Interpersonal- and Community-Level Risk Factors for Adolescent Obesity: An Examination of Sexual Identity, School Violence, and School Climate in a Large Sample of Urban Adolescents

青少年肥胖的人际和社区层面的风险因素：对大样本城市青少年的性别认同、学校暴力和学校氛围的调查

• 批准号: 10064659
• 负责人: April Joy Ancheta
• 金额: $ 4.55万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10064659
• 关键词: Academy; Address; Adolescence; Adolescent; Adolescent Risk Behavior; Adolescent obesity; Affect; Age; Area; Behavioral; Biological; Bisexual; Body mass index; Cardiovascular Diseases; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Childhood; Cholesterol; Chronic; Chronic Disease; Climate; Communities; Consequentialism; Cross-Sectional Studies; Data; Data Pooling; Development; Diabetes Mellitus; Diet; Disease; Disease model; Dyslipidemias; Economic Burden; Economics; Environment; Environmental Risk Factor; Event; Evidence based intervention; Fibrinogen; Fostering; Foundations; Funding; Gays; General Population; Goals; Health; Health Status; Health behavior; Heterosexuals; Hypertension; Individual; Interdisciplinary Study; Intervention Studies; Investigation; Knowledge; Lesbian; Life; Life Expectancy; Link; Longevity; Medicine; Mentors; Mentorship; Methods; Modeling; National Institute of Nursing Research; Nurses; Obesity; Organizational Policy; Overweight; Personal Satisfaction; Physical activity; Police; Policies; Population; Prevalence; Prevention; Preventive Intervention; Process; Public Health; Research; Research Personnel; Research Priority; Research Training; Resources; Risk; Risk Factors; Sampling; Schools; Science; Scientist; Sexual Health; Sexual and Gender Minorities; Social Interaction; Strategic Planning; Surveys; Testing; Time; Training; United States; United States National Institutes of Health; Universities; Violence; adolescent health; age group; aged; base; boys; bullying; career; climate data; comorbidity; cost; demographics; design; experience; girls; health disparity; high risk; high risk population; improved; interest; meetings; minority health; multilevel analysis; obesity prevention; obesity risk; peer; prevent; racial and ethnic; reduce school violence; response; school health; school violence; secondary analysis; sedentary lifestyle; sex; sexual identity; sexual minority; skills; social; social factors; social health determinants; stressor

PROJECT SUMMARY/ABSTRACT Adolescent obesity, a preventable chronic condition that affects over 1 in 5 adolescents (ages 12-19 years) in the United States, has been linked to cardiovascular disease, diabetes, and high cholesterol. The cost attributed to adolescent obesity is approximately $14 billion annually, and obesity shortens life expectancy by up to eight years. Sexual minority adolescents (SMA; those who identify as gay/lesbian or bisexual, or who are unsure of their sexual identity) are significantly more likely to be obese and to have lower rates of physical activity and higher rates of sedentary behavior compared to their heterosexual peers. School violence (e.g., bullying and other violent acts) is associated with obesity, such that obesity risk is increased due to negative health behavior engagement in response to violent events. Given that SMA experience school violence at disproportionately high rates compared to their heterosexual peers, it is possible that school violence helps account for their higher risk of obesity. A protective school climate (i.e., a school with policies and practices that protect sexual minorities) is an important community-level determinant that has been shown to decrease sexual-minority-related school violence. Despite these known associations, few investigations have examined the relationship between school violence and obesity among SMA, and none have examined how school climate may influence this relationship. The proposed study will address these gaps through secondary analysis of cross-sectional, district-level pooled data from the Centers for Disease Control and Prevention's (CDC's) Youth Risk Behavior Surveys (from which we will obtain individual-level health behaviors and interpersonal-level school violence data) linked with the CDC's School Health Profiles (from which we will obtain community-level school climate data). Guided by an adapted Social Ecological Model, the specific aims are: (1) to examine the association between school violence and obesity and whether it differs for SMA and their heterosexual peers, and (2) to examine the association among sexual identity, school violence, and obesity and whether it differs across different levels of school climate. The proposed aims are consistent with the goals of the National Institute of Nursing Research and align with its strategic plan to support science that investigates key social and environmental factors that promote long-term wellness and prevent the development of disease across settings and the lifespan, with the goal of eliminating health disparities. To facilitate such research, the applicant will build her knowledge and skills in sexual minority health, adolescent chronic disease, and multilevel modeling and moderation analysis. With the mentorship of a dedicated and National Institutes of Health-funded interdisciplinary research team, and the resource-rich environment of Columbia University, the applicant will build a strong foundation from which to move toward her long-term goal of becoming an independent nurse scientist with expertise in obesity-related health disparities among SMA.

项目总结/文摘