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Expansion of RTI Rarity™ project aims to gain insights to improve equitable access to publicly funded family planning services
RESEARCH TRIANGLE PARK, N.C. — RTI International, a nonprofit research institute, has been selected as a Title X Family Planning Research Grant awardee by the Office of the Assistant Secretary for Health’s (OASH) Office of Population Affairs (OPA). Researchers will analyze data related to equitable access to a broad range of family planning methods and preventive health services that are funded by the Title X National Family Planning Program to help individuals achieve or prevent pregnancy. The $986,000 contract, to be carried out through August 2025, expands the RTI Rarity™ project.
Research shows that in the U.S., people who are marginalized due to non-medical risk factors, such as age, race, ethnicity, income or insurance status, are more likely to face inequitable access to sexual and reproductive health services and experience worse outcomes. Through the Title X Family Planning Research Grants, OPA aims to gain insights that will improve the delivery of family planning services and expand equitable access to quality sexual and reproductive health services offered under Title X of the Public Health Service Act.
The project will be led by senior RTI researchers Christina Fowler, Ph.D. and Lisa M. Lines, Ph.D. The research team will adapt RTI Rarity’s Local Social Inequity model, an “artificially intelligent” approach to risk adjustment for local social determinants of health, to include sexual and reproductive health (SRH) outcomes. The team will use the new Local Social Inequity in Sexual and Reproductive Health (LSI-SRH) scores to study the placement and characteristics of Title X family planning service sites in relation to local social inequities in the communities they serve. The study will focus on the Title X service network across all 50 states and the District of Columbia, with an in-depth exploration of equitable access in California’s Title X program.
“We are looking forward to advancing the goal of equitable access to Title X family planning services by developing the LSI-SRH scores,” said Dr. Lines. “The new scores will use community-level data on social risks and health policies to predict sexual and reproductive health outcomes. The resulting LSI-SRH scores could help shape site policies and services and direct funds and other assistance to Title X service sites that serve communities at higher risk of worse health outcomes, such as teen pregnancy and sexually transmitted diseases.”
For the project, RTI is partnering with Essential Access Health, a nonprofit organization that promotes and champions health equity and quality SRH care. Essential Access has been a Title X grantee since the program was established in 1970. It currently administers the Title X federal family planning program in California and Hawaii. California’s Title X program is the largest and most diverse system in the nation with nearly 400 service sites in more than 20 counties.
Researchers will utilize data from Essential Access’s Title X service network to explore ways of using the LSI-SRH scores to measure equitable access to Title X services in California. The research team will also study the challenges and barriers faced by Title X service sites in implementing equitable access solutions.
“We are excited to partner with Essential Access Health to explore relationships between the placement and characteristics of Title X funded service sites and levels of social inequity in the communities where they are located,” said Dr. Fowler. “As one of several initiatives funded by the Office of Population Affairs, this study will produce actionable information that contributes to OPA’s efforts to ensure equitable access to high-quality sexual and reproductive health services, including family planning.”
