OPA trends: innovative strategies to expand equitable access to family planning services - the context within which title x clinics operate has changed dramatically in recent years

Rule changes have led to a significant number of clinics leaving and returning to the program; the covid-19 pandemic transformed how services are provided; and state-level policies continue to impede access to sexual and reproductive health (SRH) services for many. Meanwhile, there has been a growing understanding of the disparities in SRH care and wellbeing, including for people of color and for lgbtq+ populations. These changes underscore the critical need to help publicly funded family planning centers improve equitable access to high quality services and to ensure client-centered care across populations, particularly those that are historically underserved. In collaboration with OPA, child trends will implement a set of research and dissemination activities with the broad goal of helping title x providers identify innovative and effective strategies to expand equitable access to high quality family planning services and to improve clients' experiences. We will address three of the four OPA research priorities within four objectives. We will: 1) describe strategies for expanding equitable access to quality family planning (priority a); 2) identify existing and emerging approaches to improving client experiences with family planning care (priority d); 3) enhance the field's understanding of best practices and approaches for collecting, assessing, and using data on client satisfaction and how that is informing providers' ability to reach underserved populations (priority d); and 4) expand the field's understanding of family planning service delivery via telehealth and other covid-related innovations (priority b). We will focus on historically underserved populations (people of color, lgbtq+, individuals in underserved or resource limited areas), incorporating an equity lens into all research, from protocol development to data collection, analysis, and dissemination. To meet these research objectives, we propose a mixed methods approach, collecting and analyzing in-depth data from family planning clients (via surveys and interviews) and providers (via interviews with clinic staff). This work will build on the project team's extensive experience working with OPA, title x project officers, and grantees to conduct interviews with service sites across title x regions; highlighting strategies and lessons learned during the covid-19 pandemic (2020-21); recruiting and interviewing family planning clients; and conducting survey design, data collection and analysis with adolescents and young adults in the area of SRH. The project team will engage service delivery grantees throughout the grant for feedback on our research and how to best fill knowledge gaps, allowing US to effectively translate our research into actionable recommendations. We will leverage our expert communications team to ensure that findings and actionable recommendations reach stakeholders, including title x and other publicly funded family planning providers, researchers, and policymakers. This project will benefit the family planning field by taking an equity-based approach to examining issues across multiple priority areas from the perspectives of both providers and clients and disseminating new knowledge via actionable recommendations relevant to title x audiences who are working to increase equitable access and improve client experience of care.