EPIUnit - Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal.
EPIUnit - Instituto de Saúde Pública da Universidade Do Porto, Porto, Portugal; ITR- Laboratório para a Investigação Integrativa e Translacional, Porto, Portugal.
Public Health. 2023 Jul;220:80-87. doi: 10.1016/j.puhe.2023.05.001. Epub 2023 Jun 3.
This study aimed to prospectively explore the association between early lifetime exposure to psychosocial adversity and engagement in health risk behaviours (HRBs) during early adolescence.
This was a prospective study.
This study used data from the baseline (2005-2006), third (2016-2017) and fourth waves (2018-2020) of the Generation XXI birth cohort. Socio-economic circumstances (SECs) at baseline, adverse childhood experiences (ACEs; e.g. abuse, neglect, household dysfunction) at age 10 years and HRBs (i.e. alcohol consumption, smoking, physical exercise level, sedentary behaviours, sleep duration and eating behaviours) at age 13 years were measured. Patterns of HRBs were obtained using latent class analysis. Latent class regression analysis was used to estimate the likelihood of being engaged in HRBs according to the extent of exposure to ACEs (i.e. 0 ACEs, 1-3 ACEs, 4-5 ACEs and ≥6 ACEs) and negative family SECs.
Adolescents whose mothers had a low level of education (adjusted odds ratio [aOR] = 2.72 [95% confidence interval {CI}, 2.33-3.18]), low occupational status (aOR = 3.21 [95% CI, 2.68-3.85]) and low income (aOR = 2.70 [95% CI, 2.23-3.28]) were more likely to be engaged in HRBs than their peers with higher SECs. Adolescents who experienced more ACEs were at a significantly increased risk of involvement in HRBs (aOR = 1.86 [95% CI, 1.33-2.63] for 4-5 ACEs vs aOR 2.41 [95% CI, 1.72-3.43] for ≥6 ACEs). No significant gender differences were observed.
Adolescents from families with low SECs were more likely than their more affluent counterparts to be engaged in HRBs. Furthermore, more ACEs contributed to widening health inequalities.
本研究旨在前瞻性探讨个体在青少年早期经历的早期生命期心理社会逆境与参与健康风险行为（HRB）之间的关联。
这是一项前瞻性研究。
本研究使用了 21 世纪出生队列的基线（2005-2006 年）、第三（2016-2017 年）和第四波（2018-2020 年）的数据。在基线时评估社会经济状况（SEC），在 10 岁时评估童年逆境经历（ACEs；例如，虐待、忽视、家庭功能障碍），在 13 岁时评估 HRB（即饮酒、吸烟、体育锻炼水平、久坐行为、睡眠时间和饮食行为）。使用潜在类别分析获得 HRB 模式。使用潜在类别回归分析根据 ACEs 暴露程度（即 0 个 ACEs、1-3 个 ACEs、4-5 个 ACEs 和≥6 个 ACEs）和负性家庭 SEC 来估计参与 HRB 的可能性。
与 SEC 较高的同龄人相比，母亲教育程度较低（调整后的优势比[aOR] = 2.72 [95%置信区间 {CI}，2.33-3.18]）、职业地位较低（aOR = 3.21 [95% CI，2.68-3.85]）和收入较低（aOR = 2.70 [95% CI，2.23-3.28]）的青少年更有可能参与 HRB。经历更多 ACEs 的青少年参与 HRB 的风险显著增加（4-5 个 ACEs 的 aOR = 1.86 [95% CI，1.33-2.63]，≥6 个 ACEs 的 aOR = 2.41 [95% CI，1.72-3.43]）。未观察到显著的性别差异。
社会经济地位较低的家庭中的青少年比其富裕的同龄人更有可能参与 HRB。此外，更多的 ACEs 导致健康不平等加剧。
