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Conclusion

During the past decade, several changes have taken place in the United States that have affected the delivery of SRH care, including family planning services, and the understanding of what constitutes quality. This broader context has been accounted for in designing these recommendations. This update of the QFP expands on previous recommendations on providing person-centered SRH care and expands the definition of quality to include individuals’ needs, values, and preferences. 

During the past decade, several changes have taken place in the United States that have affected the delivery of SRH care, including family planning services, and the understanding of what constitutes quality. This broader context has been accounted for in designing these recommendations. This update of the QFP expands on previous recommendations on providing person-centered SRH care and expands the definition of quality to include individuals’ needs, values, and preferences.

In addition to incorporating new evidence, this update incorporates newer approaches to care, including adopting a health equity lens and recognizing the impact of structural and interpersonal racism, classism, ableism, and bias based on sexual orientation and/or gender identity on health and SRH care. The aim is to enable a broad range of health care providers to help ensure that all people, regardless of individual characteristics can have their SRH needs met. Specific updates include an expanded emphasis on person-centeredness and equity, an explicit gender-inclusive approach, and use of language throughout to recognize that people of all genders may need and access SRH care and center the needs of groups and individuals who experience SRH inequities in shaping the recommendations, rather than considering "special populations" separately.

Additionally, the evidence supports a recommendation to discuss reproductive desires with a person-centered approach that focuses on open-ended communication and nonjudgmental counseling and does not endorse a single framework to achieve these discussions. Additional technical content includes (1) guiding principles and details on approaches to care to help providers carry out these guiding principles, (2) new care delivery strategies, like telehealth and over-the-counter (OTC) oral contraception, (3) a broader content on early pregnancy management and resources, (4) and expanded approach to family building, (5) new or expanded preventive health care services related to mental health, healthy weight, perimenopausal care, gender-affirming care, and human trafficking, (6) new STI and HIV prevention strategies, including self-care approaches and postand pre-exposure prophylaxis (PEP and PrEP).

The new recommendations also include care for a broad range of provider specialties in varied settings both within and beyond the formal health care system, including patient-led and self-care options and intentionally incorporate published scientific evidence and existing guidelines, and include more expansive types of evidence. In sum, these recommendations intend to set the standard of SRH care and can be used by all current and future providers of SRH services in varied settings, including primary care, specialty care (for example, obstetrics/gynecology, neurology, and rheumatology), and community settings (for example, mobile clinics, schools, and pharmacies). These recommendations are specifically intended for all current or potential providers of SRH services, including those funded by the Title X program. 

OPA will update the QFP recommendations periodically to reflect new findings in the scientific literature and revisions to the clinical guidelines referenced in this update of the QFP.

Declaration of Interest Statement

All authors report no conflict of interest. The study sponsor (Department of Health and Human Service, Office of Population Affairs; contract #HHSP233201500035I) played a role in study design; reviewing the report; and the decision to submit the report for publication.

Acknowledgements

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services. References to nonfederal sites on the Internet are provided as a service to QFP readers and do not constitute or imply endorsement of these organizations or their programs by OPA or the U.S. Department of Health and Human Services. OPA is not responsible for the content of these sites. URL addresses listed in QFP were current as of the date of publication.

Funding

No financial disclosures were reported by the authors of this paper.

Credit Author Statement

  • Sarah Romer: Conceptualization, methodology, formal analysis, writing-original draft, writing—review and editing, supervision. 
  • Jennifer Blum: Conceptualization, methodology, formal analysis, writing-original draft, writing—review and editing, supervision.
  • Sonya Borrero: Conceptualization, methodology, formal analysis, writing-original draft, writing-review and editing, supervision.
  • Jacqueline Crowley: Formal analysis, writing-original draft, writing-review and editing. 
  • Jamie Hart: Conceptualization, methodology, formal analysis, writing-original draft, writing— review and editing, supervision. 
  • Maggie Magee: Formal analysis, writing-original draft, writing—review and editing. 
  • Jamie Manzer: Conceptualization, methodology, formal analysis, writing-original draft, writing—review and editing, supervision. 
  • Lisa Stern: Conceptualization, methodology, formal analysis, writing original draft, writing—review and editing, supervision.