Accelerated campaign to enhance STD services (ACCESS) for youth - Successes, challenges, and lessons learned

Background and Objectives: Adolescents have the highest sexually transmitte d disease (STD) incidence and are often hard to reach with preventive servi ces, Fourteen youth-focused projects were funded by the Centers for Disease Control and Prevention in 1994 through 1995 to pilot innovative, locally r elevant, locally acceptable approaches; expand the range and accessibility of services beyond clinic-based facilities; and stimulate increased commitm ent of local resources. Design: 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 deten tion facilities, schools, parks, and parking lots. Six projects used peer v olunteers; four worked with community coalitions. Most (12/14) obtained loc al resources, Where assessed, parental support was strong for providing STD prevention services, Conclusions: These projects increased the access and range of services avai lable to a substantial number of high-risk youth with high STD rates. Howev er, sustaining and scaling-up pilot project activities will be resource int ensive. Increased financial and training support to augment evaluation capa city will be critical for innovation to become an integral part of STD prev ention programs.