A multilevel study of the associations between economic and social context, stage of adolescence, and physical activity and body mass index
A multilevel study of the associations between economic and social context, stage of adolescence, and physical activity and body mass index
复制标题
DOI：
10.1542/peds.2006-2089m
复制
发表时间：
2007-02-01
期刊：
影响因子：
8
通讯作者：
Ferron, John M.
中科院分区：
文献类型：
--
作者：
McKay, Caroline Mae;Bell-Ellison, Bethany A.;Ferron, John M.
Objective.针对青少年危险行为的预防措施效果有限，部分原因是依赖于个人层面的干预措施，而不考虑行为发生的背景。此外，发展的作用还没有得到很好的研究，其可能的调节作用的行为的背景影响。本研究的目的是检查经济和社会背景的影响，不活跃或体重高于正常的几率，以及是否影响不同的基础上的阶段的发育。分析使用了来自全国儿童健康调查（n = 37 930）的10至17岁青少年的子集，这些青少年来自所有州和哥伦比亚特区（n = 51）。因变量包括体力活动和BMI。州一级的经济情况是通过生活在联邦贫困线200%以下的家庭比例来衡量的。社会背景是通过对社会资本的两个指标（互助和社会信任）的综合反应来衡量的。进行多层次建模，以调查国家级的经济和社会背景和身体活动和BMI之间的关联，同时控制个人的社会人口特征，以及这些关联是否依赖于个人的阶段的precence.Results.Results.州一级的互助和社会信任都与青少年不符合当前体育活动建议的几率显着相关，但州一级的贫困则不然。对于体重指数，所有3个状态变量都是体重指数高于正常值的重要预测因子.有证据表明，青春期阶段对两种结局均有调节作用。这些研究结果表明，需要纳入背景水平的数据在监测系统中评估青少年的风险行为，并考虑到多层次的性质日益严重的问题时，不活动和超过正常体重的公共卫生预防工作的重点。
Objective. Prevention efforts targeting adolescent risk behavior have had limited effectiveness, partly because of the reliance on individual-level interventions that do not consider the context within which behavior occurs. In addition, the role of development has not been well studied regarding its possible moderating effects on contextual influences on behavior. The purpose of this study was to examine the influence of economic and social context on the odds of being inactive or having above-normal weight and whether the influence differed on the basis of stage of adolescence.Methods. Analysis used a subset of adolescents aged 10 to 17 years from the National Survey of Children's Health (n = 37 930) from all states and the District of Columbia (n = 51). Dependent variables included physical activity and BMI. State-level economic context was measured by the proportion of families living below 200% of the federal poverty level. Social context was measured by aggregated means of responses to 2 indicators of social capital: mutual aid and social trust. Multilevel modeling was conducted to investigate associations between state-level economic and social context and physical activity and BMI, while controlling for individual sociodemographic characteristics, and whether these associations were dependent on an individual's stage of adolescence.Results. Both state-level mutual aid and social trust were significantly related to the odds of an adolescent not meeting current physical activity recommendations, yet state- level poverty was not. For BMI, all 3 state- level variables were significant predictors of having an above- normal BMI. Evidence was found of the moderating influence of stage of adolescence for both outcomes.Conclusions. These findings point to the need for the inclusion of contextual-level data in surveillance systems assessing risk behavior in adolescents and consideration of the multilevel nature of the growing problem of inactivity and above-normal weight when focusing public health prevention efforts.