Current Projects

  • How do perceptions of Covid-19 risk influence health decisions in pregnancy? A mixed-methods study [2022-2025]

    I am leading a cross-provincial (Ontario and BC) study of how perceptions of Covid-19 risk and Covid-19 circumstance influenced health decision-making in pregnancy. This parallel mixed-methods study began in mid 2022, and the protocol is available here.

     

    It has two objectives:

     

    1. Quantitative strand: Describe differences between 2019, 2021, and 2022 pregnancy cohorts relative to key outcomes and quality of care indicators related to vaccination, perinatal care, mental health and social supports. Examine the differential impacts on racialized and low-income pregnant people.
    2. Qualitative strand: Understand how pregnant people’s perceptions of COVID-19 risk influenced their decision-making about key elements of pregnancy, including vaccination, perinatal care, social support and mental health.

     

    The quantitative strand will use a retrospective, quasi-experimental (pre-post) design to assess cohort differences in rates of clinical care and health outcomes. Using administrative data from ICES (Ontario) and PopulationData British Columbia, we will compare health outcomes of three cohorts, which we will pair with the Canadian Index of Multiple Deprivation to explore the influences of demographic and socioeconomic variables. The qualitative strand uses a qualitative descriptive approach to interview people who have given birth during the pandemic about their changing circumstances, risk perception, and decision-making process relevant to vaccination, perinatal care, social support and mental health. Data integration will occur during design and interpretation.

     

     

    Contact: pregnancy@mcmaster.ca

     

    Funded by Canadian Institutes of Health Research

  • Cannabis in Pregnancy & Lactation [2019-2024]

    I am leading a pan-Canadian study of how pregnant and lactating people make decisions about using cannabis products during pregnancy and lactation.

     

    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 of prenatal use in Canada 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 two systematic reviews of evidence on pregnant people and health care providers’ experiences, opinions, and beliefs about this topic. You can view a keynote presentation on this first systematic review here.

     

    In the second phase of the project, we interviewed 52 pregnant and lactating people about how they made decisions to continue, cease, or change their cannabis use. Our first publication, on reasons for cannabis use throughout perinatal stages, was published by the Canadian Medical Association Journal. Our second analysis of this project, recently published in the journal Birth, describes how pregnant people use information to make these decisions. Further analysis about how people consider and act to mitigate risk of perinatal cannabis use has recently been accepted by Women’s Health. Our final analysis will describe how clinicians and patients describe an ideal clinical counselling session about perinatal cannabis use.

     

    The final analysis for this project is underway. We interviewed prenatal clinicians and social care providers about the challenges they experience when counselling pregnant and lactating people about cannabis use.

     

     

    Contact: canpreg@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. The protocol for this project is available here.

     

    We have completed an environmental scan of existing resources, which is available on our project website. A discourse analysis of these materials is forthcoming in Violence Against Women.

     

    Analysis for the second phase of the project is ongoing, with some initial publications detailing resident physician understanding of child maltreatment (here), and the implications of online child maltreatment education for healthcare and social service providers (here).

     

    A description of the project is available here.

     

     

    Contact: Ilana Allice (allicei@mcmaster.ca)

     

    Funded by the Public Health Agency of Canada

  • 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 how the patient partner role has been conceptualized. Next, we conducted a survey of over 500 Canadian patient partners. So far, we have published some information about who Canadian patient partners are and how Covid-19 impacted their work. Additional analyses are ongoing. The final phase of CPPS involves interviewing patient partners and organizational staff who work with patient partners. Data collection is in progress. Project updates will be available through the: Public and Patient Engagement Collaborative

     

    Contact: Laura Tripp (mccamml@mcmaster.ca)

     

    Funded by the Canadian Institutes of Health Research

Completed Projects

Meredith Vanstone,

Associate Professor, Department of Family Medicine

DBHSC 5001F, McMaster University

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

Meredith.Vanstone@mcmaster.ca

  • I am leading a pan-Canadian study of how pregnant and lactating people make decisions about using cannabis products during pregnancy and lactation.

     

    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 of prenatal use in Canada 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 two systematic reviews of evidence on pregnant people and health care providers’ experiences, opinions, and beliefs about this topic. You can view a keynote presentation on this first systematic review here.

     

    In the second phase of the project, we interviewed 52 pregnant and lactating people about how they made decisions to continue, cease, or change their cannabis use. Our first publication, on reasons for cannabis use throughout perinatal stages, was published by the Canadian Medical Association Journal. Our second analysis of this project, recently published in the journal Birth, describes how pregnant people use information to make these decisions. Further analysis about how people consider and act to mitigate risk of perinatal cannabis use has recently been accepted by Women’s Health. Our final analysis will describe how clinicians and patients describe an ideal clinical counselling session about perinatal cannabis use.

     

    The final analysis for this project is underway. We interviewed prenatal clinicians and social care providers about the challenges they experience when counselling pregnant and lactating people about cannabis use.

     

     

    Contact: canpreg@mcmaster.ca

     

    Funded by the Canadian Institutes of Health Research

  • 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. The protocol for this project is available here.

     

    We have completed an environmental scan of existing resources, which is available on our project website. A discourse analysis of these materials is forthcoming in Violence Against Women.

     

    Analysis for the second phase of the project is ongoing, with some initial publications detailing resident physician understanding of child maltreatment (here), and the implications of online child maltreatment education for healthcare and social service providers (here).

     

    A description of the project is available here.

     

     

    Contact: Ilana Allice (allicei@mcmaster.ca)

     

    Funded by the Public Health Agency of Canada

  • 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 how the patient partner role has been conceptualized. Next, we conducted a survey of over 500 Canadian patient partners. So far, we have published some information about who Canadian patient partners are and how Covid-19 impacted their work. Additional analyses are ongoing. The final phase of CPPS involves interviewing patient partners and organizational staff who work with patient partners. Data collection is in progress. Project updates will be available through the: Public and Patient Engagement Collaborative

     

    Contact: Laura Tripp (mccamml@mcmaster.ca)

     

    Funded by the Canadian Institutes of Health Research