We will study the impact of adolescent sports participation on early-adulthood health using longitudinal data from the National Study of Youth and Religion. We focus on two primary outcomes measured at ages 23--28 -- self-rated health and total score on the PHQ9 Patient Depression Questionnaire -- and control for several potential confounders related to demographics and family socioeconomic status. Comparing outcomes between sports participants and matched non-sports participants with similar confounders is straightforward. Unfortunately, an analysis based on such a broad exposure cannot probe the possibility that participation in certain types of sports (e.g. collision sports like football or soccer) may have larger effects on health than others. In this study, we introduce a hierarchy of exposure definitions, ranging from broad (participation in any after-school organized activity) to narrow (e.g. participation in limited-contact sports). We will perform separate matched observational studies, one for each definition, to estimate the health effects of several levels of sports participation. In order to conduct these studies while maintaining a fixed family-wise error rate, we developed an ordered testing approach that exploits the logical relationships between exposure definitions. Our study will also consider several secondary outcomes including body mass index, life satisfaction, and problematic drinking behavior.

翻译：我们将利用《全国青少年与宗教研究》的纵向数据，探讨青少年时期运动参与对早期成年健康的影响。研究聚焦于两个主要结局指标（在23-28岁年龄段测量）：自评健康状态和PHQ9患者抑郁问卷总分，并控制与人口学特征及家庭社会经济地位相关的多个潜在混杂因素。比较运动参与组与经匹配后的非运动参与组（具有相似混杂因素）的结局指标是直观的。然而，基于如此宽泛的暴露定义的分析，无法探究特定运动类型（如足球、橄榄球等接触性运动）是否会对健康产生更大影响的可能性。本研究引入暴露定义层级体系，范围从宽泛（参与任何课后组织活动）到狭窄（例如参与有限接触性运动）。我们将针对每个定义分别进行匹配观察性研究，以估算不同运动参与水平对健康的影响。为在保持固定家族-wise错误率的同时实施这些研究，我们开发了一种利用暴露定义间逻辑关系的序贯检验方法。本研究还将考虑多个次要结局指标，包括身体质量指数、生活满意度及问题性饮酒行为。