Article
Health Care Sciences & Services
Sheila Dunn, Sarah Munro, Courtney Devane, Edith Guilbert, Dahn Jeong, Eleni Stroulia, Judith A. Soon, Wendy Norman
Summary: This study describes the development and use of a virtual community of practice (VCoP) in Canada for the implementation of a novel medication abortion method. The results show that the VCoP engaged physicians from across the country and supported them in implementing this practice, even those without prior abortion experience.
JOURNAL OF MEDICAL INTERNET RESEARCH
(2022)
Article
Obstetrics & Gynecology
Danielle Calloway, Debra B. Stulberg, Elizabeth Janiak
Summary: Despite its safety record, mifepristone is subject to a highly restrictive set of regulatory measures through the REMS, reflecting and perpetuating a cycle of abortion stigma. The ExPAND Mifepristone learning collaborative targets institutional anxiety and logistical barriers to increase providers' self-efficacy. Learning collaboratives show promise in addressing the practical and psychological barriers to mifepristone use until the REMS is fully repealed.
Article
Medicine, General & Internal
Enav Z. Zusman, Sarah Munro, Wendy Norman, Judith A. Soon
Summary: A survey conducted among community pharmacists in Canada found that the majority of pharmacists were willing and ready to dispense mifepristone, with few barriers reported in terms of stocking or dispensing the medication. The implementation of the policy to allow pharmacists to directly dispense mifepristone has facilitated medication abortion in primary care settings.
Article
Health Care Sciences & Services
Regina M. M. Renner, Madeleine Ennis, Ama Kyeremeh, Wendy V. V. Norman, Sheila Dunn, Helen Pymar, Edith Guilbert
Summary: A survey conducted in Canada found that less than half of the respondents reported using telemedicine for certain aspects of first-trimester medical abortion in 2019, and the majority perceived barriers.
TELEMEDICINE AND E-HEALTH
(2023)
Article
Obstetrics & Gynecology
Kayla N. Rasmussen, Elizabeth Janiak, Alischer A. Cottrill, Debra B. Stulberg
Summary: Medication abortion is safe and effective. PCPs expressed support for lifting the mifepristone REMS to allow pharmacy dispensing, as it helps normalize medication abortion care and expand access. Challenges include federal funding restrictions, concerns about unsupervised use, and pharmacy cooperation.
Article
Obstetrics & Gynecology
Sarah B. B. Munro, Sheila Dunn, Edith R. R. Guilbert, Wendy V. V. Norman
Summary: Mifepristone medication abortion is a safe and effective method widely used in over 60 countries. Canada's approach of regulating mifepristone as a normal prescription has increased access and autonomy for individuals seeking abortion. Policy-maker-engaged research has played a crucial role in facilitating policy changes and enabling self-management of abortion within a supportive healthcare system in Canada.
SEMINARS IN REPRODUCTIVE MEDICINE
(2022)
Editorial Material
Obstetrics & Gynecology
Monica Dragoman, Chris Fofie, Sadie Bergen, Wendy Chavkin
Summary: This commentary presents the key messages from a newly developed framework for self-managed medication abortion by Global Doctors for Choice. It also highlights the clinical concerns and advocacy opportunities for clinicians in different settings with varying legal and administrative restrictions on abortion.
Article
Green & Sustainable Science & Technology
Chipo Nancy Ngongoni, William Wasswa, Moredreck Chibi
Summary: This study reviewed and analyzed 1003 innovations utilized for the COVID-19 response, and identified four strategic pillars that explain the successful integration of these innovations in Primary Health Care. These pillars include collaboration, governance, innovation design, and strategy.
Article
Obstetrics & Gynecology
Kathryn J. LaRoche, Ariane Wylie, Mira Persaud, Angel M. Foster
Summary: This study evaluates the outcomes and experiences of the Medical Abortion Access Project (MAAP) in Ottawa. The findings indicate that MAAP successfully assisted primary care facilities in integrating medication abortion care into their practices. Patient demand was identified as a key driver, and MAAP provided necessary information and logistical support. The creation of a community of practice facilitated technical and emotional support for new abortion providers.
Article
Obstetrics & Gynecology
Silpa Srinivasulu, Roya Yavari, Libby Brubaker, Laura Riker, Linda Prine, Susan E. Rubin
Summary: FDA regulations restricting the provision of mifepristone in primary care settings create structural barriers, potentially resulting in physical, emotional, and financial burdens for patients.
Article
Obstetrics & Gynecology
Na'amah Razon, Sarah Wulf, Citlali Perez, Sarah McNeil, Lisa Maldonado, Alison Byrne Fields, Diana Carvajal, Rachel Logan, Christine Dehlendorf
Summary: This study examines the impact of Risk Evaluation and Mitigation Strategy (REMS) criteria on family physicians' ability to provide medication abortion. The findings suggest that REMS criteria create administrative complexities and barriers for family physicians. Removing the REMS may simplify integration of medication abortion into primary care and improve access for patients.
