A project conducted by Child Trends with funding from the Office of Population Affairs in the U.S. Department of Health and Human Services

Project Background and Description

Publicly funded family planning centers are a critical source of family planning services in the United States, especially for low-income individuals. Since 2000, the number of U.S. women in need of publicly funded family planning services has risen, but the proportion of likely need for public support that is met by publicly funded providers has fallen. The Title X Family Planning Program, administered by the Office of Population Affairs (OPA), is the only federal program designed specifically to provide comprehensive family planning and related preventive health services to individuals. In 2016, 58 percent of women who received contraceptive care at a family planning clinic did so at a Title X-funded site.

Through a grant from OPA, Child Trends is conducting a study to help publicly funded family planning providers better meet the health care needs of their clients—particularly the needs of underserved populations, such as racial/ethnic minorities, populations with limited English proficiency, adolescents, and populations in rural areas. Our findings will deepen the field’s understanding of the characteristics and needs of family planning clients, as well as service provision by family planning providers, and will offer insight into innovative practices in the field related to client satisfaction, service delivery, and staffing.

Study Activities

The study is being implemented from 2019 to 2022 and will use both quantitative and qualitative research methods. For the quantitative component, the Child Trends study team will analyze data from the National Survey of Family Growth (NSFG), the Family Planning Annual Report (FPAR), and the Survey of U.S. Publicly Funded Family Planning Clinics (Clinic Survey). For the qualitative component, we will collect and analyze data from in-depth interviews with up to 100 family planning service providers (half in Year 1 and half in Year 2). The study will address the following priority areas:

  • Priority Area 1 – Client characteristics and current services (including fertility awareness-based methods, or FABM): Child Trends will analyze NSFG data to understand the changing characteristics of family planning clients. We will also analyze data from interviews with family planning providers to gain insight into how and why services are changing, with a particular focus on the use of FABM and the opportunities and barriers related to this method. We will disseminate materials describing trends in the characteristics of women using family planning services and offer provider perspectives regarding FABM.
  • Priority Area 2 – Client satisfaction: Child Trends will analyze data from interviews with family planning providers to understand whether and how providers measure clients’ satisfaction, and whether and how providers use client satisfaction data to improve clinic practices. We will disseminate findings regarding best practices and approaches for collecting and using client satisfaction data, with a focus on informing clinics’ ability to serve underserved populations.
  • Priority Area 3 – Innovative service delivery approaches: Based on analyses of data from interviews with family planning providers, Child Trends will highlight innovative service delivery approaches—both general approaches and those intended to reach underserved populations. We will also analyze NSFG, FPAR, and Clinic Survey data to understand trends in service delivery over time. The team will disseminate materials that identify and illustrate successes, challenges, and lessons learned about expanding family planning service delivery.
  • Priority Area 4 – Workforce composition and staffing: Child Trends will analyze data from interviews with family planning providers to understand how clinics are changing their staffing, training practices, operations, funding streams, or services to be responsive to a changing client population, with particular attention to the rural/urban divide. We will also analyze FPAR data to understand trends in workforce composition at family planning clinics. The team will identify and disseminate promising approaches to staffing in challenging workforce environments for other providers.

Project Contacts

Child Trends key contacts

Federal program officer

The project described is supported by Grant Number 1 FPRPA006070-01-00 from the Department of Health and Human Services Office of Population Affairs. Contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services or the Office of Population Affairs.