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

项目摘要/摘要 性健康和生殖健康是一个重要的公共卫生问题。在美国，性行为比率 传播感染和意外怀孕在青少年和年轻人中最高，尤其是 种族/少数民族，使这些人口的预防方案变得至关重要。社会决定因素 从健康的角度来看，有必要了解背景因素是如何与健康相关联的 结果和不良童年经历(ACE)是可能在青少年中起作用的因素 性健康和生殖健康。然而，对纵向数据应用新方法是必要的 了解ACE的类型、时间和频率对性健康和生殖健康的影响。我们建议 一种创新的分析方法--纵向潜在类分析在纵向数据分析中的应用 《脆弱家庭与儿童福祉研究》。这个项目有三个具体目标。第一个目标将揭开 3岁、5岁、9岁和15岁的多种类型的王牌的模式，并检查这些模式在 种族/民族。第二个目标将研究ACEs的纵向轮廓如何与性和 15岁时的生殖健康结果，以及这些关联如何因种族/民族、性别和 性取向。最后，第三个目标将检查不同年龄的保护因素如何缓冲 ACES纵向分布对性健康和生殖健康的影响。该项目将提供以下知识 在高风险样本中，童年不良经历的模式，它们是如何 与性健康和生殖健康结果相关，这些因素如何造成健康差距， 以及哪些因素可以缓冲关联。结果将使预防科学家能够设计干预措施 在最关键的年龄阶段，以具有最相关保护因素的风险最高的群体为目标。 已出版的手稿将包括统计模型和相关语法的详细信息，以允许其他 研究人员在他们关于儿童不良经历和生殖健康的工作中利用这些方法。

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.