Youth opinions about Title X funding and policy in the United States: A mixed methods text message survey

We aim to assess youth awareness of and opinions about Title X policy changes in 2019. We analyzed data from four open-ended questions and demographic items collected through MyVoice, a national text message survey of youth aged 14–24. We calculated descriptive statistics to summarize awareness of and opinions about Title X. We integrated the quantitative findings with qualitative themes to achieve deeper understanding of the beliefs that inform youth opinions. Seven hundred and fifty youth responded to the text message survey (58.0% response rate). The majority (74.9%) was unaware of recent Title X changes. Most (79.3%) were unsupportive of these changes, and a sizable portion (40%) worried these changes could impact them. Opposition to Title X changes was based upon five themes: (1) youth need to be aware of their health options, including abortion; (2) the policy will undermine reproductive rights; (3) the policy is unfair; (4) the policy is unconstitutional; (5) the policy will threaten public health and health services, including affordable and safe abortion. Those who supported Title X changes (13.8%) described moral objections to abortion and beliefs that the government should not be responsible for abortion care. Most youth in this sample were unsupportive of Title X changes. Limited youth awareness of Title X changes suggests that better youth outreach is needed regarding sexual and reproductive health (SRH) policies. Although youth represent 40% of clients who receive SRH services through Title X, more efforts are needed to inform and engage them in salient policy changes that may directly affect their SRH health and health care access.