Article
Pharmacology & Pharmacy
Deborah Bateson, Kathleen McNamee, Caroline Harvey
Summary: Early medical abortion is a safe and cost effective alternative to surgical abortion, using mifepristone and misoprostol up to nine weeks of gestation. Informed consent and follow-up are important, and most contraceptive methods can be started immediately after the abortion.
AUSTRALIAN PRESCRIBER
(2021)
Article
Health Care Sciences & Services
Molly Wellington, Kelsey Hegarty, Laura Tarzia
Summary: The study identified various barriers faced by primary care clinicians in Australia when responding to reproductive coercion and abuse, including lack of awareness, lack of confidence, lack of referral services, and lack of abortion services. There is a need for more training and streamlined referral pathways for women experiencing reproductive coercion and abuse.
BMC HEALTH SERVICES RESEARCH
(2021)
Article
Psychology, Multidisciplinary
Lidia C. C. Casas, Juan J. J. Alvarez, Lieta V. V. Vivaldi, Adela R. R. Montero, Natalia Bozo, Jorge Babul
Summary: This article summarizes a study that explored the role of primary healthcare services in the treatment of rape survivors in Chile and identified biases and shortcomings in accessing legal abortion. The study found that rape is the least used grounds for abortion and that medical practitioners have biases and stigmatize the victims. Lack of political will and the COVID-19 pandemic have hindered timely training on the new law, leading to a lack of gender-sensitive care.
FRONTIERS IN PSYCHOLOGY
(2022)
Article
Health Care Sciences & Services
Janet M. Y. Cheung, Zoe Menczel Schrire, Melissa Aji, Matthew Rahimi, Helena Salomon, Iliana Doggett, Nicholas Glozier, Delwyn J. Bartlett, Keith Wong, Ronald R. Grunstein, Christopher J. Gordon
Summary: This study examined the attitudes and beliefs of primary care health providers in Australia towards digital health interventions (DHIs) for sleep and their implementation in practice. The results showed that while DHIs have the potential to improve care, there are still issues that need to be addressed, such as training, care pathways, and financial models.
Article
Health Care Sciences & Services
Regina M. M. Renner, Madeleine Ennis, Ama Kyeremeh, Wendy V. V. Norman, Sheila Dunn, Helen Pymar, Edith Guilbert
Summary: A survey conducted in Canada found that less than half of the respondents reported using telemedicine for certain aspects of first-trimester medical abortion in 2019, and the majority perceived barriers.
TELEMEDICINE AND E-HEALTH
(2023)
Article
Primary Health Care
Regina -Maria Renner, Vivien Hu, Edith R. Guilbert, Arianne Y. K. Albert, Katharine O'Connell White, Heidi E. Jones, Xiaoning Guan, Wendy Norman
Summary: This study aimed to evaluate the practices and characteristics of first-trimester surgical abortion facilities and providers in Canada in 2012. The results showed that the practices in Canada mostly followed evidence-based guidelines and the majority of providers were female family doctors. The procedures and care before and after the surgery were consistent among facilities and physicians.
CANADIAN FAMILY PHYSICIAN
(2023)
Article
Nursing
Andrea Carson, Emma Stirling Cameron, Martha Paynter, Wendy Norman, Sarah Munro, Ruth Martin-Misener
Summary: This study explores the experiences of nurse practitioners in implementing medication abortion in Canada and identifies ways to further support their implementation. The findings indicate that nurse practitioners engage in educational, communication, and networking activities, while facing resistance from employers, colleagues, and funders. The study highlights the importance of integrating abortion services in primary care and making them more accessible to patients.
JOURNAL OF ADVANCED NURSING
(2023)
Article
Family Studies
Pip Louise Maria Buckingham, Safeera Hussainy, Judith Soon, Wendy Norman, Deborah Bateson, Danielle Mazza
Summary: This study investigated the knowledge, attitudes, practices, barriers, and benefits of contraceptive care provided by community pharmacists in Australia. The results revealed that pharmacists recognized the importance of contraceptive counseling but lacked necessary resources and support to deliver consistent quality care. The study suggests exploring payment mechanisms, training opportunities, and pharmacy-specific resources to ensure high-quality person-centered care.
BMJ SEXUAL & REPRODUCTIVE HEALTH
(2023)
Article
Health Care Sciences & Services
Salima Meherali, Sarah Munro, Giulia Puinean, Bukola Salami, Josephine Pui-Hing Wong, Ashley Vandermorris, James Russell Andrew Benoit, Sarah Flicker, Philomina Okeke-Ihejirika, Eleni Stroulia, Wendy Norman, Shannon D. Scott
Summary: This study aims to develop an interactive mobile app to provide accurate and evidence-based sexual and reproductive health (SRH) information to immigrant adolescents. The research will use community-based participatory action research methods to understand the SRH needs and priorities of adolescents and engage them in designing and testing the mobile app. This study will address the knowledge gap on SRH information needs of immigrant adolescents and propose innovative strategies to improve their sexual and reproductive health.
