Understanding developmental trajectories among early adolescents to improve reproductive health

项目摘要 这项研究的目的是通过了解青少年健康计划的发展， 女童和男童在青春期的发展和赋权轨迹，以及 量化这一过程如何影响性健康和生殖健康行为和结果。的 拟议的项目将使用四波纵向数据，每年从2842个样本中收集 在刚果金沙萨，登记时年龄在10-14岁的青少年。从这件事中学到的 研究将为旨在改善赋权和影响长期健康轨迹的干预措施提供信息， 青少年在向成年过渡时。 具体目标是： 1.确定机构如何随着时间的推移为男孩和女孩演变。使用机构的每个子量表 （行动自由，发言权，决策）和所有领域的综合机构得分，我们 将进行潜在增长曲线建模，以评估个人得分如何随时间变化， 探索这些轨迹如何因性别而异。 2.确定影响轨迹的重要社会生态因素（机会结构）， 按性别分列。我们将使用潜在增长曲线模型来探讨随时间变化的社会经济的影响， 生态因素（包括个人，家庭，同伴和邻里因素），预测的变化， 整个机构和每个机构内的子规模，以评估机会结构如何影响 随着时间的推移，机构的发展。 3.评估非常年轻的青春期的机构与性和生殖的关联 青春期后期的健康行为。我们将使用考克斯比例风险模型来评估 每个领域的机构与首次性行为年龄的关系和Logistic回归，以评估 避孕行为和自愿性行为，评估基线水平的影响， 随着时间的推移，它对性健康和生殖健康行为的影响会发生变化。 该研究是对全球青少年早期研究纵向数据的二次数据分析。目标1 和2将采用分层潜在增长曲线模型，探讨如何三个先前验证的措施， 机构随时间和性别的变化。目标3将采用考克斯比例风险模型， 多变量逻辑回归模型，以估计赋权与关键性 和生殖健康行为和结果。

Project Summary The goal of this research is to inform the development of adolescent health programs through understanding the development and trajectories of empowerment over the course of adolescence, among girls and boys, and quantifying how this process influences sexual and reproductive health behaviors and outcomes. The proposed project will use four waves of longitudinal data, collected annually from a sample of 2,842 adolescents, aged 10-14 years at enrollment, in Kinshasa, Democratic Republic of Congo. Learnings from this research will inform interventions designed to improve empowerment and affect long-term health trajectories of adolescents as they transition into adulthood. The specific aims are: 1. Establish how agency evolves over time for boys and girls. Using each sub-scale of agency (Freedom of Movement, Voice, Decision-Making) and a combined agency score across all domains, we will conduct latent growth curve modeling to assess how individual scores change over time and explore how these trajectories differ by gender. 2. Identify significant socio-ecological factors (opportunity structures) that influence trajectories, by gender. We will use latent growth curve modeling to explore the effect of time varying socio- ecological factors (including individual, family, peer, and neighborhood factors) that predict changes in total agency and within each agency sub-scale to assess how opportunity structures influence the development of agency over time. 3. Assess the association of agency in very young adolescence with sexual and reproductive health behaviors in later adolescence. We will use Cox Proportional Hazard models to assess the relationship of each domain of agency with age at sexual debut and logistic regression to evaluate contraceptive behavior, and volitional sex, assessing the effect of both baseline levels of agency and change over time in its impact on sexual and reproductive health behaviors. The study is a secondary data analysis of longitudinal data from the Global Early Adolescent Study. Aims 1 and 2 will employ stratified latent growth curve models to explore how three previously validated measures of agency change over time and by gender. Aim 3 will employ Cox Proportional Hazards models and multivariable logistic regression models to estimate the relationship between empowerment and key sexual and reproductive health behaviors and outcomes.