Cribb Fabersunne Camila, Milliren Carly, Schuster Mark A, Elliott Marc N, Emery Susan Tortolero, Cuccaro Paula M, Davies Susan L, Richmond Tracy
Department of Pediatrics, University of California, San Francisco, San Francisco, California.
Division of Adolescent Medicine, Department of Medicine, Boston Children's Hospital, Boston, Massachusetts; Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Massachusetts.
J Adolesc Health. 2024 Aug;75(2):333-343. doi: 10.1016/j.jadohealth.2024.04.007. Epub 2024 Jun 6.
Sexual debut in early adolescence is associated with poor health outcomes in adulthood. We examined the associations of social capital within families, schools, and neighborhoods with early sexual debut.
Using data from the Healthy Passages cohort, a longitudinal multilevel study of adolescents, we performed a series of cross-classified multilevel logistic regression models to examine (1) the relative contribution of schools and neighborhoods to the variance and (2) the association of markers of social cohesion/social capital in families, schools, and neighborhoods with sexual debut by 10th grade.
There were 4,001 youth participants nested in 115 schools and 751 neighborhoods, with a high degree of cross-classification (1,340 unique combinations of school and neighborhoods). In models adjusting for individual demographics, neighborhoods contributed more to the variance (log odds U [95% confidence interval {CI}] [intra class correlation {ICC}%]) in sexual debut than schools: U = 0.11 (0.02, 0.23) [3.2%] versus U = 0.07 (0.01, 0.16) [2%]. Restriction of dating and family cohesion, markers of family social capital, were associated with reduced odds of sexual debut by 10th grade (odds ratio = 0.45 95% CI: 0.41-0.49 and 0.93, 95% CI: 0.86, 1.00). Neighborhood cohesion and education level were associated with early debut. Although reduced, there remained significant, unexplained variance in both the school and neighborhood level in the fully adjusted model (U = 0.08 [0.01, 0.17] [2.3%], U = 0.08 [0.02, 0.17] [2.2%]).
Markers of social capital at the family and neighborhood levels were associated with sexual debut by 10th grade. Developers of public health programs aiming to delay sexual debut should consider family-focused and neighborhood-focused interventions.
青春期早期开始有性行为与成年后的健康不良后果相关。我们研究了家庭、学校和社区内的社会资本与青春期早期开始有性行为之间的关联。
利用来自“健康成长”队列研究的数据,这是一项针对青少年的纵向多层次研究,我们进行了一系列交叉分类的多层次逻辑回归模型,以检验(1)学校和社区对方差的相对贡献,以及(2)家庭、学校和社区中社会凝聚力/社会资本的指标与十年级时开始有性行为之间的关联。
共有4001名青年参与者嵌套在115所学校和751个社区中,交叉分类程度较高(学校和社区的独特组合有1340种)。在调整了个体人口统计学因素的模型中,社区对开始有性行为的方差贡献(对数优势比U[95%置信区间{CI}][组内相关系数{ICC}%])比学校更大:U = 0.11(0.02,0.23)[3.2%],而学校为U = 0.07(0.01,0.16)[2%]。限制约会和家庭凝聚力,即家庭社会资本的指标,与十年级时开始有性行为的几率降低相关(优势比 = 0.45,95% CI:0.41 - 0.49;以及0.93,95% CI:0.86,1.00)。社区凝聚力和教育水平与过早开始有性行为相关。尽管有所降低,但在完全调整后的模型中,学校和社区层面仍存在显著的、无法解释的方差(U = 0.08 [0.01,0.17] [2.3%],U = 0.08 [0.02,0.17] [2.2%])。
家庭和社区层面的社会资本指标与十年级时开始有性行为相关。旨在推迟开始有性行为的公共卫生项目开发者应考虑以家庭和社区为重点的干预措施。