title: Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.
abstract: This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations.
  
  
  
  Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each.
  
  
  
  Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices.
  
  
  
  Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types.
  
  
  
  As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess change as implementation of recent family planning service recommendations continues.
authors.affiliation: Centers for Disease Control and Prevention, Division of STD Prevention, 1600 Clifton Road, MS-E-80, Atlanta, GA, 30329, USA. Electronic address: Acq0@cdc.gov.
authors.forename: Marion W
authors.initials: MW
authors.lastname: Carter
authors.affiliation: Office of the Assistant Secretary of Health, Office of Population Affairs, 1101 Wootton Parkway, Suite 700, Rockville, MD 20852, USA.
authors.forename: Loretta
authors.initials: L
authors.lastname: Gavin
authors.affiliation: Centers for Disease Control and Prevention, Division of Reproductive Health, 4770 Buford Highway NE, Mailstop F-74, Chamblee, GA 30341-3717, USA.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Zapata
authors.affiliation: Oak Ridge Institute for Science and Education, based at the Centers for Disease Control and Prevention, Division of STD Prevention, 1600 Clifton Road, MS-E-80, Atlanta, GA 30329, USA.
authors.forename: Marta
authors.initials: M
authors.lastname: Bornstein
authors.affiliation: Office of the Assistant Secretary of Health, Office of Population Affairs, 1101 Wootton Parkway, Suite 700, Rockville, MD 20852, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Mautone-Smith
authors.affiliation: Office of the Assistant Secretary of Health, Office of Population Affairs, 1101 Wootton Parkway, Suite 700, Rockville, MD 20852, USA.
authors.forename: Susan B
authors.initials: SB
authors.lastname: Moskosky
mesh_terms: D000293:Adolescent; D000328:Adult; D003151:Community Health Centers / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003695:Delivery of Health Care; D005193:Family Planning Services / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government; D006801:Humans; D016015:Logistic Models; D008297:Male; D011787:Quality of Health Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000517:prevention & control; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
keywords: Contraceptive counseling; Contraceptive methods; Title X; Youth-friendly services