JMIR RESEARCH PROTOCOLS
(2023)
Article
Public, Environmental & Occupational Health
Mridula Shankar, Leesa Hooker, Kristina Edvardsson, Wendy Norman, Angela J. Taft
Summary: The aim of this study is to estimate the prevalence of unintended pregnancy and associated factors among young Australian women. The research found that unintended pregnancy among young Australian women is mainly experienced by those with structural disadvantages and exposure to sexual coercion. Therefore, service improvements should be made to achieve equitable distribution of contraception and abortion services, along with initiatives responding to sexual coercion.
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
(2023)
Article
Obstetrics & Gynecology
Madeleine Ennis, Regina M. Renner, Bimbola Olure, Wendy Norman, Stephanie Begun, Lisa Martin, Lisa H. Harris, Lauren Kean, Meghan Seewald, Sarah Munro
Summary: This study surveyed physicians, nurse practitioners, and administrators in Canada who provide abortion services to assess their experiences of stigma and harassment. The results showed that low-volume clinicians experienced less harassment compared to higher volume clinicians and administrators. Canadian abortion care providers expressed concerns about stigma interfering with their provision of abortion services and called for further destigmatization and protection through policy and practice interventions.
Article
Medicine, General & Internal
Sarah Munro, Giuseppina Di Meglio, Aleyah Williams, Skye Pamela Barbic, Stephanie Begun, Amanda Black, Andrea Carson, Michelle Fortin, Kaiya Jacob, Zeba Khan, Ruth Martin-Misener, Salima Meherali, Victoria Paller, Hajar Seiyad, Carol-Anne Vallee, Kate Wahl, Wendy Norman
Summary: This study aims to identify the barriers that youth face when accessing contraception in Canada, from the perspectives of both youth and youth service providers. It will use a prospective, mixed-methods, integrated knowledge mobilisation approach, involving in-depth interviews with youth and service providers. The study will also focus on co-creating and evaluating knowledge translation products with youth, service providers, and policy makers.
Article
Medicine, General & Internal
Danielle Mazza, Mridula Shankar, Jessica R. Botfield, Jessica E. Moulton, Samantha Paubrey Chakraborty, Kirsten Black, Jane Tomnay, Deborah Bateson, Jody Church, Tracey-Lea Laba, Jessica Kasza, Wendy Norman
Summary: The ORIENT trial aims to evaluate the effectiveness of a nurse-led model of care in increasing uptake of long-acting reversible contraception (LARC) and improving access to medical abortion services in rural and regional areas of Australia. The trial will enroll 32 general practices and randomize them to implement the nurse-led model or continue with usual care. The primary outcome measures include changes in LARC prescribing rates, while secondary outcomes include changes in medical abortion prescribing rates and provision of telehealth services.
Article
Pharmacology & Pharmacy
Enav Z. Zusman, Sarah Munro, Wendy V. Norman, Judith A. Soon
Summary: This study examines the experiences of Canadian community pharmacists in dispensing mifepristone directly to patients. The results indicate that most pharmacists perceive various benefits of providing mifepristone in pharmacies and encounter minimal challenges.
CANADIAN PHARMACISTS JOURNAL
(2023)
Article
Medicine, Research & Experimental
Regina M. Renner, Madeleine Ennis, Mahan Maazi, Sheila Dunn, Wendy V. Norman, Janusz Kaczorowski, Edith Guilbert
Summary: Substantial changes in abortion care regulations, available medications and national clinical practice guidelines have occurred since the 2012 national Canadian Abortion Provider Survey (CAPS). We developed and piloted the CAPS 2019 survey instrument to explore changes in the abortion provider workforce, their clinical care, as well as experiences with stigma and harassment. The survey instrument is suitable for investigating a complex multidisciplinary workforce, their care and experience with stigma on a national level, and can be adapted to other countries.
PILOT AND FEASIBILITY STUDIES
(2023)
Article
Public, Environmental & Occupational Health
Tamil Kendall, Pallavi Sriram, Amrit Parmar, Wendy V. Norman
Summary: This study analyzed Canadian newspaper coverage on medication abortion and the regulatory framework for mifepristone. The findings showed a high level of support for medication abortion and the removal of regulatory barriers. Most of the coverage focused on the health aspect of medication abortion and highlighted the potential improvements in availability, accessibility, acceptability, and quality of abortion services through liberalization of the regulatory framework.
WOMENS HEALTH ISSUES
(2023)
Article
Medicine, General & Internal
Carol-Anne Vallee, Ana Clara Sosa Cazales, Brian Fitzsimmons, Wendy V. Norman
Summary: Abortion has been legal in Canada since 1969 and is provided by obstetricians, nurses, and family doctors in both rural and urban areas. The challenges for providing accessible abortion care include the need for more practitioners to reduce travel and wait times, the listing of abortion providers in a confidential directory, and improved training and distribution of services for second-trimester surgical abortion. The era of only a small number of healthcare workers providing all aspects of abortion care is over.
BRITISH COLUMBIA MEDICAL JOURNAL
(2023)