環境對身體活動的影響以及對年齡/性別與身體活動關係的調節

The Effect of Physical Environment on Physical Activity and its Moderating Role to The Relationship Between Age/Gender and Physical Activity

趙美玲(Mei-Ling Chao)

指導教授 ： 江東亮 ； 陳雅美

國立臺灣大學/公共衛生學院/健康政策與管理研究所/博士(2022年)

https://doi.org/10.6342/NTU202200516

摘要

背景：現今休閒身體活動的研究已經瞭解某些特定環境因素的影響，但對於環境扮演的角色與因果關係則仍有待釐清。環境對休閒身體活動可能有直接影響，但也有可能對不同人口變項（例如：性別或年齡）與休閒身體活動關係產生調節作用。本研究目的是從生態模式探討環境與休閒時間身體活動（leisure-time physical activities, LTPA）之間的關係，並分析環境對年齡及性別與身體活動關係的調節作用。
方法：本研究係次級資料分析，資料來源有三：休閒身體活動、都市化程度變項及其他人口學變項來自2013年國民健康訪問調查、運動設施密度來自教育部體育署，以及綠地面積來自內政部國土測繪中心。國民健康訪問調查共完訪16,125名25歲以上成人。本研究根據受訪前一週LTPA的頻率、時間、強度，計算出每週身體活動頻率、時間及規律性，並依據世界衛生組織建議分為三組：規律休閒身體活動、缺乏休閒身體活動與休閒身體活動不足。本研究使用階層迴歸分析，探究環境及年齡/性別與LTPA的關係。
結果：根據2013年的國民健康訪問調查，台灣25歲以上人口只有29.2%達到規律身體活動建議量，而缺乏身體活動及身體活動不足則分別占44.2%和26.6%。本研究發現：首先，地區都市化程度越高，LTPA規律性越好（β=0.1151，p<0.01）、時間越長(β=0.1018，p<0.01)；地區運動設施密度越高，LTPA規律性越差(β=-0.1037，p<0.001)、頻率越低(β=-0.079，p<0.01)、時間越短(β=-0.0882，p<0.001)；但地區綠地面積與LTPA無顯著相關。其次，在環境的調節影響部分，都市化程度有對性別、年齡與LTPA有調節作用，運動設施密度只對年齡與LTPA的關係有調節作用，綠地面積對性別、年齡與LTPA活動關係則均無顯著調節作用。具體而言，地區都市化程度越高，男性LTPA表現越好，而女性則以地區都市化程度越低表現越好(規律性：β=-0.2064，p<0.01，頻率β=-0.2573，p<0.001，時間β=-0.289，p<0.001)。年長者在都市化越高地區，其LTPA頻率越好(β=0.1037，p<0.05)；年長者在越低運動設施密度地區LTPA表現越好(規律性：β=-0.0703，p<0.01，頻率β=-0.08273，p<0.001，時間長短β=-0.0479，p<0.05)。
結論：本研究發現環境變項不僅與休閒身體活動有淨相關，也在年齡及性別對休閒身體活動的關係上扮演調節的角色，惟受限於橫斷面研究設計，不僅研究結果必須小心解釋，且有待更多深入探討。但在實務上，我們仍建議宜針對不同性別或年齡別需求，規劃設計適合的休閒身體活動環境，以提高規律身體活動人口。

關鍵字

國民健康訪問調查 ； 都市化程度 ； 綠地面積 ； 運動設施密度

並列摘要

Background: Existing research on leisure physical activity has identified the influence of certain environmental factors, but is inconclusive about the role of environment and causality. In particular, how the environment interacts with individual-level factors and shapes the pattern of people’s recreational physical activity is still unclear, resulting in inadequate policy recommendations. The environment could be both an independent and moderating factor for leisure physical activity. However, most of the studies deal with it either by stratification or focusing on specific population, and ignore the moderating effect of the environment. This study aimed to explore the relationship between the environment and leisure-time physical activities (LTPA) using the ecological model, and to analyze the moderating effect of the environment on the relationship of age and gender to physical activity.
Methods:This is a secondary data analysis of 16,125 adults aged 25 years old and over. Data on LPHA, urbanization, and demographic variables were from the 2013 National Health Interview Survey; data on density of sport facilityfrom the Sports Department of the Ministry of Education; dat on green area from the Land Surveying and Mapping Center of the Ministry of the Interior. We calculated the frequency, time, and regularity of weekly physical activity based on the frequency, time, and intensity of LTPA in the previous week. We classified LTPA into 3 groups (regular LTPA, lack of LTPA and insufficient LTPA, as defined by the World Health Organization) by the frequency, time spent and intensity of subjects’ in the previous week. We used multiple regression analysis to examine the associations between the environment and LTPA and the moderating role of the environment on the association between age/sex and LTPA.
Results: According to the 2013 National Health Interview Survey, We found that only 29.2% of adults engaged in regular LPTA, while 44.2% were lack of LPTA and 26.6% have insufficient LPTA. This study found that: First, the higher the degree of regional urbanization, the better the regularity of LTPA (β=0.1151, p<0.01) and the longer the time (β=0.1018, p<0.01); the higher the density of regional sports facilities, the worse the regularity of LTPA ( β=-0.1037, p<0.001), the frequency was lower (β=-0.079, p<0.01), and the time was shorter (β=-0.0882, p<0.001); but there was no significant correlation between regional green space area and LTPA. Secondly, in the moderating effect of the environment, the degree of urbanization has a moderating effect on gender, age and LTPA, the density of sports facilities only has a moderating effect on the relationship between age and LTPA, and the area of green space has no effect on the relationship between gender, age and LTPA activity. significant adjustment. Specifically, the higher the degree of regional urbanization, the better the performance of male LTPA, while the better the performance of women with the lower degree of regional urbanization (regularity: β=-0.2064, p<0.01, frequency β=-0.2573, p <0.001, time β=-0.289, p<0.001). Elderly people in areas with higher urbanization have better LTPA frequency (β=0.1037, p<0.05); older people have better LTPA performance in areas with lower density of sports facilities (regularity: β=-0.0703, p<0.01, Frequency β=-0.08273, p<0.001, duration β=-0.0479, p<0.05).
Conclusions: This study demonstrated that the environment has not only independent effect on LTPA but also a moderating role on the association between age/sex and LTPA. However, due to its cross-sectional nature of study design, the interpretation of results should be cautious and further research is warranted Meanwhile, designs and facilities of LTPA that respond to differences in gender and life stages will be helpful to promote accessibility of physical activities.

並列關鍵字

National Health Interview Survey(NHIS) ； urbanization ； green space ； sport facilities density

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