Relationship between adolescent weight, sexual behavior and reproductive outcomes

描述（由申请人提供）：一半的美国儿童和青少年超重或有超重的风险。这是令人担忧的，因为儿童时期BMI升高会增加成年期疾病和残疾早发的风险，并缩短寿命。越来越多的证据表明，体重在人际关系的形成中也起着重要作用。体重似乎会影响约会和性机会，以及参与性风险行为和生殖结果。特别是，研究表明，超重或认为自己超重与参与性风险行为的风险增加有关。然而，大多数研究利用成年人群和横断面研究设计，因此在识别这些行为的早期前兆方面能力有限。此外，很少有研究探讨体重对青春期或成年期生殖结果的进一步下游影响。我们最近的研究表明，体重和性行为之间的关系在青春期早期和中期就很明显，并存在显著的种族差异，这对现有的文献体系做出了贡献。随着儿童肥胖率的持续上升，重要的是我们要更好地了解身体大小如何以及对谁来说是影响青少年开始和长期维持性风险行为和生殖结果的关键背景因素。我们建议通过使用两个全国代表性的纵向数据集进行二次数据分析来研究青少年体重，性行为和生殖结果之间的关系：1997年全国青年纵向调查（NLSY 97）和全国青少年健康纵向调查（Add Health）。这些补充数据集跟踪学校和非学校参加的青少年，因为他们过渡到成年早期。我们进行聚类分析，以确定亚组的青年在从事性风险行为的风险最高的基础上，他们的实际或感知的重量。我们应用生长曲线建模技术，以确定纵向模式的性行为和生殖结果在成年过渡期，这些轨迹的关键预测因素，以及体重的影响。我们探讨了种族和性别的影响，很少有研究已经检查。这一建议是创新的，因为我们采取了发展的方法来确定所观察到的关联的机制，并确定这些关联最强的青年分组。这将使我们能够确定哪些人可能从有针对性的性健康预防计划中受益最多。 公共卫生相关性：体重是影响性行为的重要因素。超重或认为自己超重与性风险行为和不良生殖结果的参与增加有关。很少有研究探讨青少年的体重，性行为和生殖结果之间的关系，这限制了我们识别这些风险关系的早期前兆的能力。我们使用两个具有全国代表性的纵向数据集进行二次数据分析，这些数据集跟踪从青春期早期到成年早期的个体，以确定可能从有针对性的性健康预防计划中受益最多的个体。

DESCRIPTION (provided by applicant): Half of U.S. children and adolescents are overweight or at-risk for overweight. This is concerning because elevated BMI during childhood increases the risk of early onset of disease and disability in adulthood and reduced longevity. Mounting evidence demonstrates that weight also plays a significant role in interpersonal relationship formation. Weight appears to affect dating and sexual opportunities as well as engagement in sexual risk behaviors and reproductive outcomes. In particular, studies have demonstrated that being or perceiving oneself as overweight is associated with an increased risk of engagement in sexual risk behaviors. However, most studies utilize adult populations and cross sectional study designs and are therefore limited in their ability to identify the early precursors of these behaviors. Moreover, few studies have explored further downstream effects of weight on reproductive outcomes in adolescence or adulthood. Our recent research has contributed to the existing body of literature by demonstrating that the relationship between weight and sexual behaviors is evident as soon as during early and middle adolescence with significant racial variations. As rates of childhood obesity continue to rise, it is important that we develop a better understanding of how and for whom body size serves as a key contextual factor affecting adolescents' initiation and long-term perpetuation of sexual risk behaviors and reproductive outcomes. We propose to examine the relationship between adolescent weight, sexual behavior and reproductive outcomes by conducting secondary data analyses using two nationally representative longitudinal datasets: the National Longitudinal Survey of Youth 1997 (NLSY97) and the National Longitudinal Survey of Adolescent Health (Add Health). These complementary datasets follow school and non-school attending adolescents as they transition to early adulthood. We perform cluster analysis to identify subgroups of youth at highest risk for engaging in sexual risk behaviors based on their actual or perceived weight. We apply growth curve modeling techniques to identify longitudinal patterns of sexual behaviors and reproductive outcomes during the adolescent-to-adulthood transition, key predictors of these trajectories, and the effect of weight. We explore the effect of race and gender which few studies have examined. This proposal is innovative because we take a developmental approach to identify the mechanisms underlying the observed associations and identify subgroups of youth for whom these associations are strongest. This will allow us to identify individuals who may benefit most from targeted sexual health prevention programs. PUBLIC HEALTH RELEVANCE: Weight is an important contextual influence on sexual behavior. Being or perceiving oneself as overweight is associated with increased engagement in sexual risk behaviors and adverse reproductive outcomes. Little research has examined the relationship between weight, sexual behaviors and reproductive outcomes among adolescents which limits our ability to identify early precursors of these risk relationships. We conduct secondary data analyses using two nationally representative longitudinal datasets that follow individual from early adolescence through young adulthood to identify individuals who may benefit most from targeted sexual health prevention programs.