An ecological approach to understanding youth smoking trajectories: problems and prospects.

An ecological approach to understanding youth smoking trajectories: problems and prospects.
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了解青少年吸烟轨迹的生态方法:问题和前景。

DOI:
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发表时间:
2003
期刊:
影响因子:
6
通讯作者:
P. Wilcox
P. Wilcox
中科院分区:
医学1区
文献类型:
--
作者:
P. Wilcox

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非随机模式的总青年吸烟率和轨迹跨社区表明,个人层面的特征不能完全解释的行为问题。相反,至少部分解释必须在社区背景下的某个地方。这种社区层面的情境效应可以直接影响群体和个人层面的行为(如主效应),也可以制约个人层面因素对个人行为的影响(如调节效应)。本文回顾了以前的研究,探讨社区层面的背景影响,吸烟和物质使用更普遍,并确定了重要的局限性,这现存的工作,从而确定了未来的实证研究议程。接下来,(在)兼容性以前的实证研究结果与当前的理论模型进行了讨论。在提供替代这些现有的模型,本文最后介绍和讨论的多层次,综合模型的青少年吸烟轨迹。在这个模型中,社区/机构的力量被假定为影响吸烟以上和超越个人层面的主要影响。这些假设的社区水平的力量是广泛和多样的,代表学校的特点,邻里的人口特征,宗教文化,媒体的影响,经济背景,医疗服务等,除了展示上下文的主要影响,社区的影响,在拟议的多层次模型可以介导的社区水平的过程,包括控制和社会化的过程中讨论。此外,社区一级的特点可能会相互作用,产生某些烟草使用的结果,也许最重要的是,他们可能缓和或条件的影响,吸烟的个体差异。
Non-random patterns of aggregate youth smoking rates and trajectories across communities suggest that individual-level characteristics cannot account fully for the behavior in question. Instead, at least part of the explanation must lie somewhere within the community context. Such community-level contextual effects can impact directly both group and individual-level behavior (e.g. main effects), and they can also condition the effects of individual-level factors on individual behaviors (e.g. moderating effects). This paper reviews previous research examining community-level contextual effects regarding smoking and substance use more generally and identifies important limitations of this extant work, thus defining an agenda for future empirical studies. Next, the (in)compatibility of previous empirical findings with current theoretical models is discussed. In offering an alternative to these existing models, the paper concludes with presentation and discussion of a multi-level, integrated model of adolescent smoking trajectories. In this model, community/institutional forces are presumed to impact smoking above and beyond individual-level main effects. These posited community-level forces are broad and varied, representing school characteristics, neighborhood demographic characteristics, religious culture, media influence, economic context, health services and so on. In addition to exhibiting contextual main effects, the effects of community in the proposed multilevel model can be mediated by community-level processes, including the processes of control and socialization discussed herein. Also, community-level characteristics may interact in producing certain tobacco-use outcomes and, perhaps most importantly, they may moderate or condition the effects of interindividual differences on smoking.
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