Determinants and disparities in high-risk sexual behaviors in US adolescents

描述（由申请人提供）：对社会和行为科学家来说，预防青少年高危性行为是最困难和最重要的挑战。本研究将确定导致青少年高危性行为的因素及其差异。目标包括测试由三合一影响理论指导的性行为因果模型（TTI; Flay & Petraitis, 1994），这是一个在预测其他青少年危险行为方面得到良好测试的模型，它详细说明了关键近端因素和更多远端因素的作用。与TTI一致的是，近端因素包括自我效能、态度和社会规范；远端因素包括整体积极期望、抑郁症状、父母亲缘关系和学业取向。最后，潜在的重要社会文化影响将作为模型中的最终（最远）因素进行测试。拉丁美洲人的全球期望和文化取向是该模型强调的两个重要因素，但在青少年性行为的综合模型中尚未得到充分研究。这些目标将通过对1994-2002年收集的Add Health数据（全国青少年健康纵向研究）的二次分析来实现。这些数据（第一波N = 20,745；第二波N = 14,738；第三波N = 15,197）为从青春期中期到成年早期的模型提供了非常有力的检验。这些数据包括来自朋友、伴侣和父母的报告，也有相当比例的拉丁裔青年（包括大量的墨西哥裔美国人，但也包括古巴裔美国人和波多黎各裔美国人的样本）和非洲裔美国人。两次随访的重点行为结果包括报告的过早性交、无保护的性交和性伴侣的数量。此外，报告的意外怀孕、报告的性传播疾病以及在第三阶段的性传播疾病检测中呈阳性的结果将被包括在内，以验证行为报告，并进一步测试模型的预测效果。为了实现研究目标，将采用结构方程、生存模型和多层次模型等适用于纵向数据的前沿分析技术。通过澄清导致这些行为的因果路径，并确定哪些特定的保护或风险因素对差异明显的青少年群体最为关键，拟议的项目可能有助于为不同的青少年群体制定更有效的减少性风险计划。在美国，青少年的性冒险行为是导致过早死亡和残疾的主要原因，也会导致意外怀孕。尽管有证据表明种族之间和种族内部的性行为模式不同，但社会文化因素在高风险性行为决定因素的综合理论指导模型中的作用尚未得到检验。通过在这样的理论模型中澄清文化取向等因素，这项研究将有助于预防项目努力解决不同青少年群体中最关键的性冒险威慑因素。

DESCRIPTION (provided by applicant): Preventing youths' high-risk sexual behaviors represent some of the most difficult and important challenges for social and behavioral scientists. This study will identify factors contributing to youths' high-risk sexual behaviors and their disparities. The objectives involve testing a causal model of sexual behaviors guided by the theory of triadic influence (TTI; Flay & Petraitis, 1994), a model well-tested in predicting other adolescent risk behaviors that specifies the operation of key proximal factors as well as more distal factors. Consistent with TTI, proximal factors will include self-efficacy, attitudes, and social norms; distal factors include global positive expectancies, depressive symptoms, parental relatedness, and academic orientation. Finally, potentially vital socio-cultural influences will be tested as ultimate (most distal) factors in the model. Global expectancies and cultural orientation in Latinos are two important factors of emphasis in the model that are understudied within comprehensive models of adolescents' sexual behaviors. The objectives will be accomplished through secondary analyses of Add Health data (National Longitudinal Study of Adolescent Health) collected from 1994-2002. These data (N = 20,745 at Wave I; N = 14,738 at Wave II; N = 15,197 at Wave III) afford very strong tests of the model from mid-adolescence through young adulthood. These data include reports from friends, partners and parents, and also have substantial proportions of Latino youth (including substantial Mexican Americans, but also over samples of Cuban American and Puerto Rican youth) and African Americans. Behavioral outcomes of focus at both follow-ups include reported early intercourse, unprotected sexual intercourse, and number of sexual partners. Additionally, reported unintended pregnancies, reported STDs, and positive tests on STD assays at Wave III will be included both to validate the behavioral reports and to provide further testing of the model's predictive efficacy. Cutting edge analysis techniques appropriate for longitudinal data such as structural equation, survival, and multi-level modeling will be employed to achieve the study objectives. By clarifying the causal paths leading to these behaviors and identifying which specific protective or risk factors are most critical for adolescent groups where disparities are apparent, the proposed project may aid in the development of more effective sexual-risk reduction programs designed for diverse adolescent populations. Adolescent sexual risk taking behaviors are major causes of premature death and disability in the US as well as lead to unplanned pregnancies. Despite evidence suggesting differing patterns of sexual behaviors between and within ethnic groups, the role of socio-cultural factors within comprehensive theory-guided models of the determinants of high-risk sexual behaviors have been relatively untested. By clarifying such factors like cultural orientation within such a theoretical model, this study will assist preventive programs in their efforts to address the most critical sexual risk taking deterrence factors for diverse adolescent groups.