提升國小高年級學生鈣質攝取之教育介入成效探討

The Effects of A Calcium Intake Promoting Nutrition Education Program For Fifth Graders of Taiwan

杭極敏(Chi-Ming Hang)

指導教授 ： 林薇

國立臺灣師範大學/教育學院/人類發展與家庭學系/博士(2009年)

摘要

本研究的目的乃在發展適用於台灣地區國小高年級學童之提升鈣質攝取量教育介入計畫並評估其成效。以社會生態模式的架構，綜合健康信念模式和社會認知理論中飲食行為形成重要影響因子，發展教學策略及設計課程設計，計四單元，每單元40分鐘。在台灣地區北、中、南三區中每區之都市及鄉村中選取1所國民小學，每所學校以五年級一個班級為實驗組、一個班級為控制組，共計實驗組6班（N=178）、控制組6班（N=174），於實驗教學前、教學後一星期及教學後一個月分別對實驗組與控制組學生進行前測、後測及後後測評量，以了解教育介入之成效。成效評量項目包括以鈣質攝取頻率表評估之鈣質攝取量，及鈣質攝取行為之相關因素。研究結果發現：（1）實驗組學生於教育介入後，鈣質食物攝取量、鈣質相關之知識、對鈣質食物的喜好、知覺利益、「口味不合時會吃」的自我效能顯著提升，知覺障礙顯著降低，且除鈣質食物攝取量及預防骨質疏鬆症的知覺利益外，在其他項目也有短期延宕效果。（2）介入成效不因學生性別而有差異，對不同地區學生教學成效亦多無顯著差異，只有在知識方面，雖然都有提升，但是對鄉村地區學生的成效更優於城市地區的學生，而「家人都不吃時會吃」的自我效能的提升則只有對鄉村地區的學生有顯著成效。雖然介入後學童鈣質食物攝取量較控制組為高，但改變幅度不大，且並未達到學童的建議攝取量。探究原因，除因教學時間短較難在行為上產生大幅改變外，環境中食物供應-包括學校午餐和家庭供應，仍是無法掌握的因素。故欲提升學童鈣質攝取量至建議量，除加強學童之營養教育外，可能尚須有教育、農業或衛生政策上的配合，例如降價供應學校午餐乳製品等積極性改善學童飲食環境的措施。

關鍵字

鈣質攝取 ； 國小高年級學生 ； 社會生態模式 ； 營養教育

並列摘要

The purpose of this study was to assess the effects of a calcium intake promoting nutrition education program on fifth graders. The program was based on the concept of Social-Ecological Model and also major components of the Health Belief Model and the Social Cognitive Theory. Fifth-grade students from six elementary schools in northern, central, southern areas of Taiwan participated the study. The intervention group (N=178) was provided with a nutrition education program which included four 40-min classroom sessions and 2 parent’s newsletters. The control group (N=174) was not provided with any nutrition education program. The outcomes of the intervention were measured by questionnaires administered one week before (pre-test), a week after (post-test) and four weeks after (follow-up test) the intervention. The results indicated that: the intervention group’s knowledge, preference, self-efficiency and perceived benefits increased, as the perceived barriers decreased. As a result, the calcium intake increased. Although the calcium intake of the intervention group was significantly higher than the control group at the end of the intervention, it was still far below the DOH recommended level. Other than the intervention period was short and insufficient for significant improvement in behavior, school lunch’s failure to meet the recommended standard and the uncertainty of sufficient calcium-rich foods offered at home meals may all be reasons for the discrepancy. Therefore, besides school curriculum, related health and agriculture policies to increase the availability of calcium-rich foods, both in school and family, may be essential to solve the problem of calcium inadequacy of school children.

並列關鍵字

calcium intake ； elementary student, ； social-ecological model ； nutrition education

參考文獻

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