Sasha A. Fleary, Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States;, Email:
Patrece Joseph, Eliot-Pearson Department of Child Study and Human Development, Tufts University, Medford, MA, United States.
Am J Health Behav. 2021 Jul 26;45(4):677-694. doi: 10.5993/AJHB.45.4.7.
Given the increasing national-level efforts to reduce disparities in obesogenic behaviors in youth, in this paper, we assessed the change in disparities in meeting guidelines for fruits and vegetables intake (FV), physical activity (PA), and sedentary behavior (SB) among adolescents in the United States in the last 13 years. Using the Youth Risk Behavior Surveillance System (2005-2017), overall and characteristic-specific (sex, age, race/ethnicity) disparities ratios for meeting FV, PA, and SB guidelines were calculated using the Extended Gastwirth Index Method. Linear regressions, one-way analysis of variance, and posthoc tests assessed change in characteristic-specific disparities over the years. Linear and quadratic trends assessed change in characteristic-specific contributions to overall disparities. Sex-specific and age-specific disparities increased for meeting FV and PA and decreased for meeting SB guidelines. Race/ethnicity-specific disparities decreased for meeting FV and SB guidelines. Characteristics-specific contributions to overall disparities for each behavior changed over the years. Disparities in obesogenic behaviors are still an ongoing concern despite national-level efforts to improve adolescents' behaviors. The methodology allowed for meaningful disparities ratios that facilitated comparison of categorical demographic characteristics across the years and identifying targetable intervention groups to reduce disparities.
鉴于国家层面在减少青少年肥胖相关行为方面的努力不断增加，本文评估了过去 13 年来美国青少年在满足水果和蔬菜摄入量（FV）、身体活动（PA）和久坐行为（SB）指南方面的差距变化。使用青少年风险行为监测系统（2005-2017 年），使用扩展 Gastwirth 指数法计算了总体和特征特异性（性别、年龄、种族/民族）差异比，以评估多年来满足 FV、PA 和 SB 指南的特征特异性差距的变化。线性回归、单向方差分析和事后检验评估了多年来特征特异性差异的变化。线性和二次趋势评估了特征特异性对总体差异的贡献变化。在满足 FV 和 PA 指南方面，性别特异性和年龄特异性的差距增加，而在满足 SB 指南方面则减少。在满足 FV 和 SB 指南方面，种族/民族特异性的差距减少。每种行为的总体差异的特征特异性贡献在这些年间发生了变化。尽管国家层面在努力改善青少年的行为，但肥胖相关行为方面的差距仍然是一个持续存在的问题。该方法允许进行有意义的差异比，这有助于比较多年来的分类人口统计学特征，并确定可减少差异的可干预目标群体。
