Adolescent health-risk behavior and community disorder.

Various forms of community disorder are associated with health outcomes but little is known about how dynamic context where an adolescent spends time relates to her health-related behaviors.Assess whether exposure to contexts associated with crime (as a marker of community disorder) correlates with self-reported health-related behaviors among adolescent girls.Girls (N = 52), aged 14-17, were recruited from a single geographic urban area and monitored for 1 week using a GPS-enabled cell phone. Adolescents completed an audio computer-assisted self-administered interview survey on substance use (cigarette, alcohol, or marijuana use) and sexual intercourse in the last 30 days. In addition to recorded home and school address, phones transmitted location data every 5 minutes (path points). Using ArcGIS, we defined community disorder as aggregated point-level Unified Crime Report data within a 200-meter Euclidian buffer from home, school and each path point. Using Stata, we analyzed how exposures to areas of higher crime prevalence differed among girls who reported each behavior or not.Participants lived and spent time in areas with variable crime prevalence within 200 meters of their home, school and path points. Significant differences in exposure occurred based on home location among girls who reported any substance use or not (p 0.04) and sexual intercourse or not (p 0.01). Differences in exposure by school and path points were only significant among girls reporting any substance use or not (p 0.03 and 0.02, respectively). Exposure also varied by school/non-school day as well as time of day.Adolescent travel patterns are not random. Furthermore, the crime context where an adolescent spends time relates to her health-related behavior. These data may guide policy relating to crime control and inform time- and space-specific interventions to improve adolescent health

Methodology and measurement of areas of crime prevalence.

<p>(A) Conceptual depiction of path pattern exposure data to areas of crime prevalence. Each 5 minute path point includes the 3-year crime data within a 200-meter (∼1 block) buffer of this point. (B) Location of participant homes (yellow) and 200-meter buffers (black) within the study recruitment area (red) with background levels of crime ‘hot-spots’ (grey shading) and Census block groups (grey lines). (C) Path points of 1 participant (green) within and outside of the study area (red) with the inset indicating a zoomed area of path with points linked using color coding (red in the morning to blue in the evening), 200-meter buffers (black) and crime hot-spots (grey shading) and Census block groups (grey lines).</p

Mean and standard deviation (sd) exposure to areas of crime prevalence (3 year aggregate) by reported behavior among all participants for exposure only based on home or using all path data^*.

*<p><i>P values compare participants reporting either any substance use or any sexual intercourse to participants reporting no sexual intercourse or substance use. Home represents 200 meters surrounding the residential parcel.</i></p

Average 200/day of week and self-reported health-related behavior in the last 30 days.

<p>Average 200/day of week and self-reported health-related behavior in the last 30 days.</p