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Family Planning Research Awards

Service Delivery Improvement Research Grants

OPA Announces New Family Planning Service Delivery Improvement Research Cooperative Agreements

FY 2012 Awards

OPA recently awarded two Family Planning Service Delivery Improvement Research Cooperative Agreements for three-year project periods (9/1/2012 - 8/31/2015):

Emory University
School of Medicine, Atlanta, GA 30322
Principal Investigator: Anne Lang Dunlop, MD, MPH

Outcome and Translatability Evaluation of a Client-Centered Counseling Toolkit in Title X Settings

This project will evaluate the impact and translatability of a comprehensive Contraceptive Counseling and Reproductive Health Promotion (CC-RHP) Toolkit that incorporates evidence-based approaches in the Title X setting. The first phase of the study will gather feedback from clients and providers to refine the evidence based-model used in the CC-RHP Toolkit. In phase two, a client-level outcome evaluation, consisting of a cluster randomized controlled trial within a Title X clinic, will test the efficacy of the CC-RHP Toolkit compared to the information usually provided to clients, on clients’:

  • selection of highly-effective, long-acting reversible methods;
  • correct and consistent use of a method; risk of conception of a pregnancy that is unintended;
  • exposure to substances (use of tobacco, risky alcohol use or illicit drugs);
  • exposure to sexually transmitted infections;
  • use of preconception folic acid; and
  • averted pregnancies.

Finally, the impact of the toolkit on providers’ performance of contraceptive counseling and other reproductive health promotion practices will be evaluated by measuring provider and client acceptability and satisfaction with aspects of the family planning encounter pre- and post-implementation of the toolkit.

New York University
665 Broadway, Suite 801, New York, NY 10012
Principal Investigator: James Jaccard, PhD

Improving Contraceptive Counseling in the United States

This project will develop a contraceptive counseling protocol (CCP) grounded in scientific evidence and evaluate the CCP’s effectiveness in promoting behaviors conducive to preventing unintended pregnancy among women attending Title X clinics. During the first 9 months, researchers will develop and refine the CCP by conducting focus groups and in-depth interviews with key Title X clinic administrators, contraceptive counselors, and clients. The CCP, in addition to reinforcing traditional medical information on methods of contraception, will reflect practical and scientifically grounded principles for effective decision making and provider-client communication based on an extensive review of research on contraceptive behavior. Phase two of the project will evaluate the CCP. Ten clinics will be randomly assigned to one of two groups. One group will continue treatment as usual, while the other will use the newly developed CCP. Approximately 135 women will be enrolled in each clinic, yielding a total of 1,350 participants. Immediately following their counseling session, women will complete a computer-administered interview that serves as a fidelity check and permits evaluation of the impact of the CCP on the effectiveness of the chosen method and counseling satisfaction. All women will be re-interviewed by phone 6 and 12 months later. Gaps in protection, accuracy/consistency of contraceptive use, and method switching will be assessed at that time. The effect of the CCP on these outcomes will be analyzed with the results disseminated in the final 3 months of the project.

Service Delivery Research Grants

FY 2010 Awards
OPA Family Planning Service Delivery Improvement Research Awards
Improving Family Planning Counseling via a Computerized Tool

Grantee Organization
Research Triangle Institute
PO Box 12194
Research Triangle Park, NC 27709
Principal Investigator:
Ellen Wilson, Ph.D.
Project Period: 9/1/2010 – 8/31/2013

The objective of this project is to develop and test an interactive, multimedia, Web-based Family Planning Counseling Aid (FPCA). The FPCA is designed to be a low-cost tool that will improve clinic efficiency by enhancing the quality of FP services without increasing the providers' counseling workload. This decision aid is expected to help identify contraceptive methods best suited to the client and learn more about them.

Specific aims are to develop the FPCA; assess the feasibility of integrating the FPCA into FP clinics' workflow and the usability of the tool by both clients and providers; and assess the impact of the FPCA on the quality and content of counseling. Study sites will be two FP clinics--a county health department and a Planned Parenthood clinic. To develop the FPCA, existing counseling and decision support tools will be reviewed and input will be sought from an expert panel. To ensure that the FPCA meets the needs of both patients and clinicians, pretests will be conducted and focus groups will be conducted with clients and interviews conducted with clinicians.

It is believed that the FPCA will help patients be better informed and more engaged in the counseling process and make more realistic contraceptive choices and will help clinicians tailor their counseling to be more patient centered The expectation is that the improved counseling will help increase women's satisfaction with their contraceptive method and the effectiveness of their contraceptive use.

