糖尿病防治之社區介入教育成效研究---以台北市都會型某小型社區為例(II)
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Date
2003-07-31
Authors
劉潔心
劉貴雲
Journal Title
Journal ISSN
Volume Title
Publisher
行政院國家科學委員會
Abstract
本研究主要目的在探討如何運用有效的社區介入策略，來提昇社區居民對糖尿病防治活動之參與和行動能力。本研究為期兩年，第一年主要進行社區居民糖尿病防治之需求評估及診斷，第二年主要依據第一年研究成果，與社區核心團隊共同發展並執行符合社區居民需求之糖尿病防治教育介入計畫。第一年研究成果，已於期中報告中呈現，本文將繼續呈現第二年與社區核心團隊共同發展介入計畫的研究過程及結果。研究第二年，分為兩階段進行，第一階段為社區糖尿病防治教育介入計畫之擬定：此階段研究者藉由社區討論會的方式與社區核心組織成員互動，以強化社區核心組織的能力及促進社區組織間的合作，討論過程中發現健康營造中心經營面臨經費來源困難、志工缺乏互動交流機會、無充分分工機制等狀況，因此研究者最後選擇以學校為介入管道，發展「糖尿病預防教育介入手冊」介入計畫。第二階段，則執行社區居民糖尿病防治介入計畫及評價社區層面介入效果：在計畫執行方面，根據第一年分析診斷結果，選擇以社區學童家長為對象，進行「糖尿病預防教育介入手冊」之實驗介入，並進行前後測介入成效評價；另一方面，研究者藉由對社區核心組織成員進行「社區核心組織評價問卷」評價及對社區居民進行「社區居民對健康營造中心成效評價問卷」問卷評價，以瞭解社區核心組織成員的成長及社區居民對健康營造中心的評價。本研究重要結果如下：（一）社區核心組織評價問卷結果，可分為組織操作過程、組織結構、組織結盟有效性三方面。 1.在組織操作過程方面：成員溝通上，成營造中心內各里保健志工隊的溝通狀況不足，多數志工很少主動協助營造中心的活動；反觀里保健志工內的狀況，無論在成員溝通及主動協助參與營造中心活動上的比率都較營造中心為高；在成員參與成本的阻力與助力上，志工認為參與營造中心志工時，最大參與的阻力為「不能達到參與的目的」；組織氣候上，成員凝聚力方面整體營造中心成員的凝聚力較里保健志工隊成員的凝聚力來得低； 2.在組織結構方面：多數志工能瞭解營造中心的成立目的及其願景。3.在組織結盟有效性方面：成員工作滿意度上，多數成員認為給自己70-79 分，且在此三次問卷調查結果，志工對其工作滿意度上無明顯的改變；成員參與上，成員參與營造中心會議的情形較里保健志工隊來得差，且志工主動發表意見的比率也不高，且多數志工認為營造中心尚未能發揮其功效，仍有進步的空間。（二）社區居民有85％的民眾未聽過社區健康營造中心，同時有近半數有聽過的民眾不清楚位於自己社區的健康營造中心地點為何及不清楚社區營造中心的服務內容。（三）社區中18-39 歲的民眾為社區糖尿病之高危險族群，而根據社區分析診斷結果發現，學校乃是最適合介入的管道。
This study aims to explore the manipulation of effective community intervention strategies for augmenting the participation and action-taking ability of community members towards diabetes prevention. This is a two-year study. In the first year, the objectives include assessing the diabetes prevention needs from the opinion leaders and community members, diagnosing and establishing community resources networks, and facilitating the cooperation of community organization alliances. Focus groups were used to collect information on community resources. The results of the first year study have been published. In the second year, the study focuses on developing and implementing the community diabetes prevention program. This article presents the process and achievements of the second year study. For the development of diabetes prevention program, the researcher selected a core community organization as the intervened point of partnership, and then collectively developed the diabetes prevention program that met the needs of the community members. The researcher also enhanced the community organizing competence by using the empowerment process, and further stimulated the action-taking ability in the community. In the process of this intervention, key members of this project were able to seek the needs of community members, to find problems in the community organization, and to propose effective solutions through full communication, coordination, and cooperation with each other. Finally, they decided to form a "Volunteer Development Club" in order to solve the difficulties the community organization faced. Additionally, considering the incomplete development of the core community organization for comprehensively exerting the community action, the researcher determined to choose school settings as the intervened point based on the results of the first year study. The target audiences for diabetes prevention intervention were the community members aged 18-39, recognized as the high-risk group. A diabetes prevention educational manual for the parents or guardians of students was developed, and the intervention program was implemented. After completing the intervention, an effective evaluation on the program participants, community members, and key members of the community organization was conducted. The findings of this study are as followed: 1. The intervention using the diabetes prevention educational manual can significantly enhance the attitudes towards diabetes, self-efficacy of diabetes prevention, and behavioral intention of diabetes prevention among parents or guardians of students in the community. Moreover, this intervention also significantly improves in the increase of physical activity and self-efficacy of doing exercise among the students' parents. 2. The results of the intervention in core members of the community health building center, the use of community empowerment strategies can effectively help the community identify current problems, obtain community consensus, and partially establish community resources. However, whether it is appropriate to adopt this intervention strategy depends on the development status of community organization to select a suitable intervention channel. This study suggests that school settings, existing community organizations, provide an efficient and effective intervention channel when the community organization is not ready for exerting comprehensive community actions. 3. For the intervention results of empowerment of the core community organization, it was found that factors of not being able to host a comprehensive community activity include: insufficient communication between key members; most volunteers said that they seldom participated in activities hosted by the community health building center; volunteers seldom expressed their opinion or ideas in community meetings; most volunteers thought that the community health building center has not completely shown its functions...
