Young Men's Health and the Transition to Fatherhood

描述（由申请人提供）：本职业发展奖（K23）的目标是扩展申请人对家庭中父亲的定性工作，并获得理论、方法和干预技能，以了解年轻男性在向父亲身份过渡期间的健康状况，并制定改善男性健康的方法。与女性相比，男性的预期寿命较短，从事更危险的健康行为，并且未充分利用推荐的卫生服务。然而，在美国，男性健康的主要概念是基于器官，往往没有考虑到社会和环境因素。虽然大多数男性都是父亲，但人们对转变为父亲对男性健康的影响知之甚少，尤其是对年轻男性而言。众所周知，男人会参加孩子的出生，并准备在转变为父亲的过程中改变生活。本提案的具体目标是：1)检查向父亲的转变对年轻男性健康和健康行为的影响；2)表征这一转变期间年轻男性的医疗保健利用情况；3)利用目标1-2中获得的信息，并通过焦点小组，设计和试点一项随机干预措施，利用技术促进年轻男性向父亲的转变期间的健康。为了检验这些目标，申请人提出了与他的四位杰出导师（博士）一起设计的正式和经验培训计划。Greg Duncan， P. Lindsay Chase-Lansdale， David Cella和Eric Whitaker)，以及著名的父亲研究专家Rebekah Levine Coley博士，这将使他获得研究方法方面的经验和技能，包括调查设计，纵向和横断面分析，压力的心理生物学（包括生物标记分析），经济学和决策，生殖和生育理论，以及包括使用技术在内的健康沟通。为了检验目标1和目标2，本提案使用了国家青少年健康纵向研究（Add Health）中男性参与者的数据，这是一个纵向的、具有全国代表性的数据集，涵盖了青春期到成年早期。目标1和目标2使用前后比较和时间点比较来检查有孩子和没有孩子的年轻男性之间的差异，然后使用纵向方法创建一个人-年数据集来检查成为父亲对结果的贡献。选择问题可以通过多种方式处理，包括构建兄弟模型。目标3通过与新父亲进行焦点小组讨论，扩大上述调查结果，以确定健康信息提供的相关健康主题偏好。在对通过技术提供健康信息进行试点测试后，将对200名父亲进行随机干预，并评估健康和健康行为的变化。总而言之，本提案的目标是了解和改善年轻男性的健康、医疗保健利用和寿命，这是一个历史上难以达到的群体。

DESCRIPTION (provided by applicant): The goal of this Career Development Award (K23) is to expand on the applicant's qualitative work on fathers in families and gain the theoretical, methodological, and intervention skills to understand young men's health during the transition to fatherhood and to devise ways to improve men's health. Compared to women, men have a shorter life expectancy, engage in more risky health behaviors, and underutilize recommended health services. However, the predominant conceptualizations of men's health in the United States are largely organ- based and often do not account for social and contextual factors. Though the majority of men are fathers, there is little knowledge about how the transition to fatherhood affects men's health, especially among young men. Men are known to attend their child's birth and are prepared to make life changes during the transition to fatherhood. The specific aims of this proposal are: 1) to examine the effect of the transition to fatherhood on young men's health and health behaviors, 2) to characterize healthcare utilization for young men during this transition and 3) using the information obtained in aims 1-2 and through focus groups, to design and pilot a randomized intervention using technology to promote young men's health during the transition to fatherhood. To examine these aims, the applicant presents a plan for formal and experiential training that was devised along with his four exceptional mentors (Drs. Greg Duncan, P. Lindsay Chase-Lansdale, David Cella, and Eric Whitaker) and noted fathering research expert Dr. Rebekah Levine Coley that will allow him to gain experience and skills in research methodology including survey design, longitudinal and cross-sectional analyses, the psychobiology of stress (including biomarker analyses), economics and decision making, theories of reproduction and fertility, and health communication including the use of technology. To examine aims 1 and 2, this proposal uses data from male participants in the National Longitudinal Study of Adolescent Health (Add Health) a longitudinal, nationally representative dataset that spans adolescence to early adulthood. Aims 1 and 2 use pre-post comparisons and point-in-time comparisons to examine differences between young men with children and those without, and then uses longitudinal methods to create a person-year dataset to examine the contribution of becoming a father to the outcomes. Selection issues are dealt with in a variety of ways, including building sibling models. Aim 3 expands on the above findings through focus groups with new fathers to determine the set of relevant health topics preferences for health information delivery. After pilot testing the delivery of health information via technology, a randomized intervention of 200 fathers will be conducted and changes to health and health behaviors will be evaluated. In sum, the goal of this proposal is to understand and improve the health, healthcare utilization, and longevity of young men, a historically difficult-to reach group.