Accelerated Campaign to Enhance STD Services (ACCESS) for youth: successes, challenges, and lessons learned.
OBJECTIVE
Adolescents have the highest sexually transmitted disease (STD) incidence and are often hard to reach with preventive services. Fourteen youth-focused projects were funded by the Centers for Disease Control and Prevention in 1994 through 1995 to pilot innovative, locally relevant, locally acceptable approaches; expand the range and accessibility of services beyond clinic-based facilities; and stimulate increased commitment of local resources.


METHODS
Review and synthesis of 14 youth-focused, innovative projects.


RESULTS
Most projects undertook multiple interventions (11/14) in multiple venues (9/14). The majority (9/14) incorporated behavioral interventions, and half offered clinical services in nontraditional settings such as detention facilities, schools, parks, and parking lots. Six projects used peer volunteers; four worked with community coalitions. Most (12/14) obtained local resources. Where assessed, parental support was strong for providing STD prevention services.


CONCLUSIONS
These projects increased the access and range of services available to a substantial number of high-risk youth with high STD rates. However, sustaining and scaling-up pilot project activities will be resource intensive. Increased financial and training support to augment evaluation capacity will be critical for innovation to become an integral part of STD prevention programs.
DeLisle
S
S
National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Wasserheit
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JN
D000293:Adolescent; D016497:Adolescent Health Services; D002487:Centers for Disease Control and Prevention, U.S.; D005260:Female; D006078:Government Programs; D006801:Humans; D008297:Male; D011314:Preventive Health Services; D015397:Program Evaluation; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D014481:United States