Interpersonal- and Community-Level Risk Factors for Adolescent Obesity: An Examination of Sexual Identity, School Violence, and School Climate in a Large Sample of Urban Adolescents

青少年肥胖的人际和社区层面的风险因素：对大样本城市青少年的性别认同、学校暴力和学校氛围的调查

• 批准号: 10212999
• 负责人: April Joy Ancheta
• 金额: $ 4.35万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10212999
• 关键词: Academy; Address; Adolescence; Adolescent; Adolescent Risk Behavior; Adolescent obesity; Affect; Age; Area; Behavioral; Biological; Bisexual; Body mass index; Cardiovascular Diseases; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Childhood; Cholesterol; Chronic; Chronic Disease; Communities; Consequentialism; Cross-Sectional Studies; Data; Data Pooling; Development; Diabetes Mellitus; Diet; Disease; Disease model; Dyslipidemias; Economic Burden; Environment; Environmental Risk Factor; Event; Evidence based intervention; Fibrinogen; Fostering; Foundations; Funding; Gays; General Population; Goals; Health; Health Status; Health behavior; Heterosexuals; Hypertension; Individual; Interdisciplinary Study; Intervention Studies; Investigation; Knowledge; Lesbian; Life; Life Expectancy; Link; Longevity; Medicine; Mentors; Mentorship; Methods; Minority Groups; Modeling; National Institute of Nursing Research; Nurses; Obesity; Organizational Policy; Overweight; Personal Satisfaction; Physical activity; Police; Policies; Prevalence; Prevention; Process; Public Health; Research; Research Personnel; Research Priority; Research Training; Resources; Risk; Risk Factors; Sampling; Schools; Science; Scientist; Sexual Health; Sexual and Gender Minorities; Social Interaction; Strategic Planning; Surveys; Testing; Time; Training; United States; United States National Institutes of Health; Universities; Violence; adolescent health; age group; aged; base; boys; bullying; career; climate data; comorbidity; cost; demographics; design; economic disparity; educational atmosphere; experience; girls; health disparity; high risk; high risk population; improved; interest; meetings; minority health; multilevel analysis; obesity prevention; obesity risk; peer; prevent; preventive intervention; racial and ethnic disparities; reduce school violence; response; school health; school violence; secondary analysis; sedentary lifestyle; sex; sexual identity; sexual minority; skills; social; social factors; social health determinants; stressor

PROJECT SUMMARY/ABSTRACT Adolescent obesity, a preventable chronic condition that affects over 1 in 5 adolescents (ages 12-19 years) in the United States, has been linked to cardiovascular disease, diabetes, and high cholesterol. The cost attributed to adolescent obesity is approximately $14 billion annually, and obesity shortens life expectancy by up to eight years. Sexual minority adolescents (SMA; those who identify as gay/lesbian or bisexual, or who are unsure of their sexual identity) are significantly more likely to be obese and to have lower rates of physical activity and higher rates of sedentary behavior compared to their heterosexual peers. School violence (e.g., bullying and other violent acts) is associated with obesity, such that obesity risk is increased due to negative health behavior engagement in response to violent events. Given that SMA experience school violence at disproportionately high rates compared to their heterosexual peers, it is possible that school violence helps account for their higher risk of obesity. A protective school climate (i.e., a school with policies and practices that protect sexual minorities) is an important community-level determinant that has been shown to decrease sexual-minority-related school violence. Despite these known associations, few investigations have examined the relationship between school violence and obesity among SMA, and none have examined how school climate may influence this relationship. The proposed study will address these gaps through secondary analysis of cross-sectional, district-level pooled data from the Centers for Disease Control and Prevention's (CDC's) Youth Risk Behavior Surveys (from which we will obtain individual-level health behaviors and interpersonal-level school violence data) linked with the CDC's School Health Profiles (from which we will obtain community-level school climate data). Guided by an adapted Social Ecological Model, the specific aims are: (1) to examine the association between school violence and obesity and whether it differs for SMA and their heterosexual peers, and (2) to examine the association among sexual identity, school violence, and obesity and whether it differs across different levels of school climate. The proposed aims are consistent with the goals of the National Institute of Nursing Research and align with its strategic plan to support science that investigates key social and environmental factors that promote long-term wellness and prevent the development of disease across settings and the lifespan, with the goal of eliminating health disparities. To facilitate such research, the applicant will build her knowledge and skills in sexual minority health, adolescent chronic disease, and multilevel modeling and moderation analysis. With the mentorship of a dedicated and National Institutes of Health-funded interdisciplinary research team, and the resource-rich environment of Columbia University, the applicant will build a strong foundation from which to move toward her long-term goal of becoming an independent nurse scientist with expertise in obesity-related health disparities among SMA.

