Determinants and disparities in high-risk sexual behaviors in US adolescents

预防青少年的高风险性行为是社会和行为科学家面临的一些最困难和最重要的挑战。本研究将探讨青少年高危性行为的成因及差异。目标涉及测试的因果关系模型的性行为的三重影响理论（TTI; Flay & Petraitis，1994），一个模型在预测其他青少年的风险行为，指定的操作关键的近端因素以及更远的因素进行了良好的测试。与TTI一致，近端因素包括自我效能、态度和社会规范;远端因素包括总体积极期望、抑郁症状、父母相关性和学术取向。最后，潜在的重要社会文化影响将作为模型中的最终（最远）因素进行测试。拉丁美洲人的全球期望和文化取向是模型中强调的两个重要因素，这些因素在青少年性行为的综合模型中得到了充分研究。这些目标将通过对1994-2002年收集的Add Health数据（国家青少年健康纵向研究）进行二次分析来实现。这些数据（第一波N = 20，745;第二波N = 14，738;第三波N = 15，197）提供了从青春期中期到青年期的非常强的模型测试。这些数据包括来自朋友、伴侣和父母的报告，也有相当大比例的拉丁裔青年（包括大量的墨西哥裔美国人，但也超过了古巴裔美国人和波多黎各青年的样本）和非洲裔美国人。在两次随访中重点关注的行为结果包括报告的过早性交、无保护性交和性伴侣数量。此外，报告的意外怀孕，报告的性病，以及在第三波性病检测阳性测试将被包括在内，以验证行为报告，并提供模型的预测效力的进一步测试。将采用适用于纵向数据的尖端分析技术，如结构方程、生存率和多水平建模，以实现研究目标。通过澄清导致这些行为的因果关系，并确定哪些具体的保护或风险因素是最关键的青少年群体的差异是显而易见的，拟议的项目可能有助于制定更有效的性风险降低计划，为不同的青少年人口。在美国，青少年的性冒险行为是导致过早死亡和残疾的主要原因，也是导致意外怀孕的主要原因。尽管有证据表明不同种族群体之间和内部的性行为模式不同，但社会文化因素在高风险性行为决定因素的综合理论指导模型中的作用相对未经检验。通过在这样一个理论模型中澄清诸如文化取向等因素，本研究将有助于预防方案努力解决不同青少年群体最关键的性冒险威慑因素。

DESCRIPTION (provided by applicant): Preventing youths' high-risk sexual behaviors represent some of the most difficult and important challenges for social and behavioral scientists. This study will identify factors contributing to youths' high-risk sexual behaviors and their disparities. The objectives involve testing a causal model of sexual behaviors guided by the theory of triadic influence (TTI; Flay & Petraitis, 1994), a model well-tested in predicting other adolescent risk behaviors that specifies the operation of key proximal factors as well as more distal factors. Consistent with TTI, proximal factors will include self-efficacy, attitudes, and social norms; distal factors include global positive expectancies, depressive symptoms, parental relatedness, and academic orientation. Finally, potentially vital socio-cultural influences will be tested as ultimate (most distal) factors in the model. Global expectancies and cultural orientation in Latinos are two important factors of emphasis in the model that are understudied within comprehensive models of adolescents' sexual behaviors. The objectives will be accomplished through secondary analyses of Add Health data (National Longitudinal Study of Adolescent Health) collected from 1994-2002. These data (N = 20,745 at Wave I; N = 14,738 at Wave II; N = 15,197 at Wave III) afford very strong tests of the model from mid-adolescence through young adulthood. These data include reports from friends, partners and parents, and also have substantial proportions of Latino youth (including substantial Mexican Americans, but also over samples of Cuban American and Puerto Rican youth) and African Americans. Behavioral outcomes of focus at both follow-ups include reported early intercourse, unprotected sexual intercourse, and number of sexual partners. Additionally, reported unintended pregnancies, reported STDs, and positive tests on STD assays at Wave III will be included both to validate the behavioral reports and to provide further testing of the model's predictive efficacy. Cutting edge analysis techniques appropriate for longitudinal data such as structural equation, survival, and multi-level modeling will be employed to achieve the study objectives. By clarifying the causal paths leading to these behaviors and identifying which specific protective or risk factors are most critical for adolescent groups where disparities are apparent, the proposed project may aid in the development of more effective sexual-risk reduction programs designed for diverse adolescent populations. Adolescent sexual risk taking behaviors are major causes of premature death and disability in the US as well as lead to unplanned pregnancies. Despite evidence suggesting differing patterns of sexual behaviors between and within ethnic groups, the role of socio-cultural factors within comprehensive theory-guided models of the determinants of high-risk sexual behaviors have been relatively untested. By clarifying such factors like cultural orientation within such a theoretical model, this study will assist preventive programs in their efforts to address the most critical sexual risk taking deterrence factors for diverse adolescent groups.