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

项目概要/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， 传播感染和意外怀孕在青少年和年轻人中最高， 种族/少数民族，使这些人口的预防方案至关重要。一个社会决定因素 从健康的角度来看，有必要了解环境因素如何与健康相关联 结果和不良童年经历（ACE）代表了可能在青少年中发挥作用的因素。 性健康和生殖健康。然而，有必要将新方法应用于纵向数据， 了解ACE的类型、时间和频率对性健康和生殖健康的影响。我们提出 应用创新的分析方法，纵向潜在类分析，纵向数据从 脆弱家庭和儿童福利研究。该项目有三个具体目标。第一个目标将揭示 3、5、9和15岁之间多种类型ACE的模式，并研究这些模式在以下方面的差异： 种族/民族。第二个目标将研究ACE的纵向特征如何与性和 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，第三个目标将研究不同年龄的保护因素如何缓冲 纵向ACE概况对性健康和生殖健康的影响。该项目将提供知识， 在高风险样本中，儿童期不良童年经历的模式， 与性健康和生殖健康结果相关，这些因素如何成为健康差异的基础， 以及哪些因素可以缓冲关联。研究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，针对具有最相关保护因素的最危险群体。 出版的手稿将包括统计模型和相关语法的细节，以允许其他 研究人员利用这些方法在他们的工作中不良的童年经历和生殖健康。

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.