancy, I have also participated in research about:

     

     

     

     

     

     

    I continue to use reproductive and prenatal care as a fruitful topic to study how policies impact health professional practice and healthcare.

  • 3 Wishes Project Multi-Site Evaluation

    [2016-2020]

    With Dr. Deborah Cook, I’ve worked on a number of projects related to compassion and dignity at the end-of-life. The 3 Wishes Project is a clinical program which started at St. Joseph’s Healthcare Hamilton and is currently active in dozens of ICUs in North America.

     

    By eliciting and implementing wishes that honour the legacy and life of a dying patient, the 3 Wishes Project forges human connection between patients, family members, and clinicians. With funding from the Greenwall Foundation, we initiated a program evaluation of the 3 Wishes Project as implemented at 4 sites in North America. We’ve also examined the interface between 3 Wishes and organ donation, and examined the implications of particular wishes such as Word Clouds, keepsakes, and personalized art.

     

    While the research was completed in 2019, the clinical program continues to grow and expand. We are currently thinking about how 3 Wishes might alleviate some of the trauma associated with death during the COVID-19 pandemic, when families are restricted from being physically present at the bedside of dying patients.

  • Qualitative Evidence Synthesis in Health Policy

    [2013-2018]

    Since my postdoctoral fellowship in 2013, I have been interested in the ways in which health policy decision-makers gather and incorporate social and ethics evidence into decisions about health programs and technologies.

     

    As part of this work, I established partnerships with health technology policy-makers to produce social and ethics evidence to support their considerations about the funding and implementation of particular health technologies. I did this by producing qualitative evidence syntheses on topics such as:

     

     

     

     

     

     

     

    This work has also generated methodological contributions about qualitative evidence synthesis reporting and quality appraisal.

Meredith Vanstone,

Associate Professor, Department of Family Medicine

DBHSC 5003E, McMaster University

100 Main St. W., Hamilton, ON L8P 1H6

Meredith.Vanstone@mcmaster.ca