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Principal Investigator: Linnea Ariel Zimmerman
Organization: JOHNS HOPKINS UNIVERSITY
Fiscal Year: 2024
Award: $81,875
Funding agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development
Project Summary
The goal of this research is to inform the development of adolescent health programs through understanding
the development and trajectories of empowerment over the course of adolescence, among girls and boys, and
quantifying how this process influences sexual and reproductive health behaviors and outcomes. The
proposed project will use four waves of longitudinal data, collected annually from a sample of 2,842
adolescents, aged 10-14 years at enrollment, in Kinshasa, Democratic Republic of Congo. Learnings from this
research will inform interventions designed to improve empowerment and affect long-term health trajectories of
adolescents as they transition into adulthood.
The specific aims are:
1. Establish how agency evolves over time for boys and girls. Using each sub-scale of agency
(Freedom of Movement, Voice, Decision-Making) and a combined agency score across all domains, we
will conduct latent growth curve modeling to assess how individual scores change over time and
explore how these trajectories differ by gender.
2. Identify significant socio-ecological factors (opportunity structures) that influence trajectories,
by gender. We will use latent growth curve modeling to explore the effect of time varying socio-
ecological factors (including individual, family, peer, and neighborhood factors) that predict changes in
total agency and within each agency sub-scale to assess how opportunity structures influence the
development of agency over time.
3. Assess the association of agency in very young adolescence with sexual and reproductive
health behaviors in later adolescence. We will use Cox Proportional Hazard models to assess the
relationship of each domain of agency with age at sexual debut and logistic regression to evaluate
contraceptive behavior, and volitional sex, assessing the effect of both baseline levels of agency and
change over time in its impact on sexual and reproductive health behaviors.
The study is a secondary data analysis of longitudinal data from the Global Early Adolescent Study. Aims 1
and 2 will employ stratified latent growth curve models to explore how three previously validated measures of
agency change over time and by gender. Aim 3 will employ Cox Proportional Hazards models and
multivariable logistic regression models to estimate the relationship between empowerment and key sexual
and reproductive health behaviors and outcomes.
Terms: <12-20 years old><Acceleration><Address><Adolescence><Adolescent><Adolescent Development><Adolescent Youth><Adult females><Adult women><Affect><Age><Agreement><Behavior><Belgian Congo><Cohort Studies><Concurrent Studies><Contraception Behavior><Contraceptive Behavior><Cox Proportional Hazards Models><Data><Data Analyses><Data Analysis><Decision Making><Democratic Republic of the Congo><Development><Developmental Process><Dimensions><Economics><Enrollment><Family><Females in adulthood><Freedom><Gender><Gender Role><Generalized Growth><Goals><Growth><Health><Health Knowledge Attitudes Practice><Health behavior><Health behavior and outcomes><Household><Individual><Intervention><Intervention Strategies><Knowledge Attitudes Practice><Knowledge, Attitudes, and Behaviors><Learning><Liberty><Link><Logistic Regressions><Male Adolescents><Measures><Modeling><Morbidity><Morbidity - disease rate><Movement><Neighborhoods><Outcome><Parents><Patriarchies><Perception><Population><Process><Program Development><Puberty><Reproductive Health><Research><Research Resources><Resources><Risk><Running><Sampling><Schools><Sex Behavior><Sex Roles><Sexual Activity><Sexual Behavior><Sexual Development><Sexually Transmitted Diseases><Sexually Transmitted Disorder><Sexually Transmitted Infection><Socialization><Societies><Structure><Time><Tissue Growth><Unplanned pregnancy><Venereal Diseases><Venereal Disorders><Venereal Infections><Voice><Women in adulthood><Zaire><adolescence (12-20)><adolescent boy><adolescent health><adult youth><adulthood transition><age group><aged><ages><analyzing longitudinal><behavior influence><behavioral influence><body movement><boys><data interpretation><develop therapy><developmental><economic><empowerment><enroll><gender disparity><girls><health related behavior><improved><initiation of sexual activity><innovate><innovation><innovative><instrument><intervention design><intervention development><interventional strategy><juvenile><juvenile human><lens><lenses><longitudinal analysis><mortality><novel><ontogeny><parent><peer><programs><reproductive><sex><sex activity><sex development><sexual activities><sexual and reproductive health><sexual debut><sexual initiation><sexual violence><sexually acquired infection><sexually violent><therapy design><therapy development><transition from adolescence to adulthood><transition into adulthood><transition to adulthood><treatment design><treatment development><unintended pregnancy><young adult><young adulthood>