Influence of neighbourhood collective efficacy on adolescent sexual behaviour: variation by gender and activity participation.

摘要

BACKGROUND: Adolescent sexual engagement is a good proxy measure of health risks in the USA owing to a higher prevalence of risky sexual behaviours among sexually active adolescents and to associated undesirable health outcomes. Neighbourhood collective efficacy is considered a potential social process that may prevent or delay early sexual engagement among adolescents. This study examined whether neighbourhood collective efficacy is associated with adolescent lifetime sexual intercourse and whether the association differs by gender, out-of-school activity participation and race/ethnicity. METHODS: This study is a two-level multilevel analysis of the 2000-01 Wave 1 Los Angeles Family and Neighborhood Survey (L.A.FANS-1) data. Responses of 2671 adults who answered collective efficacy-related questions were used to create a tract-level measure of collective efficacy (65 tracts). The tract-level collective efficacy measure was linked to adolescents 12-17 years old who answered a question on lifetime sexual intercourse (n= 859). Individual and family factors including age, gender, race/ethnicity, parental monitoring, activity participation, family composition and family income were controlled for to estimate neighbourhood effects net of individual and family differences. Interactions of collective efficacy with individual-level covariates were also tested. RESULTS: The protection of collective efficacy against lifetime sexual intercourse was significant only among boys [odds ratio (OR) = 0.67, 95% confidence interval (CI) = 0.47, 0.95]. The effect differed by participation status in out-of-school activities. The influence of collective efficacy was significant only in boys who did not participate in out-of-school activities (OR = 0.46, 95% CI = 0.29, 0.73). The association of collective efficacy with the outcome was similar across racial/ethnic groups including Latino adolescents. CONCLUSIONS: This study indicates the role of neighbourhood collective efficacy in protecting against adolescent sexual engagement with variation by gender and activity participation status. Findings point to the importance of considering specific neighbourhood characteristics and cross-level interactions in developing effective policies and programmes.