The Effects of Peer Networks on the Status of Gonorrhea and Chlamydia Infections among High School Adolescents in the United States Pubblico
Williams, Tiffany S. (2012)
Published
Abstract
Sexually transmitted diseases are the most common reportable
infectious disease in the United States. The two most common STDs
are chlamydia and gonorrhea. Adolescents ages 15-19 are the most
affected by these STDs and have rates higher than the total
population. Females and African Americans of this subset also have
disproportionate rates.
During adolescence, people engage in their most risky behaviors. Peers become an important source of reinforcement and modeling concerning the individual's attitude and belief system. Since most of their time is spent with their peers, this network provides more influence on their behaviors compared to their family. Thus, examination of an individual‟s social network may provide increased insight into the individual's behavior.
The goal of this thesis is to evaluate the effects of peer networks on the status of gonorrhea and chlamydia infections among high school adolescence in the U.S. using the National Longitudinal Survey of Adolescent Health.
Due to the design of the study, generalized estimating equations (GEE) methods were conducted under the assumption of an exchangeable intra-cluster correlation structure. Models identifying risk factors for positive status infections of gonorrhea and chlamydia were produced. 1985 students were used in the analysis.
Sixty one (2.96%) students were classified as having had
gonorrhea or chlamydia. Individual attributes, race and gender, in
combination with the peer network levels of drinking, smoking,
skipping school, and fighting, are significant in helping predict
the status of gonorrhea and chlamydia infections. The odds for
getting these STDs, adjusting for gender, drinking, smoking and
fighting, is approximately 4 times higher for blacks. Furthermore,
females have odds approximately 3 times higher than males when
adjusting for all other predictors in the model. The GEE analysis
concluded that none of the ego network measures have an individual
effect on the acquisition of gonorrhea and chlamydia. However, in
the prediction model individuals' gender, race, centrality, and
density of their send/receive network are significant. Adjusting
for gender, centrality, and send/received density, blacks are 2.54
times higher than non-blacks for a positive STD status.
Public health implications and future directions of
research are also discussed.
Table of Contents
Table of Contents
1. Introduction…………………………………………………………………………………….............1
1.1. Problem Statement………………………………………………………………….........2
1.1.1. Problem
Statistics……………………………………………………….........3
1.1.2. Problem Among
Adolescents………………………………………..........3
1.1.3. Problem by
Gender……………………………………………………….........3
1.1.4. Problem by
Race/Ethnicity……………………………………………........4
1.2. Purpose Statement…………………………………………………………………..........4
1.3. Objectives…………………………………………………………………………...............4
2. Background/Literature Review……………………………………………………………….........5
2.1. Theory………………………………………………………………………………................5
2.1.1. Social Ecological
Framework………………………………………...........5
2.1.2. Bronfenbrener's Ecological Systems
Theory……………………..5
2.2. Previous Research...………………………………………………………………….........6
2.3. Antecedents...………………………………………………………………………............6
3. Methods………………………………………………………………………………………..................8
3.1. Study Description………………………………………………………………….............8
3.2. Wave I……………………………………………………………………………….................8
3.3. In-School Survey……………………………………………………………………............8
3.3.1.
Recruitment……………………………………………………………….............8
3.3.2.
Questionnaire……………………………………………………………............9
3.4. In-home Survey…………………………………………………………………….............9
3.4.1.
Recruitment………………………………………………………………............9
3.4.2. Special
Samples…………………………………………………………...........9
3.4.3.
Saturation………………………………………………………………..............9
3.4.4.
Questionnaire……………………………………………………………............10
3.4.5. Weights…………………………………………………………………….............10
3.5. Wave II In-home Survey……………………………………………………………........11
3.5.1.
Recruitment………………………………………………………………............11
3.5.2.
Questionnaire……………………………………………………………............11
3.5.3
Weights……………………………………………………………………..............11
3.6. Network Analysis…………………………………………………………………..............11
3.6.1. Data Collection………………………………………………………….............11
3.7. Independent Variables………………………………………………………………..........12
3.7.1. Individual-level Network Variables……………………………………......12
In-degree…………………………………………………………………..............12
Out-Degree………………………………………………………………..............12
Bonacich
Centrality…………………………………………………….............12
Reach……………………………………………………………………..................13
Reach in Three
Steps……………………………………………………...........13
Proximity
Prestige………………………………………………………...............13
Influence
Domain………………………………………………………................14
3.7.2. Ego Network Variables………………………………………………….............14
Ego Send Network
Density………………………………………………...........14
Size of Ego Send
Network………………………………………………............15
Ego Send/Receive Network
Density…………………………….........15
Size of Ego Send/Received
Network…………………………………........15
3.7.3. Ego-Network Behavior/ Attributes Means…………………….....15
Mean Values on Behavior Attributes Measur…………………....16
3.8. Outcome Variables…………………………………………………….................16
3.8.1. Questionnaire Scales………………………………………...............16
3.9. Statistical Analysis…………………………………………………….................18
4. Results……………………………………………………………………………….....................19
Behavior and Attribute Variables……………………………………………….............20
Social Network Measures………………………………………………………................32
5. Discussion…………………………………………………………………………….........................40
5.1. Discussion…………………………………………………………………….....................40
5.2.
Implications………………………………………………………………….....................41
5.3. Limitations and Future Directions………………………………………...........41
References…………………………………………………………………………………….......................42
Appendix A: All Tables………...……………………………………………………..................44
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