Role of Romantic Relationships in the Sexual Behavior of Obese and Non-Obese Girl

描述（由申请人提供）：越来越多的证据表明，体重影响青春期女孩之间亲密关系（即约会和性）的形成和性谈判。肥胖女孩的约会和性经历一直较少，但一旦性活跃，就会有更多的性危险行为（即不使用避孕套）。指导这项研究的概念框架假设，肥胖女孩和非肥胖女孩在与同伴和亲密伴侣相处时的社交技巧差异，以及在关系经历上的差异，可以解释这些差异。然而，没有研究真正检验过肥胖女孩和非肥胖女孩的人际交往能力和亲密关系是否有差异。我们建议通过使用来自两个大型美国青春期女孩纵向队列的数据进行二次数据分析来解决这一研究差距。我们使用了全国青少年健康纵向调查（Add Health），这是1994年至2008年间进行的一项具有全国代表性的队列研究；以及匹兹堡女孩研究（PGS），这是一项正在进行的基于人群的队列研究，始于2000年，在青少年性冒险率高、青少年肥胖率高的环境中进行。我们的具体目标是：(1)确定与非肥胖少女相比，肥胖少女在同伴和亲密关系技能的发展方面是否有延迟；(2)比较肥胖与非肥胖少女的亲密关系特征；(3)利用纵向生长曲线模型确定肥胖和非肥胖少女的恋爱和性关系特征轨迹随时间的变化是否存在差异；(4)确定同伴和亲密关系技能如何随时间影响肥胖和非肥胖少女的亲密关系轨迹；(5)比较肥胖与非肥胖非裔美国女孩和白人女孩在人际交往能力和亲密关系特征方面的发展。创新：我们的建议是创新的，因为它是第一个探索关系环境作为肥胖与青春期女孩性冒险行为之间联系机制的研究。我们使用两个互补的数据集——一个具有全国代表性的队列和一个来自高风险环境的基于人群的队列——将使我们能够识别细微差别，这些细微差别对于更全面地理解社会技能和关系经验在解释肥胖和非肥胖青少年的性行为变化方面所起的作用至关重要。我们采取了一种发展的方法，通过研究关系经历是如何随着时间的推移而演变的。最后，通过探索非裔美国人和白人青春期女孩之间的关系体验差异，我们的方法承认，美规范的文化差异是存在的，而且是重要的。公共卫生意义：本研究的首要目标是扩展将体重与青少年性风险联系起来的概念框架，从而为量身定制青少年性风险降低干预措施和性谈判技巧建设项目提供有用的关键信息。

DESCRIPTION (provided by applicant): Mounting evidence demonstrates that weight influences intimate (i.e., dating and sexual) relationship formation and sexual negotiations among adolescent girls. Obese girls consistently report having fewer dating and sexual experiences, but more sexual risk behaviors (i.e., condom nonuse) once they are sexually active. The conceptual framework that has guided this research presumes that differences in the social skills for relating to peers and intimate partners along with differences in the relationship experiences of obese and non-obese girls account for these differences. However, no studies have actually examined whether the interpersonal skills and intimate relationships of obese and non-obese girls differ. We propose to address this research gap by conducting a secondary data analysis using data from two large, longitudinal cohorts of U.S. adolescent girls. We use the National Longitudinal Survey of Adolescent Health (Add Health), a nationally representative cohort study conducted between 1994 and 2008; and the Pittsburgh Girls Study (PGS), an on-going population-based cohort study started in 2000, and conducted in a setting with high rates of adolescent sexual risk-taking and high rates of adolescent obesity. Our specific aims are to (1) determine whether obese adolescent girls experience a delay in the development of peer and intimate relationship skills compared to non-obese adolescent girls; (2) compare the characteristics of intimate relationships among obese and non-obese adolescent girls; (3) use longitudinal growth curve modeling to determine whether trajectories of romantic and sexual relationship characteristics differ between obese and non-obese adolescent girls over time; (4) determine how peer and intimate relationship skills affect trajectories of intimate relationships among obese and non-obese adolescent girls over time; and, (5) compare the development of interpersonal skills and intimate relationship characteristics between obese and non-obese African American and White adolescent girls. INNOVATION: Our proposal is innovative as it is the first study to explore relationship context as a mechanism linking obesity to adolescent girls' sexual risk-taking behaviors. Our use of two complementary datasets - one nationally representative cohort and one population-based cohort from a high risk setting - will allow us to identify nuances that are important for crafting a more complete understanding of the role that social skills and relationship experiences play in explaining variations in the sexual behaviors of obese and non-obese adolescents. We take a developmental approach by examining how relationship experiences evolve over time. Finally, by exploring how relationship experiences differ among African American and White adolescent girls, our approach acknowledges that cultural differences in beauty norms exist and are important. PUBLIC HEALTH SIGNIFICANCE: The overarching goal of this research is to expand the conceptual framework linking weight to adolescent sexual risk-taking thereby providing critical information useful for tailoring adolescent sexual risk-reduction interventions and sexual negotiation skills building programs.