Improving Intrauterine Device Service Provision in Title X clinics in Chicago

Grantee Organization:
University of Chicago
Obstetrics & Gynecology
5841 S. Maryland Avenue
Chicago, Illinois 60637
Principal Investigator:
Melissa Gilliam, MD, MPH
Project Period: 9/1/2010 – 8/31/2013

The proposed study will focus on decreasing the rate of unintended pregnancy among young women (ages 15-25) by improving the delivery of intrauterine device (IUD) services in the Title X family planning setting. This research will use a mixed-methods (qualitative and quantitative) approach - Failure Modes Effects and Criticality Analysis (FMECA) - to understand and improve IUD service delivery. FMECA is one of several safety risk assessment techniques commonly used in industries outside of healthcare (e.g., nuclear energy, aviation) and represents the first application of safety risk assessment in the field of family planning. In the FMECA, the clinicians and staff who provide clinical care delineate each step in the processes and systems involved in the delivery of care. The detailed description of the steps in the systems and processes of care are then graphically translated into a process "map." For the ANALYSIS, each step on the "map" is further qualified to assess the systems or parts of a system that perform in an undesirable or unintended way (FAILURES), the ways in which the systems fail (MODES), consequences of a failure mode (EFFECTS). A composite score reflecting the frequency, consequence of an error, and any safeguards mitigating the failure (CRITICALITY), can be assigned to each step. This technique predicts how and where systems and processes have vulnerabilities or safety risks that can impair women's ability to obtain desired IUDs.

Same Day Insertion of Intrauterine Devices (IUDs) or Implants for Women seeking Emergency Contraception (EC) or Pregnancy Testing

Grantee Organization:
University of Pittsburgh
230 McKee Place, Suite 600
Pittsburgh, PA 15213
Principal Investigator:
Eleanor, Schwarz, M.D.
Project Period: 9/1/2010 – 8/31/2013

This study will evaluate the effect of structured counseling about highly effective reversible contraceptives and the offer of same-day placement of an IUD or contraceptive implant on knowledge, attitudes, and use of highly effective reversible contraception three months after women seek EC or pregnancy testing from a Title X clinic. The study investigators will also assess rates of testing and treatment for pelvic inflammatory disease in the 3 months following a visit to a Title X clinic operating under one of the three distinct service delivery protocols, with particular attention to those women who opt for same-day IUD insertion. Data will be collected at the time of each participant's initial visit to the study clinic and 3 months after the visit by telephone interview. Additional relevant data will be abstracted from the study clinic's medical records. The projected sample will consist of 1200 subjects between the ages of 15 and 45 years. This study will provide clinicians and policymakers with important information regarding the feasibility, acceptability, safety and effectiveness of offering structured counseling and same-day access to IUDs and contraceptive implants for women seeking EC or pregnancy testing from Title X clinics.

Increasing Efficiency and Utilization of Family Planning Services through Systematic Integration

Grantee Organization:
Georgetown University
4301 Connecticut Ave, NW Ste 310
Washington, DC 20008
Principal Investigator:
Rebecka Lundgren, MPH
Project Period: 9/1/2010 – 8/31/2013

Systematic Screening is an evidence based practice successfully tested in developing countries, that typically consists of designing and using an algorithm of five to ten questions for a provider to ask a client and depending on the answer, the provider offers the service to meet the identified service needs of the client or asks another question to identify the need for a different service. This study will explore whether Systematic Screening is a feasible and effective strategy in achieving the following aims: (1) increase the use of family planning (FP) and sexually transmitted infection (STI) services among women and men by integrating FP counseling with diabetes care and other services; and (2) increase clinic efficiency by increasing the number of services provided in a single visit. This study is a collaborative effort between Golden Valley Health Centers (GVHC) and Georgetown University's Institute for Reproductive Health (IRH). Formative research will be conducted to determine the best approach for integrating Systematic Screening into GVHS services. This study will contribute to existing knowledge regarding strategies to increase the use of FP services among vulnerable populations in the U.S., particularly in Title X programs.

Natural Family Planning Research Grants

FY 2008 Awards
Natural Family Planning Research Grants

Family Planning Male Research Cooperative Agreements

FY 2008 Awards
Family Planning Male Research Cooperative Agreements

Special Studies

FY 2008
Analysis of the Effectiveness of Title X Family Planning Providers' Use of the 340B Drug Pricing Program (pdf, 868 kb)
340B Evaluation Report Now Available - Assessment of Strategies for Providing Culturally Competent Care in Title X Family Planning Clinics