Stanton B, Fang X, Li X, Feigelman S, Galbraith J, Ricardo I
Department of Pediatrics, University of Maryland School of Medicine, Baltimore, USA.
Arch Pediatr Adolesc Med. 1997 Apr;151(4):398-406. doi: 10.1001/archpedi.1997.02170410072010.
To examine the evolution of risk behaviors over 2 years among a community-based cohort of low-income African American preadolescents and young adolescents enrolled in a randomized trial of an acquired immunodeficiency syndrome risk reduction intervention.
Longitudinal, community-based cohort.
Nine recreation centers serving 3 public housing developments.
Three hundred eighty-three African American youths aged 9 through 15 years at baseline.
Frequency distributions, chi 2 analyses, and regression analyses regarding 10 risk behaviors were conducted. To assess whether a specific risk behavior or its protective (nonrisk) behavioral analogue, composing a risk-nonrisk behavioral complex (eg, was sexually active and was sexually abstinent or used drugs and refrained from drugs), was stable over time, kappa values were determined for the 10 risk-nonrisk behavioral complexes.
Instrument assessing risk/ behaviors administered at baseline and every 6 months aurally and visually via talking computer.
The prevalence of sexual intercourse, cigarette smoking, alcohol consumption, and drug use increased notably over time. Drug use increased from a 6-month cumulative prevalence of 7% at baseline to 27% at the 24-month follow-up (P < .001). Cumulatively over the 2-year study interval, 81% of youths had engaged in fighting, 58% had engaged in sexual intercourse, and from 33% to 40% had engaged in truancy, knife or bat carrying or both, alcohol consumption, drug use, and cigarette smoking. All of the risk-nonrisk behavioral complexes except weapon carrying were stable during the semiannual assessment intervals. Fighting (kappa = 0.22, P < .01), sexual intercourse (kappa = 0.33, P < .001), alcohol consumption (kappa = 0.21, P < .001), and unprotected sexual intercourse (kappa = 0.34, P < .05) were stable for 2 years. Six risk-nonrisk behavioral complexes were stable for the 2-year interval among youths aged 13 through 15 years at baseline, while only 2 risk-nonrisk behavioral complexes were stable among younger youths. The intervention seemed to affect the stability of 4 risk behaviors: truancy, drug use, unprotected sexual intercourse, and, possibly, fighting. For unprotected sexual intercourse, this intervention effect seemed to be due to stabilization of nonparticipation in risky behavior. Intervention youths were less likely to adopt a risk behavior (ie, engage in it for > or = 2 risk assessment periods) than control youths, but they were not less likely to experiment with a risk behavior.
There is evidence that although the prevalence of risk behaviors does change with age, most risk-nonrisk behavioral complexes seem to be relatively stable over time and stability may increase with time. Risk reduction interventions seem to decrease risk adoption, stabilize nonrisk behaviors, and possibly destabilize risk behavior.
在参与一项获得性免疫缺陷综合征风险降低干预随机试验的低收入非裔美国学龄前儿童和青少年组成的社区队列中，研究2年期间风险行为的演变情况。
基于社区的纵向队列研究。
为3个公共住房开发区服务的9个娱乐中心。
基线时年龄在9至15岁的383名非裔美国青少年。
对10种风险行为进行频率分布、卡方分析和回归分析。为评估特定风险行为或其保护性（无风险）行为类似物（构成风险-无风险行为复合体，如进行性行为与禁欲或使用毒品与戒毒）随时间是否稳定，确定了10种风险-无风险行为复合体的kappa值。
通过语音计算机在基线时以及每6个月通过听觉和视觉方式进行的风险/行为评估工具。
随着时间推移，性交、吸烟、饮酒和吸毒的患病率显著增加。吸毒从基线时6个月累计患病率7%增至24个月随访时的27%（P<.001）。在2年研究期间累计，81%的青少年参与过打架，58%有过性交，33%至40%有过逃学、携带刀具或棍棒或两者皆有、饮酒、吸毒和吸烟行为。除携带武器外，所有风险-无风险行为复合体在半年评估期间均保持稳定。打架（kappa = 0.22，P<.01）、性交（kappa = 0.33，P<.001）、饮酒（kappa = 0.21，P<.001）和无保护性交（kappa = 0.34，P<.05）在2年内保持稳定。6种风险-无风险行为复合体在基线时年龄为13至15岁的青少年中2年期间保持稳定，而在年龄较小的青少年中只有2种风险-无风险行为复合体保持稳定。该干预似乎影响4种风险行为的稳定性：逃学、吸毒、无保护性交以及可能的打架。对于无保护性交，这种干预效果似乎是由于参与危险行为的稳定。干预组青少年比对照组青少年更不可能采取风险行为（即连续≥2个风险评估期参与该行为），但他们尝试风险行为的可能性并不小。
有证据表明，尽管风险行为的患病率确实随年龄变化，但大多数风险-无风险行为复合体随时间似乎相对稳定，且稳定性可能随时间增加。风险降低干预似乎可减少风险行为的采取，稳定无风险行为，并可能使风险行为不稳定。
