結合社會認知理論及周全性職場健康促進模式改善職場員工體適能及身體活動量之介入成效–以臺北市某行政中心為例

研究目的：本研究以社會認知理論架構及周全性職場健康促進模式為基礎，設計健康體能方案，並評價介入對改善員工體適能之成效，以作為相關職場單位推廣之參考。研究方法：本研究為類實驗設計 (橫斷式準實驗單組前後測設計)，立意取樣選取臺北市某行政中心員工共50人為招募對象，經扣除流失樣本，合計共45人為有效樣本。本研究透過社會認知理論及周全性職場健康促進模式為基礎，進行介入計畫之規劃。具體而言，社會認知理論提出個人的行為表現是經過個人認知與環境因素三者之間複雜交互作用所影響，因此使用「提高學員自我效能」、「利用社群行動提升群體效能」、「觀察成功經驗增強學習模仿」、「設計獎勵誘因引發動機」、「提供支持性運動環境之促進因子」等理論策略，對應「職場周全性健康促進推動模式」之四大層面進行介入設計。介入期間為2個月，透過宣傳、提供訊息、運動有氧增肌課程、line群組及App (application, App) 使用、獎勵揪團及「走樓梯做公益｣等方式作為介入策略。主要的介入目標為體適能，包含：雙手握力、坐姿體前彎、屈膝仰臥起坐、三分鐘登階及立定跳遠。另外，本研究亦評估研究對象之身體活動量與其他社會認知構念在介入前後的差異。利用描述性統計及成對樣本t檢定進行分析。研究結果：本研究發現，以社會認知理論及周全性職場健康促進模式為基礎所規劃的介入計畫能顯著改善研究對象的臀圍比 (t=5.98, p < .05)、雙手握力 (左手t= –3.00, 右手t=–2.38, p < .05)、坐姿體前彎、30秒及60秒仰臥起坐 (t=2.88, –4.56, –5.43, p < .05) 之體能指數，並提升身體活動量 (t= –2.05, p < .05)。另外，本體適能介入計畫亦顯著提升員工的社會支持。在個人背景因素方面，性別與30秒仰臥起坐次數有關 (t=2.38, p < .05)；年齡及現職服務年資則與三分鐘登階有關 (r= –.34, –.57, p < .05)。結論：結合理論妥善設計的活動介入策略，可改善職場同仁的健康體能，並有助於提升身體活動量。建議相關工作職場單位積極推廣並結合支持性社交網絡，以改善身體健康並實現健康促進的目標。

關鍵字

社會認知理論；周全性職場健康促進模式；自我效能；身體活動量；體適能

並列摘要

Objectives: Based on the social cognitive theory (SCT) and the comprehensive workplace health promotion (CWHP) model, this study aimed to design and evaluate the effectiveness of a theory-based physical fitness program. Method: This study was a quasi–experimental study (cross–sectional quasi–experimental single–group pre– and post–test study). A total of 50 employees from an administrative center in Taipei City were initial selected for participation. After intervention, 45 employees were used as effective samples. According to the SCT that behavior is affected by the complex interaction between personal cognition and environmental factors, the intervention developed by the current study aimed to improve physical fitness through increasing the following concepts of SCT, namely “self–efficacy,” “collective efficacy,” “observational learning,” “incentive motivation,” and “supportive environment.” These targeted concepts were also matched to the four levels of intervention in the CWHP model. Interventions spanned for two months and encompassed a variety of strategies (e.g., health education, health communication, exercise muscle building courses etc.) to increase physical fitness. The primary outcome of the current intervention was physical fitness, including hand grip, sit and reach test, knee–bend sit–ups, three–minute steps and standing long jump. Study analyses included descriptive analyses and paired sample t–tests. Results: Our results showed that the intervention program significantly improved the physical fitness regarding hip ratio (t=5.98, p < .05), hands grip (Left hand t= –3.00, Right hand t=–2.38, p < .05), sit and reach test, 30– and 60–second sit–ups (t=2.88, –4.56, –5.43, p < .05), and physical activity (t= –2.05, p < .05). The intervention was associated with increased levels of social support among participants. In addition, we found that gender was associated with 30–second sit–ups (t=2.38, p < .05). Other individual characteristics, namely age and years of service, were negatively associated with 30–second sit–ups (r= –.34, –.57, p < .05). Conclusion: A theory–based intervention can improve the physical fitness and the amount of physical activity among employees. It is recommended that workplace promotion should integrate supportive social networks to improve physical fitness and achieve the goal of health promotion.