A Longitudinal Study of Health Risk Behavior in Youth

这是一项对所有危害健康的行为进行队列序贯研究的建议。具体目标是1)按性别和种族比较学龄儿童的背景/风险因素、保护资源和健康行为以及早期青少年的健康风险行为；2)确定风险因素、保护资源和学龄儿童的健康行为如何随时间变化；以及3)确定4、5和6年级的哪组风险因素和保护资源最能预测青春期早期(7年级和8年级)的健康风险行为(性活动、吸烟、酒精和其他药物使用、饮食行为、身体活动和导致故意或无意伤害的行为)。导致美国年轻人发病和死亡的主要原因是与可预防的、危害健康的行为有关，这些行为往往一起发生。这些行为在少数民族中越来越普遍，但人们对增加风险或提供保护的因素知之甚少。使用队列序贯设计，德克萨斯州中部2200名不同种族的儿童将接受长达5年的调查，以满足这些特定目标。这项研究的发现将通过以下方式推进对青春期早期健康危险行为的认识：1)强调压力和种族是学龄儿童中未被研究的背景/风险因素，2)探索学龄儿童应对和幽默作为保护资源的未被研究的概念，3)探索学龄儿童健康行为与他们青春期早期健康危险行为之间的关系，4)确定这些危险因素和保护资源是否以及如何随时间变化，以及它们是否预测青春期早期的健康危险行为。以及5)探索风险因素和保护资源之间的关系，这些因素和保护资源在盎格鲁和墨西哥裔美国年轻人的健康风险行为中都具有中等和中介的结果。分层线性模型的使用将增加对弹性模型中主要变量如何随时间变化的理解，并允许我们对提供干预措施的关键时间做出推断，以减少青春期早期的健康风险行为。

This is a proposal for a cohort-sequential study of the full array of health-risk behaviors. Specific aims are to 1) compare contextual/risk factors, protective resources, and health behaviors of school-aged children as well as health-risk behaviors of early adolescents by gender and ethnicity; 2) identify how risk factors, protective resources, and health behaviors of school-aged children change over time; and 3) determine which set of risk factors and protective resources over grades 4, 5, and 6 best predict health-risk behaviors (sexual activity, tobacco use, alcohol and other drug use, dietary behaviors, physical activity, and behaviors that lead to intentional or unintentional injury) in early adolescence (7th and 8th grades). The leading causes of morbidity and mortality among American youth are associated with preventable, health-risk behaviors that tend to occur together. These behaviors are increasingly prevalent among ethnic minorities, yet little is known about factors that increase risk or provide protection against these behaviors. Using a cohort-sequential design, a convenience sample of 2200 ethnically diverse children in grades 4-6 in central Texas will be surveyed up to 5 years to meet these specific aims. Findings from the study will advance knowledge about health-risk behaviors in early adolescence by 1) emphasizing stress and ethnicity as understudied contextual/risk factors in school-aged children, 2) exploring understudied concepts of coping and humor as protective resources in school- aged children, 3) exploring the relationship between school-aged children's health behaviors and their health-risk behaviors in early adolescence, 4) identifying whether and how these risk factors and protective resources change over time and whether they predict health-risk behavior in early adolescence, and 5) exploring relationships among risk factors and protective resources that both moderate and mediate outcomes of health-risk behavior in both Anglo and Mexican American youth. The use of hierarchical linear models will increase understanding of how the major variables in the resilience model change over time and allow us to make inferences about the critical time at which to deliver interventions to reduce health-risk behaviors in early adolescence.