title: Enhancing service delivery through title x funding: findings from California.
abstract: BACKGROUND
  The federal Title X grant program provides funding for family planning services for low-income women and men. In California, all clinics receiving Title X funds participate in the state's family planning program, Family PACT, along with other public and private providers. The relative extent to which Title X-funded clinics and other Family PACT providers have incorporated enhancements beyond their core medical services has never been studied.
  
  
  METHODS
  In 2010, a survey was sent to public- and private-sector Family PACT clinicians to assess whether funding streams were associated with the availability of special services: extended clinic hours, outreach to vulnerable populations, services for clients not proficient in English and use of advanced clinic-based technologies. Bivariate and logistic regression analyses controlling for potentially confounding factors were conducted.
  
  
  RESULTS
  Greater proportions of Title X-funded clinics than of other public and private providers had Spanish-speaking unlicensed clinical staff (89% vs. 71% and 58%, respectively) and Spanish-language signs (95% vs. 85% and 82%). Title X-funded providers were more likely than other public providers to offer extended clinic hours, provide outreach to at least three vulnerable or hard-to-reach populations, and use three or more advanced technologies (odds ratios, 2.0-2.9).
  
  
  CONCLUSIONS
  Compared with other Family PACT providers, clinics that receive Title X funding have implemented greater infrastructure enhancements to promote access and improve the quality of service for underserved populations. This may be because Title X-funded providers have more financial opportunities to provide the array of services that best respond to their clients' needs.
authors.affiliation: Bixby Center for Global Reproductive Health, University of California, San Francisco, CA, USA. thielh@obgyn.ucsf.edu
authors.forename: Heike Thiel
authors.initials: HT
authors.lastname: de Bocanegra
authors.forename: Fran
authors.initials: F
authors.lastname: Maguire
authors.forename: Denis
authors.initials: D
authors.lastname: Hulett
authors.forename: Kathryn
authors.initials: K
authors.lastname: Horsley
authors.forename: Maryjane
authors.initials: M
authors.lastname: Puffer
authors.forename: Claire D
authors.initials: CD
authors.lastname: Brindis
mesh_terms: D000554:Ambulatory Care Facilities / Q000191:economics / Q000458:organization & administration*; D002140:California / Q000453:epidemiology; D005193:Family Planning Services / Q000191:economics / Q000458:organization & administration*; D005260:Female; D005380:Financing, Government; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D020380:Needs Assessment / Q000458:organization & administration; D011203:Poverty / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017149:Private Sector / Q000458:organization & administration; D017150:Public Sector / Q000458:organization & administration; D011787:Quality of Health Care; D035862:Vulnerable Populations / Q000706:statistics & numerical data*