title: Adolescent health-risk behavior and community disorder.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  Assess whether exposure to contexts associated with crime (as a marker of community disorder) correlates with self-reported health-related behaviors among adolescent girls.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, United States of America.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wiehe
authors.forename: Mei-Po
authors.initials: MP
authors.lastname: Kwan
authors.forename: Jeff
authors.initials: J
authors.lastname: Wilson
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D003075:Coitus; D003415:Crime / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006801:Humans; D008385:Marijuana Smoking; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012309:Risk-Taking; D012725:Sexual Behavior; D012907:Smoking