Health Consequences of Drug Use and IPV Trajectories for Young Latinas

 说明(申请人提供)：很少有实证研究记录与帮派有关联的青春期女性的生活轨迹，以及青少年吸毒和伴侣暴力受害的长期健康后果。这项研究的目的是确定和确定在青春期到成年期出现的不同的吸毒和亲密伴侣暴力受害轨迹如何在一个高度不利的社区的背景下促进墨西哥裔美国妇女的身心健康结果。这一妇女群体特别脆弱，因为她们获得和利用医疗保健的比率较低，是最有可能得不到保险的年龄段，而且由于她们处于生殖和性健康阶段，这对社区来说是一种风险、脆弱性和潜在的高成本的联系。这项申请建议对CDC资助的一项研究中发现的一组墨西哥裔美国青少年女性进行15年的跟踪调查，这些女性在青春期与男性帮派成员有关联，并参与了高吸毒率和亲密伴侣暴力的受害者。在研究小组先前研究的基础上，并使用性别与权力理论和社会纽带理论的分析工具，这一应用程序将实施并行混合方法嵌套设计方法，以提供对药物使用和IPV的长期后果的全面了解。样本将包括300名年轻的成年墨西哥裔美国女性。这项研究的具体目标是：1)确定身体(心血管和代谢风险标记物和STI感染)和精神(抑郁、创伤后应激、焦虑/压力)健康结果的流行率；2)确定和表征从青春期到青年时期不同的药物使用和IPV轨迹；3)确定不同年龄阶段的性关系力量和家庭社会纽带是否会改变药物使用和IPV轨迹和健康结果；以及4)定性描述文化和社区背景及其对生命过程中药物使用和IPV轨迹的影响。这项研究将产生重要的积极影响，通过确定哪些妇女在过渡到青年时期时最有可能出现有害的药物和IPV轨迹。通过这样做，我们将为确定关键年龄分级时期的行为干预临界点以及文化和背景合适的价值观和战略奠定基础，这些价值观和战略将减少现有研究中代表性不足的类似高危女性人群的健康差距。

 DESCRIPTION (provided by applicant): Few empirical studies have documented the life trajectories of gang-affiliated adolescent females and the long- term health consequences of adolescent drug use and partner violence victimization. The purpose of this study is to identify and determine how distinct drug use and intimate partner violence victimization trajectories that emerge in adolescence through young adulthood contribute to physical and mental health outcomes among Mexican American women within the context of a highly disadvantaged community. This group of women are particularly vulnerable given they have low rates of access and utilization of health care, are the most likely age group to be uninsured, and represent a nexus of risk, vulnerability and potentially high costs to communities given their reproductive and sexual health stage of life. This application proposes a 15 year follow up of a cohort of Mexican American adolescent females previously identified in a CDC funded study who were affiliated with male gang members during their adolescence and involved in high rates of drug use and victims of intimate partner violence. Building upon the research teams previous studies and using analytical tools from the theory of gender and power and social bonding theory, this application will implement a concurrent mixed methods nested design approach to provide a comprehensive understanding of the long-term consequences of drug use and IPV. The sample will consist of 300 young adult Mexican-American females. The specific aims for this study are: 1) determine the prevalence of physical (cardiovascular and metabolic risk markers and STI infection) and mental (depression, PTSD, anxiety/stress) health outcomes; 2) identify and characterize distinct drug use and IPV trajectories from adolescence through young adulthood; 3) determine whether sexual relationship power and family social bonds during distinct age-graded stages alter drug use and IPV trajectories and health outcomes; and 4) characterize qualitatively the culture and community context and their influence on drug use and IPV trajectories over the life course. This research will have an important positive impact by identifying women who are at the highest risk for developing harmful drug and IPV trajectories as they transition into young adulthood. In doing this, we will lay the foundation for identifying critical points of behavioral intervention during key age-graded periods as well as culturally and contextually appropriate values and strategies that will reduce health disparities among similar high-risk female populations that have gone underrepresented in existing research.