项目总结/摘要 青少年肥胖症是一种可预防的慢性疾病，在美国每5名青少年（12-19岁）中就有1人以上患有肥胖症。 在美国，它与心血管疾病、糖尿病和高胆固醇有关。成本 每年因青少年肥胖造成的损失约为140亿美元，肥胖缩短了预期寿命， 最多八年。性少数青少年（SMA;那些谁确定为男同性恋/女同性恋或双性恋，或谁是 不确定他们的性别身份）更有可能肥胖，并且身体健康的比例更低。 与异性恋同龄人相比，他们的活动和久坐行为率更高。校园暴力（如： 欺凌和其他暴力行为）与肥胖有关，因此肥胖风险因负 参与应对暴力事件的健康行为。鉴于SMA经历过校园暴力， 与异性恋同龄人相比，他们的比例不成比例地高，学校暴力可能有助于 导致他们肥胖的风险更高保护性的学校氛围（即，一所有政策和实践的学校 保护性少数群体）是社区一级的重要决定因素， 与性少数群体有关的校园暴力尽管有这些已知的联系，很少有调查研究 学校暴力和SMA中肥胖之间的关系，没有人研究学校如何 气候可能会影响这种关系。拟议的研究将通过次级方案解决这些差距。 对来自疾病控制和预防中心的横断面、区级汇总数据进行分析， (CDC的）青年危险行为调查（从中我们将获得个人层面的健康行为， 人际层面的学校暴力数据）与疾病预防控制中心的学校健康概况（我们将 获取社区一级的学校气候数据）。在适应性社会生态模型的指导下， 是：（1）检查学校暴力和肥胖之间的关联，以及SMA和 他们的异性恋同龄人，（2）检查性别认同，校园暴力， 肥胖和它是否在不同级别的学校氛围中存在差异。建议的目标符合 国家护理研究所的目标，并与其战略计划保持一致，以支持科学， 调查促进长期健康和预防疾病的关键社会和环境因素。 在整个环境和生命周期中预防疾病的发展，目标是消除健康差距。到 促进这种研究，申请人将建立她的知识和技能，在性少数群体的健康，青少年 慢性病，多层次建模和适度分析。在一位敬业的， 美国国立卫生研究院资助的跨学科研究团队，以及资源丰富的环境， 在哥伦比亚大学，申请人将为实现长期目标奠定坚实的基础 成为一名独立的护士科学家，专门研究SMA中与肥胖相关的健康差异。

项目成果

The Impact of Positive School Climate on Suicidality and Mental Health Among LGBTQ Adolescents: A Systematic Review.

• DOI: 10.1177/1059840520970847
• 发表时间: 2021-04
• 期刊: The Journal of school nursing : the official publication of the National Association of School Nurses
• 作者: Ancheta AJ;Bruzzese JM;Hughes TL
• 通讯作者: Hughes TL

Examining the associations of sexual minority stressors and past-year depression with overeating and binge eating in a diverse community sample of sexual minority women.

• DOI: 10.1016/j.eatbeh.2021.101547
• 发表时间: 2021-12
• 期刊: Eating behaviors
• 影响因子: 2.8
• 作者: Ancheta AJ;Caceres BA;Zollweg SS;Heron KE;Veldhuis CB;VanKim NA;Hughes TL
• 通讯作者: Hughes TL