運用Walk Score®網站探討宜走性環境與臺灣高齡者身體活動之關聯性

隨著醫藥的進步及公共衛生的改善，全球高齡人口不斷攀升，高齡者的健康促進及疾病的預防成為各國重視的健康議題。而身體活動已證實為預防慢性病有效因子，因此如何增加高齡者身體活動量儼然成為公共衛生政策推動之方向。本研究針對臺灣高齡者居住區域宜走性環境與其身體活動間之關聯性進行探討，研究目的為 (1)調查研究對象社會人口學變項及身體活動之現況。 (2)瞭解研究對象社會人口學變項與身體活動之關聯性。 (3)瞭解研究對象之宜走性環境 (Walk Score分數)與身體活動之關聯性。本研究針對臺灣地區65歲以上高齡者利用分層隨機抽樣進行電話訪問調查，主要變項包含社會人口學變項 (性別、年齡、居住地區、身體質量指數、工作狀態、教育程度)，身體活動時間測量 (國際身體活動量表電訪短版問卷)及居住區域宜走性環境測量 (Walk Score分數)，回收之有效樣本為1,056份，資料以IBM SPSS 23.0進行分析，統計方法包括描述性統計、卡方檢定、二元邏輯斯迴歸方法。研究結果顯示， (1)臺灣高齡者達到身體活動建議量 (每周150分鐘(含)以上身體活動)者占總體84.1%。 (2)研究對象年齡為「75歲以上」相較於「65-74歲」較不易達到身體活動建議量 (勝算比=0.65)；教育程度在「大專以上」相較於「高中職以下」較易達到身體活動建議量 (勝算比=1.90)。 (3)本研究運用二元邏輯斯迴歸分析，採用二個模型進行分析高齡者居住區域宜走性環境與身體活動之關聯性，第一個模型是未控制任何混淆因子，第二個模型為控制「年齡」及「教育程度」因子後的結果。第一個模型及第二個模型結果皆顯示，居住區域宜走性環境與達到身體活動建議量間無顯著關聯性。本研究結果可提供政府於規劃及推動高齡者身體活動相關政策之參考，除了提升高齡者對身體活動之重視及實踐外，因本研究發現Walk Score®網站所提供的Walk Score分數與我國高齡者身體活動無統計上顯著相關，因此亦建議未來公共衛生政策執行者可運用其他宜走性環境測量工具 (如地理資訊系統)進行評估。

關鍵字

高齡者；身體活動；宜走性環境； Walk Score

並列摘要

With the advancement of medicine and the improvement of public health, the global elderly population continues to rise, and the health promotion of the elderly and the prevention of diseases have become health issues that many countries hold in high regard. Physical activity has been proven to be an effective factor in the prevention of chronic diseases, and thus how to promote the physical activity of the elderly has become the direction of public health policy. This study aims to explore the association of Walk Score® -measured neighborhood walkability and physical activity among older adults in Taiwan. Therefore, the aims of this study are (1) to describe the prevalence of socio-demographic variables and physical activity. (2) to examine the association of the socio-demographic variables and physical activity. (3) to examine the association of the Walk Score® -measured neighborhood walkability and physical activity. A telephone-based cross-sectional survey targeting Taiwanese older adults was conducted. Data related to socio-demographic variables (gender, age, area of residence, body mass index, work status, education level), physical activity time measured (The International Physical Activity Questionnaire Taiwan Version) and neighborhood walkability (Walk Score® website) were obtained from 1,056 older adults. Descriptive statistics, Chi-square test, adjusted binary logistic regression were performed using IBM SPSS 23.0. The result showed that (1) The elderly in Taiwan who achieved physical activity recommendation (at least 150 minutes of physical activity throughout the week) accounted for 84.1% of the total. (2) Elderly who aged over 75 years old were less likely to achieve physical activity recommendation than aged 65-74 years old (odds ratio [OR]=0.65), and with educational level of "junior college or above" were more likely to achieve physical activity recommendation than that of "senior vocational school or below" (OR=1.9). (3) This study used adjusted binary logistic regression analysis and used two models for analyzing the association of the Walk Score® -measured neighborhood walkability and physical activity. The first model didn’t control any confounding factors, and the second model controlled "age" and "education level". Both models showed that there were no significant association of the Walk Score® -measured neighborhood walkability and physical activity recommendation. The above-mentioned results are critical to inform government policy-makers and physical activity intervention designers for health promotion of the elderly. In addition to enhancing the importance and practice of physical activity by the elderly, this study found that the Walk Score provided by the Walk Score® website is not statistically significantly related to the physical activity of the elderly in Taiwan. Therefore, it is also recommended that future public health policy implementers could use suitable environmental measurement tools for walkability, such as the use of Geographic Information System (GIS).