Relationship between adolescent weight, sexual behavior and reproductive outcomes

描述（由申请人提供）：一半的美国儿童和青少年超重或有超重风险。这是令人担忧的，因为儿童时期BMI升高会增加成年后早期发病和残疾的风险，并缩短寿命。越来越多的证据表明，体重在人际关系的形成中也起着重要作用。体重似乎会影响约会和性机会，以及性风险行为和生殖结果。特别是，研究表明，超重或认为自己超重与性风险行为的风险增加有关。然而，大多数研究利用成年人群和横断面研究设计，因此在识别这些行为的早期前兆方面能力有限。此外，很少有研究进一步探讨体重对青春期或成年期生殖结果的下游影响。我们最近的研究为现有的文献做出了贡献，证明体重和性行为之间的关系在青春期早期和中期就很明显，而且存在显著的种族差异。随着儿童肥胖率的持续上升，我们必须更好地了解体型是如何以及对谁来说是影响青少年开始和长期持续的性风险行为和生殖结果的关键环境因素。我们建议通过使用两个具有全国代表性的纵向数据集：1997年全国青少年纵向调查（NLSY97）和全国青少年健康纵向调查（Add Health）进行二次数据分析，来检验青少年体重、性行为和生殖结果之间的关系。这些补充性数据集跟踪上学和不上学的青少年过渡到成年早期的情况。我们进行聚类分析，根据实际或感知的体重，确定青少年从事性风险行为风险最高的亚组。我们应用生长曲线建模技术来识别青春期到成年期性行为和生殖结果的纵向模式，这些轨迹的关键预测因素，以及体重的影响。我们探讨了种族和性别的影响，这方面的研究很少。这一建议具有创新性，因为我们采用了一种发展的方法来确定观察到的关联背后的机制，并确定这些关联最强的青年亚群。这将使我们能够确定可能从针对性健康预防计划中获益最多的个人。

DESCRIPTION (provided by applicant): Half of U.S. children and adolescents are overweight or at-risk for overweight. This is concerning because elevated BMI during childhood increases the risk of early onset of disease and disability in adulthood and reduced longevity. Mounting evidence demonstrates that weight also plays a significant role in interpersonal relationship formation. Weight appears to affect dating and sexual opportunities as well as engagement in sexual risk behaviors and reproductive outcomes. In particular, studies have demonstrated that being or perceiving oneself as overweight is associated with an increased risk of engagement in sexual risk behaviors. However, most studies utilize adult populations and cross sectional study designs and are therefore limited in their ability to identify the early precursors of these behaviors. Moreover, few studies have explored further downstream effects of weight on reproductive outcomes in adolescence or adulthood. Our recent research has contributed to the existing body of literature by demonstrating that the relationship between weight and sexual behaviors is evident as soon as during early and middle adolescence with significant racial variations. As rates of childhood obesity continue to rise, it is important that we develop a better understanding of how and for whom body size serves as a key contextual factor affecting adolescents' initiation and long-term perpetuation of sexual risk behaviors and reproductive outcomes. We propose to examine the relationship between adolescent weight, sexual behavior and reproductive outcomes by conducting secondary data analyses using two nationally representative longitudinal datasets: the National Longitudinal Survey of Youth 1997 (NLSY97) and the National Longitudinal Survey of Adolescent Health (Add Health). These complementary datasets follow school and non-school attending adolescents as they transition to early adulthood. We perform cluster analysis to identify subgroups of youth at highest risk for engaging in sexual risk behaviors based on their actual or perceived weight. We apply growth curve modeling techniques to identify longitudinal patterns of sexual behaviors and reproductive outcomes during the adolescent-to-adulthood transition, key predictors of these trajectories, and the effect of weight. We explore the effect of race and gender which few studies have examined. This proposal is innovative because we take a developmental approach to identify the mechanisms underlying the observed associations and identify subgroups of youth for whom these associations are strongest. This will allow us to identify individuals who may benefit most from targeted sexual health prevention programs.