Obesity and substance use: Identifying pathways and processes in adolescence

肥胖和物质使用：确定青春期的途径和过程

• 批准号: 8283132
• 负责人: Haydee Isabella Lanza
• 金额: $ 6.21万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-15 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8283132
• 关键词: Address; Adolescence; Adolescent; Adult; Alcohol or Other Drugs use; Alcohols; Body Size; Body mass index; Cardiovascular system; Child; Data; Decision Making; Feeling; Frequencies; Gender; Goals; Health; Health Status; Health behavior; Healthcare Systems; Heterogeneity; Individual; Influentials; Link; Literature; Longitudinal Studies; Marijuana; Modeling; Non obese; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Pathway interactions; Pattern; Prevalence; Preventive Intervention; Problem behavior; Process; Public Health; Research; Risk; Risk Behaviors; Risk-Taking; Role; Sampling; Services; Severities; Sex Characteristics; Social Identification; Social status; Stigmatization; Subgroup; Tobacco; biopsychosocial; depressive symptoms; deviant; emerging adult; ethnic difference; experience; high risk; improved; mortality; obesity in children; peer; peer victimization; physical conditioning; prospective; psychologic; psychological outcomes; psychosocial; social; substance use prevention; theories; young adult

DESCRIPTION (provided by applicant): The increasing prevalence of childhood obesity in recent decades has raised serious concerns over impaired physical health, psychosocial maladjustment, and higher mortality rates. Despite growing concerns, substance use, a serious health-risk behavior, has not been largely studied in conjunction with obesity. The proposed project is a prospective longitudinal study that examines relations between adolescent obesity and substance use in young adulthood, and attempts to identify the underlying pathways and processes by which obesity may increase risk for substance use. Taking a biopsychosocial perspective on risk-taking, the proposed study will utilize the sample derived from Waves 1-3 of The National Longitudinal Study of Adolescent Health (Add Health). Data have been obtained on body mass index (BMI) and obesity status; social standing (victimization, peer rejection, feelings of social stigmatization); deviant peer affiliation; psychosocial maladjustment (depressive symptoms) and substance use (alcohol, tobacco, and marijuana) on 11,083 adolescents between 11- 19 years at Wave 1 and 18-26 years at Wave 3. The overarching goal of this research is to determine whether poor social status, deviant peer affiliation and/or psychosocial maladjustment among obese adolescents increase risk of more frequent and severe substance use in young adulthood. Furthermore, ethnic and gender disparities in obesity prevalence and ethnic- and gender-specific associations between body size and social status may influence engagement in substance use. The study's specific aims are to (1) identify whether BMI percentile of obese and non-obese adolescents predicts frequency, severity, and type of substance use in young adulthood; (2) assess whether heterogeneity in social status, deviant peer affiliation, and psychosocial maladjustment among obese adolescents informs the role of adolescent obesity on more frequent and severe substance use in young adulthood; and (3) identify ethnic and gender differences from the above aims to determine whether belonging to groups with higher BMI and obesity rates decreases risk of substance use engagement. As both obesity and substance use are severe burdens on the health care system, identifying the pathways by which adolescent obesity is related to substance use in young adulthood may have significant implications for prevention and intervention efforts aimed at mitigating frequency and severity of substance use. PUBLIC HEALTH RELEVANCE: This study will address two critical public health problems, adolescent obesity and substance use in young adulthood, with the aim of identifying the pathways and processes by which adolescent obesity may increase risk of more frequent and severe substance use in young adulthood, thus informing prevention and intervention efforts for mitigating problematic substance use among young adults. Using The National Longitudinal Study of Adolescent Health (Add Health), the project will evaluate the utility of adolescent social status, deviant peer affiliation, and psychosocial maladjustment as explanatory mechanisms of co-occurring adolescent obesity and substance use in young adulthood. Identifying specific pathways and processes by which obesity and substance use are linked will discern which subgroup(s) of obese adolescents are at highest risk for more frequent and severe substance use in young adulthood, potentially leading to improved efforts in targeting individuals at most need for substance use prevention and intervention services.

描述（由申请人提供）：近几十年来，儿童肥胖症的日益流行引起了人们对身体健康受损、心理社会失调和更高死亡率的严重关注。尽管越来越多的关注，物质使用这种严重危害健康的行为，还没有大量研究将其与肥胖联系起来。拟议的项目是一项前瞻性纵向研究，旨在研究青少年肥胖与青年时期物质使用之间的关系，并试图确定肥胖可能增加物质使用风险的潜在途径和过程。从冒险的生物心理社会角度来看，拟议的研究将利用来自全国青少年健康纵向研究（Add Health）第1-3波的样本。获得了身体质量指数（BMI）和肥胖状况的数据；社会地位（受害、同伴排斥、社会污名感）；不正常的同伴关系；对11,083名11- 19岁第1波和18-26岁第3波青少年的心理社会适应不良（抑郁症状）和物质使用（酒精，烟草和大麻）进行了研究。本研究的首要目标是确定肥胖青少年的社会地位低下、不正常的同伴关系和/或心理社会适应不良是否会增加成年后更频繁和严重的物质使用风险。此外，肥胖患病率的种族和性别差异以及体型与社会地位之间的种族和性别特异性关联可能影响物质使用的参与。该研究的具体目的是：(1)确定肥胖和非肥胖青少年的BMI百分位数是否能预测成年后物质使用的频率、严重程度和类型；(2)评估肥胖青少年的社会地位、异常同伴关系和心理社会适应不良的异质性是否会影响青少年肥胖在成年后更频繁和严重的物质使用；(3)识别种族和性别差异，以确定BMI和肥胖率较高的群体是否会降低物质使用参与的风险。由于肥胖和药物使用都是卫生保健系统的严重负担，确定青少年肥胖与成年后药物使用相关的途径可能对旨在减轻药物使用频率和严重程度的预防和干预工作具有重要意义。