{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:38:33Z","timestamp":1780576713406,"version":"3.54.1"},"reference-count":38,"publisher":"Guttmacher Institute","issue":"1","license":[{"start":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T00:00:00Z","timestamp":1454457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>CONTEXT<\/jats:title><jats:p>Understanding the nature of rural\u2013urban variation in U.S. family planning services would help address disparities in unmet contraceptive need.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>In 2012, some 558 Title X\u2013supported clinics in 16 Great Plains and Midwestern states were surveyed. Rural\u2013urban commuting area (<jats:styled-content style=\"fixed-case\">RUCA<\/jats:styled-content>) codes were used to categorize clinic locations as urban, large rural city, small rural town or isolated small rural town. Bivariate analyses examined key domains of service provision by <jats:styled-content style=\"fixed-case\">RUCA<\/jats:styled-content> category and clinic type.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The proportion of clinics offering walk\u2010in appointments was lower in isolated small rural towns (47%) than in the other <jats:styled-content style=\"fixed-case\">RUCA<\/jats:styled-content> categories (67\u201373%). Results were similar for sites that do not specialize in family planning or reproductive health, but no variation was seen among specialty clinics. Overall, availability of evening or weekend appointments varied in a linear fashion, falling from 73% in urban areas to 29% in isolated small rural towns. On\u2010site provision of most hormonal methods was most common in urban areas and least common in isolated small rural towns, while provision of nonhormonal methods was similar across <jats:styled-content style=\"fixed-case\">RUCA<\/jats:styled-content> categories. Sixty percent of clinics provided <jats:styled-content style=\"fixed-case\">IUDs<\/jats:styled-content> or implants. For clinics that did not, the only barriers that varied geographically were low <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content> demand and lack of trained <jats:styled-content style=\"fixed-case\">IUD<\/jats:styled-content> providers; these barriers were most common in isolated rural towns (42% and 70%, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>While important characteristics, such as clinics\u2019 specialization (or lack thereof), are linked to the provision of family planning services, geographic disparities exist.<\/jats:p><\/jats:sec>","DOI":"10.1363\/48e7116","type":"journal-article","created":{"date-parts":[[2016,2,3]],"date-time":"2016-02-03T19:33:55Z","timestamp":1454528035000},"page":"9-16","source":"Crossref","is-referenced-by-count":32,"title":["Differences in Family Planning Services by Rural\u2013urban Geography: Survey of Title X\u2013Supported Clinics In Great Plains and Midwestern States"],"prefix":"10.1363","volume":"48","author":[{"given":"Summer L.","family":"Martins","sequence":"first","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Starr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, William Beaumont School of Medicine Oakland University  Rochester, MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy L.","family":"Hellerstedt","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health, School of Public Health University of Minnesota  Minneapolis"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Gilliam","sequence":"additional","affiliation":[{"name":"Division of Biological Sciences University of 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