The Impact of Longitudinal Patterns of Adverse Childhood Experiences on Adolescent Reproductive Health: Examining Factors that Promote Resilience

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PROJECT SUMMARY/ABSTRACT Sexual and reproductive health is a crucial public health concern. In the United States, rates of sexually transmitted infections and unintended pregnancy are highest among adolescents and young adults, particularly racial/ethnic minorities, making prevention programs to these populations essential. A social determinants of health perspective necessitates the need to understand how contextual factors are associated with health outcomes, and adverse childhood experiences (ACEs) represent factors that may play a role in adolescent sexual and reproductive health. However, the application of novel methods to longitudinal data is necessary to understand the effects of type, timing, and frequency of ACEs on sexual and reproductive health. We propose the application of an innovative analytic method, Longitudinal Latent Class Analysis, to longitudinal data from the Fragile Families and Child Wellbeing Study. This project has three specific aims. The first aim will uncover patterns of multiple types of ACEs across ages 3, 5, 9, and 15, and examine how these patterns may differ by race/ethnicity. The second aim will examine how longitudinal profiles of ACEs are associated with sexual and reproductive health outcomes at age 15, and how these associations differ by race/ethnicity, gender, and sexual orientation. Finally, the third aim will examine how protective factors at different ages may buffer the effects of longitudinal ACEs profiles on sexual and reproductive health. This project will provide knowledge of the patterns of adverse childhood experiences across childhood in a higher risk sample, how they are associated with sexual and reproductive health outcomes, how these factors may underlie health disparities, and which factors may buffer associations. Results will allow prevention scientists to design interventions that target the most at-risk groups with the most relevant protective factors at the most critical age periods. Published manuscripts will include details of the statistical models and associated syntax to allow other researchers to utilize these methods in their work on adverse childhood experiences and reproductive health.