PRP181: The role of Title X in US Community Health Centers, 2016-2018: work in progress

Blair Darney, PhD, MPH; Frances Biel; Jee Oakley; Erika Cottrell, PhD, MPP


Context: Community health centers (CHCs) are a crucial source of care for reproductive-aged women, providing care regardless of insurance status. The federal Title X family planning program provides funding for clinics to provide family planning and reproductive health services; many Title X grantees are CHCs. Research has demonstrated that Title X clinics provide high-quality contraceptive services, and better access to effective methods (especially long-acting reversible or LARC methods) than non-Title X clinics. However, evidence to date relies on clinic-level reporting, focuses only on reproductive-health-focused clinics, or is limited to single states.

Objective: We describe rates of overall contraceptive visits and provision of hormonal and LARC (IUD and implant) methods across a network of CHCs 2016-2019. We compare patient, clinic, and state-level factors associated with provision of LARC methods in Title X and non-Title X clinics.

Study Design: Retrospective cohort of CHC patients; we calculate crude and adjusted rates using generalized estimating equations.

Setting/Dataset: OCHIN and HCN network of CHCs located in 20 states, 2016-2019.

Population studied: Primary and women’s health care clinics within the OCHIN and HCN research networks serving reproductive aged adolescents and women, ages 15-49.

Outcome measures: Rate of contraception-related visits, and rates of receipt of IUDs, implants, or hormonal contraception.

Results: We anticipate that rates of IUDs and implants will be higher at clinics receiving Title X funding. We anticipate that there will be state-level differences in Title X clinic performance.

Conclusion: Results will provide an essential baseline for Title X program performance in CHCs prior to recent changes to the Title X program that impacted program participation and requirements.
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Emily Godfrey 11/24/2020

Blair and colleagues-Great study! THank you so much for this wonderful information and for highlighting the importance of Title X grant funding! I hope you make this study into a policy brief so that we can let our politicians know how important this program is for preventing unintended pregnancies.

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