The Impact of Adversity on the Serial Development of Substance Use and Precursors to Sexual Risks among American Indian and Alaska Native Early Adolescents

提案摘要/摘要 美国印第安人和阿拉斯加原住民（AIAN）受到不利后果的影响不成比例 与危险性行为和药物使用有关。文献表明这些危害健康的行为 开始于青春期早期，13岁之前。因此，早期干预，重点是前兆风险 行为对于预防过早的性经历、物质使用和相关的负面健康至关重要 结果。不幸的是，有有限的研究，侧重于风险抵抗能力的发展，如 自我效能，减少危险的健康行为在AIAN早期青少年。本研究建议， 通过检查自我效能感的发展和形成已确定的因素来解决这一差距 为了有效地进行干预。由于AIAN青年接触不良反应的比例较高， 社会和物理环境，这是假设改变风险抵抗能力的发展，这项研究 着眼于逆境与物质使用和性风险不稳定技能的发展之间的相互作用。 拟议的研究是一个二级数据分析，提供了机会，发展先进的 培训潜在变量方法及其在服务不足的AIAN青少年社区的应用。 培训计划中的具体统计技能包括：1）中介结构方程模型，以评估交叉- 逆境、物质使用与性抗拒自我效能的分段关系; 2）潜在成长曲线 模型和增长混合模型，以分析变量之间的复杂纵向关系;以及3） 在分析青年发展轨迹时，评估时变协变量的功能。 除了发展研究设计和统计分析技术外，拟议的研究将 允许在手稿和提案规划，写作，提交，和 修订;以及发展一个专业研究网络， 领域此外，这项研究的结果有可能为解决这些问题的政策和干预措施提供信息。 AIAN通过针对青春期早期的前体来预防后期的多种风险行为， 年

Proposal Summary/Abstract American Indians and Alaska Natives (AIAN) are disproportionately impacted by adverse outcomes associated with risky sexual behavior and substance use. Literature suggests these health harming behaviors begin in early adolescence, before the age of 13. Therefore, early intervention that focuses on precursors to risky behaviors is essential to preventing early sexual experience, substance use, and the associated negative health outcomes. Unfortunately, there is limited research that focuses on the development of risk resistive skills, such as self-efficacy, on reducing risky health behaviors among AIAN early adolescents. This study proposes to address this gap by examining the development of self-efficacy and the factors that shape the identified trajectories in order to effectively intervene. Because AIAN youth experience higher rates of exposure to adverse social and physical environment, which is hypothesized to alter the development of risk resistive skills, this study looks at the interplay between adversity and the development of substance use and sexual risk restive skills. The proposed study is a secondary data analysis that provides the opportunity to develop advanced training in latent variable methodologies and their application to an underserved AIAN adolescent community. Specific statistical skills in the training plan include 1) mediated structural equation modeling to assess the cross- sectional relationships among adversity, substance use, and sex resistive self-efficacy; 2) latent growth curve modeling and growth mixture modeling to analyze complex longitudinal relationships among variables; and 3) assessment of the function of time varying covariates when analyzing youth development trajectories. In addition to developing research design and statistical analyses techniques, the proposed study will allow for the development of professional skills in manuscript and proposal planning, writing, submission, and revision; and development of a professional research network to generate collaboration and innovation in the field. Further, findings from this research have the potential to inform policies and interventions that address AIAN health disparities by targeting precursors of early adolescence to prevent multiple risk behaviors in later years.