In the Notice of Funding Opportunity: Title X Family Planning Research Grants (No. PA-FPR-22-001), the Office of Population Affairs (OPA) seeks proposals to conduct research that identifies innovative and effective strategies to (1) expand equitable access to quality Title X-funded services, and (2) to provide Title X family planning services in resource-limited areas. RTI International, in partnership with Essential Access Health (EAH), proposes a multipronged, mixed-methods study that addresses Priority Area (a): Innovative Strategies to Increase Equitable Access. The study’s goal is to increase knowledge and understanding among Title X stakeholders of contextual and site-level factors shaping equitable access to Title X services so that they can use this information to guide program requirements, resource allocation, site placement, and site-level program strategies. The study will: (1) develop and test innovative ways to measure and monitor equitable access to Title X services using a composite social determinants of health (SDoH) measure (“local social inequity score”) adapted for sexual and reproductive health (“LSI-SRH scores”) and routine, site-level Title X administrative data (e.g., geographic location, operating hours) for all 50 states and the District of Columbia; (2) identify and compile information and seek expert input on evidence-based strategies used by primary health safety net providers to increase equitable access that are relevant to Title X; (3) develop and test potentially replicable analytic strategies, using the LSI-SRH scores and a wider set of site-level measures (e.g., site administrative characteristics, contraceptive use, chlamydia screening), to assess equitable access in California’s Title X service network; and (4) solicit feedback from California’s Title X subrecipients on these findings and the barriers, challenges, and opportunities they perceive for implementing strategies to increase equitable access. If FP
AR 2.0 data are available in Year 3, we will incorporate additional site-level measures into the national-level analyses of equitable access. We will disseminate study results to OPA and other Title X stakeholders on an ongoing basis during the 3-year study period. Dissemination strategies include results memos (internal to study team and OPA) for each study, annual presentations at the Title X grantee and other stakeholder meetings, three manuscripts for submission to peer-reviewed journals, and briefs and other publications for posting to OPA’s website.