International Center for Child Health and Development, Brown School, Washington University, St. Louis, Missouri.
International Center for Child Health and Development, Masaka Field, Masaka, Uganda.
J Adolesc Health. 2024 Jan;74(1):130-139. doi: 10.1016/j.jadohealth.2023.08.006. Epub 2023 Oct 5.
This paper uses data from a 3-arm Cluster Randomized Control Trial, Suubi4Her (N = 1260; 14-17-year-old school-going girls) to (1) assess the relationship between peer pressure and adolescent risk-taking behaviors; and (2) test the mediating effect of peer pressure on an intervention on adolescent risk-taking behaviors.
Students in the southwestern region of Uganda were assigned to three study arms: control (n = 16 schools, n = 408 students) receiving usual care comprising of sexual and reproductive health curriculum; and two active treatment arms: Treatment 1 (n = 16 schools, n = 471 students) received everything the control arm received plus a savings led intervention. Treatment 2 (n = 15 schools, n = 381 students) received everything the control and treatment arms received plus a family strengthening intervention. We used multilevel models to assess the relationship between peer pressure and risk-taking behaviors. We ran structural equation models for mediation analysis.
Using baseline data, we found that direct peer pressure was significantly associated with substance use risk behaviors, (β = 0.044, 95% CI = 0.008, 0.079). We also found a statistically significant effect of the intervention on acquiring STIs through the mediating effect of sexual risk-taking significant (β = -0.025, 95% CI: -0.049, -0.001, p = .045) and total indirect (β = -0.042, 95% CI: -0.081, -0.002, p = .037) effects. Also, there was a significant mediation effect of the intervention on substance use through peer pressure (β = -0.030, 95% CI: -0.057, -0.002, p = .033).
Overall, the study points to the role of peer pressure on adolescent girls' risk-taking behaviors; and a need to address peer pressure at an early stage.
本研究使用来自 Suubi4Her（共 1260 名 14-17 岁在校女生参与；N=1260）的三臂整群随机对照试验数据，（1）评估同伴压力与青少年风险行为之间的关系；（2）检验同伴压力对青少年风险行为干预措施的中介效应。
乌干达西南部的学生被分配到三个研究组：对照组（n=16 所学校，n=408 名学生）接受性和生殖健康教育课程的常规护理；和两个主动治疗组：治疗 1 组（n=16 所学校，n=471 名学生）接受对照组的所有治疗措施，外加储蓄导向干预措施；治疗 2 组（n=15 所学校，n=381 名学生）接受对照组和治疗 1 组的所有治疗措施，外加家庭强化干预措施。我们使用多层模型评估同伴压力与风险行为之间的关系。我们进行了结构方程模型中介分析。
使用基线数据，我们发现直接同伴压力与物质使用风险行为显著相关（β=0.044，95%CI=0.008，0.079）。我们还发现，通过性风险行为的中介作用，干预对获得性传播感染的效果在统计学上具有显著意义（β=-0.025，95%CI：-0.049，-0.001，p=0.045）和总间接（β=-0.042，95%CI：-0.081，-0.002，p=0.037）效应。此外，干预措施通过同伴压力对物质使用也存在显著的中介效应（β=-0.030，95%CI：-0.057，-0.002，p=0.033）。
总体而言，该研究指出了同伴压力对少女风险行为的影响，以及在早期阶段需要解决同伴压力的必要性。