This study aims to explore the manipulation of effective community intervention strategies for augmenting the participation and action-taking ability of community members towards diabetes prevention. This is a two-year study. In the first year, the objectives include assessing the diabetes prevention needs from the opinion leaders and community members, diagnosing and establishing community resources networks, and facilitating the cooperation of community organization alliances. Focus groups were used to collect information on community resources. The results of the first year study have been published. In the second year, the study focuses on developing and implementing the community diabetes prevention program. This article presents the process and achievements of the second year study. For the development of diabetes prevention program, the researcher selected a core community organization as the intervened point of partnership, and then collectively developed the diabetes prevention program that met the needs of the community members. The researcher also enhanced the community organizing competence by using the empowerment process, and further stimulated the action-taking ability in the community. In the process of this intervention, key members of this project were able to seek the needs of community members, to find problems in the community organization, and to propose effective solutions through full communication, coordination, and cooperation with each other. Finally, they decided to form a "Volunteer Development Club" in order to solve the difficulties the community organization faced. Additionally, considering the incomplete development of the core community organization for comprehensively exerting the community action, the researcher determined to choose school settings as the intervened point based on the results of the first year study. The target audiences for diabetes prevention intervention were the community members aged 18-39, recognized as the high-risk group. A diabetes prevention educational manual for the parents or guardians of students was developed, and the intervention program was implemented. After completing the intervention, an effective evaluation on the program participants, community members, and key members of the community organization was conducted. The findings of this study are as followed: 1. The intervention using the diabetes prevention educational manual can significantly enhance the attitudes towards diabetes, self-efficacy of diabetes prevention, and behavioral intention of diabetes prevention among parents or guardians of students in the community. Moreover, this intervention also significantly improves in the increase of physical activity and self-efficacy of doing exercise among the students' parents. 2. The results of the intervention in core members of the community health building center, the use of community empowerment strategies can effectively help the community identify current problems, obtain community consensus, and partially establish community resources. However, whether it is appropriate to adopt this intervention strategy depends on the development status of community organization to select a suitable intervention channel. This study suggests that school settings, existing community organizations, provide an efficient and effective intervention channel when the community organization is not ready for exerting comprehensive community actions. 3. For the intervention results of empowerment of the core community organization, it was found that factors of not being able to host a comprehensive community activity include: insufficient communication between key members; most volunteers said that they seldom participated in activities hosted by the community health building center; volunteers seldom expressed their opinion or ideas in community meetings; most volunteers thought that the community health building center has not completely shown its functions...