title: 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.
authors.affiliation: McMaster University, Hamilton, Ontario, Canada Meredith.vanstone@mcmaster.ca.
authors.forename: Meredith
authors.initials: M
authors.lastname: Vanstone
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Karima
authors.initials: K
authors.lastname: Yacoub
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mita
authors.initials: M
authors.lastname: Giacomini
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Hulan
authors.affiliation: McMaster University, Hamilton, Ontario, Canada.
authors.forename: Sarah
authors.initials: S
authors.lastname: McDonald
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D005380:Financing, Government; D005820:Genetic Testing; D066296:Grounded Theory; D006403:Hematologic Tests; D006801:Humans; D009864:Ontario; D057766:Policy; D011247:Pregnancy; D011295:Prenatal Care / Q000523:psychology*; D036301:Qualitative Research; D012959:Socioeconomic Factors; D013997:Time Factors
keywords: Ontario, Canada; health policy; health technology; non-invasive prenatal testing; patient values; prenatal screening; prenatal testing; qualitative research