Racial and Ethnic Variation in Adolescent Obesity: A Multilevel Study of Neighbor

描述（由申请人提供）：本研究使用来自国家青少年健康纵向研究的数据，波浪I和III来检查青少年肥胖的变化，因为他们的青少年社区环境和学校设施预测，特别关注贫困社区和学校，黑人和西班牙裔。本项目拟采用交叉分类多级逻辑回归模型确定4个具体目标。首先，该项目建议确定种族/民族（黑人、西班牙裔和白人）对肥胖风险的影响。这一目标通过关注具有特定肥胖风险的少数群体，具体解决了AHRQ的一个目标。该项目的第二个目的是确定社区在多大程度上解释了肥胖的种族和民族差异。通过研究肥胖这一基本相关性的变化，该项目实现了“ 2010年健康人”提出的两个具体目标：减少超重和肥胖儿童和青少年的比例，减少肥胖成年人的比例。第三个目标是确定弱势学校在多大程度上解释了肥胖的种族差异。确定肥胖存在最大差异的地方（跨社区或跨学校）将有助于该研究人员提出最具成本效益的针对肥胖的政策干预途径。该项目将通过确定种族/民族和社区之间的已知关系是否适用于学校，从而显著推进当前的研究。这一目标对于实现卫生保健研究和质量局（AHRQ）解决疾病预防成本效益问题的目标尤其重要，因为肥胖症在1995年花费了大约990亿美元。最后，本项目将确定种族/民族和社区劣势的潜在互动影响。这将测试种族和民族的肥胖差异是否会被社区的不利因素放大。这有助于AHRQ帮助弱势群体的目标，因为众所周知，来自超重或肥胖社区的青少年比例是来自中高收入社区的青少年比例的两倍。

DESCRIPTION (provided by the applicant): The present study uses data from the National Longitudinal Study of Adolescent Health, Waves I and III to examine variation in young adult obesity as predicted by their adolescent neighborhood environments and school facilities, with a specific focus on poor neighborhoods and schools, Blacks, and Hispanics. This project proposes to use cross-classified multilevel logistic regression models to determine 4 specific aims. First, this project proposes to determine the effect of race/ethnicity (Black, Hispanic, and White) on the risk of obesity. This aim specifically addresses 1 of the goals of AHRQ, by focusing attention on minority populations at specific risk of obesity. The second aim of this project is to determine the extent to which neighborhood explains racial and ethnic variation in obesity. By examining variation in this fundamental correlate of obesity, this project addresses 2 specific objectives set forth by "Healthy People 2010:" reducing the proportion of children and adolescents who are overweight and obese and reducing the proportions of adults who are obese. The third aim is to determine the extent to which disadvantaged schools explain racial and ethnic variation in obesity. Determining where the most variation in obesity exits (across neighborhoods or across schools) will help this researcher propose the most cost effective route for obesity directed policy intervention. This project will significantly advance current research by determining if the known relationships between race/ethnicity and neighborhoods holds true for schools. This aim is particularly important in accomplishing 1 of Agency for Healthcare Research and Quality's (AHRQ) goals of addressing the issue of cost effectiveness in disease prevention because obesity cost approximately $99 billion in 1995. Lastly, this project will determine the potential interactive effects of race/ethnicity and neighborhood disadvantage. This will test to see if racial and ethnic variations in obesity are amplified by neighborhood disadvantage. This serves AHRQ's goal of aiding disadvantaged populations, since it is known that the proportion of adolescents from neighborhoods who are overweight or obese is twice that of adolescents from middle-and high-income neighborhoods.