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Women’s Experiences of Publicly Funded Non-Invasive Prenatal Testing in Ontario, Canada: Considerations for Health Technology Policy-Making
Abstract
Non-invasive prenatal testing (NIPT) via fetal DNA in maternal blood has been publicly funded in Ontario, Canada, for high-risk women since 2014. We solicited women's experiences and values related to this new health technology to describe how this test is currently being used in Ontario and to provide information about patient priorities to inform future policy decisions about the use of NIPT. Guided by constructivist grounded theory methodology, we interviewed 38 women who had diverse personal experiences with NIPT. Participants' accounts of their values for decision making about NIPT heavily relied on three mutually modulating factors: timing, accuracy, and risk. The values expressed by women conflict with the way that publicly funded NIPT has typically been implemented in Ontario. We offer recommendations for how NIPT might be integrated into prenatal care pathways in a way more consistent with women's values.
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Quotes from women from interviews or focus groups on waiting time and accuracy of test results correspond to van Schendel et al.'s findings from questionnaires: waiting time was experienced as long and/or stressful, and women had a high confidence in negative NIPT results.
“Quotes from women from interviews (Vanstone et al. [25]) or focus groups (Farrell et al. [19]) on the aspects of waiting time and accuracy of test results correspond to Van Schendel et al.’s findings from questionnaires: Waiting time was experienced as long and/or stressful, and women had a high confidence in negative NIPT results.”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [25]
The scoping review identified seven studies that investigated psychological and/or social consequences after NIPT.
“In this scoping review, we identified seven studies that investigated psychological and/or social consequences after NIPT [19–25].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [25]
Two included studies assessed women's experiences with and feelings after NIPT in interviews or focus groups.
“Two studies assessed women’s experiences with and feelings after NIPT in interviews or focus groups [19, 25].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [25]
Most included studies recruited women with an elevated Down syndrome screening risk, while two studies recruited from an unselected population regarding Down syndrome screening.
“Most studies recruited women with an elevated Down syndrome screening (DSS) risk (medium and/or high risk, cut-offs vary, range from > 1:1000 to 1:1–125) [20–22, 24, 25], two studies recruited from an unselected population regarding DSS [19, 23].”
From Psychological and social consequences of non-invasive prenatal testing (NIPT): a scoping review (2019) · cites this paper as [25]
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Metadata
- Authors
- Vanstone, M., Yacoub, K., Giacomini, M., Hulan, D., & McDonald, S.
- Affiliations
- McMaster University (CA)
- Venue
- Qualitative Health Research
- Publisher
- SAGE Publications
- Published
- 2015-06-10
- Volume
- 25
- Issue
- 8
- Pages
- 1069-1084
- ISSN
- 1049-7323 (ISSN-L)
- 1552-7557
- OpenAlex
- W2112270693
- Cited by
- 46
- References
- 73
- Citations by year
- 2025: 5 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 4 · 2019: 6 · 2018: 8 · 2017: 9 · 2016: 1
- FWCI
- 5.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Qualitative Health Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- McMaster University
- Public Health Agency of Canada
- Canadian Institutes of Health Research (136734)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Keywords
- non-invasive prenatal testing, publicly funded health services, women's experiences, patient values, prenatal decision-making, high-risk pregnancy, diagnostic accuracy, risk perception, timing of testing, Ontario
- MeSH terms
- Adult, Decision Making, Female, Financing, Government, Genetic Testing, Hematologic Tests, Humans, Ontario, Pregnancy, Prenatal Care, Socioeconomic Factors, Time Factors, Qualitative Research, Policy, Grounded Theory
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