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Home page » Research team » Garvelink, Mirjam  

Mirjam Marjolein Garvelink, MSc, PhD

Tel.: 418-525-4444

Twitter: @MMGarvelink


Postdoctoral Student

Research Advisor: Dr. France Légaré, MD, PhD, Professor, Canada Research Chair in Shared Decision Making and Knowledge Translation.



Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval



Visiting researcher (2016-2018), IQ Healthcare, Radboud Universitary Medical Center, Nijmegen, the Netherlands

Visiting researcher (2016-2018), department of Public Health and Primary care (PHEG), Leiden University Medical Center, the Netherlands

PhD in the fields of Shared Decision Making and Gynecology, Leiden University, the Netherlands (2014)

Master’s degree in Epidemiology (Council of the Netherlands Epidemiological Society), the Netherlands (2014)

Master’s degree in Health Sciences, VU University, Amsterdam, the Netherlands (2009)

Bachelor’s degree in Health Sciences, VU University, Amsterdam, the Netherlands (2008)



  • Canadian Institute for Health Research (CIHR), travel grant (accommodation and course registration) to participate to the 2016 TVN Summer program in Aging, May 10-15, Toronto, Canada.
  • January 2015 - Improving Cognitive and jolnt helath Network (ICON), SPINACH-project: SubPortIng seNiors And Caregivers to stay mobile at Home. Principal Investigators. (Budget: 19,974.50$)
  • 2015 - Postdoctoral Fellowship, CIHR (3 years, 40,000$ + 5,000$ every year)
  • 2015 - Postdoctoral Fellowship, FRQ-S (2 years, 30,000$)
  • 2015- Travel awards, CIHR (1,500$)


Research Interests

  • Shared Decision Making
  • Patient's decision aid
  • Knowledge transfer
  • Interprofessional care
  • Caregiver involvement in decision making


Research Projects

Scoping review DCS:

The Decisional Conflict Scale (DCS) was developed in 1995 by Annette O’Connor, to capture decisional conflict in terms of uncertainty related to decision making, as a measure of evaluation for decision support interventions such as patient decision aids (DAs). Since, it has been used in many studies including needs assessments, and development and evaluation of patient decision support interventions. The DCS is available in 4 different formats and validated in 7 different languages. The multitude of contexts, decision types and stages of decision making in which DCS is measured, as well as the many existing versions have created the need to explore 1) overall levels of decisional conflict and 2) how these vary across different clinical and decision contexts, different versions of the DCS, differing participant characteristics, stage of decision making, exposure to DESI’s and norms used, and 3) which of the before mentioned variables are associated with a change in DCS.

Incongruence explained: caregiver engagement and its influence on their different preferences for LOC compared to seniors. (in collaboration with the Leiden University Medical Center):

Secondary analysis of an existing database, with data from questionnaires of 3341 caregivers of the elderly in the Netherlands. We aim to assess factors that predict incongruence about LOC preferences, in order to identify future clinical situations in which the need for SDM is elevated. Additionally, we will assess factors that are associated with different preferences about the preferred LOC (which may be used in the future to initiate discussions about why people have different opinions about this), and factors that are associated with better caregiver involvement in decision making.  Based on these factors we can inform and improve clinical practice.

Qualitative project on shared decision making in dementia care networks:

Secondary analysis of data that has been collected as part of a longitudinal study of decision making in dementia, in which three waves of interviews (n=285) were conducted with the members of dementia carenetworks (I.e. seniors with dementia, informal and formal caregivers). With this data we aim to explore LOC decision-making processes of caregivers, seniors and health professionals, their experiences and how contextual factors (e.g. policy, geography, culture, use of DSI, socio demographic and medical factors) may influence these.


The TVN project aims to improve the decision process about location of care with the frail elderly and their caregivers. A training program has been developed to teach doctors and interprofessional teams how to share decision-making with their frail elderly patients.

This program was found effective in one Quebec City and one Edmonton home care team. In this project we will study whether the intervention is also effective on a broader scale; i.e. 16 home care teams attached to community health centres across the province of Quebec, and compare the results with what happens when no-one has done the training.

Home care is a rapidly growing sector and this study will lay the foundations of a national strategy to improve the decision making process about potential transition to care facilities for aging Canadians.


Most seniors prefer to stay at home and live independently for as long as possible, even when they face a severe loss of mobility and need additional care. To provide older adults and their caregivers with options on how to keep mobile in their current residence, we aimed to develop and pilot test interactive, adaptable video vignettes. We sought to systematically develops videos that were intended to support seniors, caregivers and the heathcare team in deciding how a person can remain mobile at home, and include practical solutions from an interprofessional (IP) point of view.

Mixed methods knowledge synthesis on caregiver involvement in decision making :

A mixed-methods knowledge synthesis in which quantitative and qualitative data were analyzed separately according to their respective research designs and then triangulated. In order to improve caregivers' involvement in decision making with their senior loved ones as well as to contribute to developing support services for caregivers, we sought to assess the effectiveness of the interventions aimed at improving the involvement of caregivers in decision-making with seniors, and describe how caregivers experience decision-making in the absence of interventions.


One of the most difficult decisions for seniors and informal caregivers is about location of care (LOC), i.e. moving or staying home with services and supports. The LOC decision is influenced by the needs and preferences of seniors, caregivers, the interprofessional (IP) healthcare team, and by contextual factors such as regional policy, geography, cultural and institutional values. The relative impact of all these factors on decision-making is unknown. Consequently, we aim to analyze and compare how contextual factors (e.g policy, geography, culture, use of DSI) influence the experience of caregivers and others involved in LOC decisions in 4 regions (Quebec/Alberta, Canada and South-Holland/Gelderland, the Netherlands) in a multiple-case, mixed-methods study grouped into 4 provinces.



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