國小學童菸害防制多元計畫介入成效評估：整合行為改變模式之應用

Abstract

背景：預防學童避免菸品危害是公共衛生優先議題，本研究應用整合行為改變模式評量國小學童菸害防制介入之成效。方法：採準實驗研究設計，立意取樣新北市2行政區8所偏遠國小3-6年級學童為研究對象，其中 4所學校進行菸害防制多元介入計畫，另4所學校對照組則持續常規活動。以自填式問卷蒐集介入前(T1)、介入後(T2)，並探討6個月後(T3)的延宕效果。結果：共510位參與研究，94.1%學童從未吸菸(即使一口都沒)，有64.5%學童暴露二手菸。以GEE分析菸害防制多元介入計畫之成效，結果顯示進步的有：學童的菸害知識(T2: β = 0.65, p< 0.001, T3:β = 0.41, p = 0.027)，不吸菸的行為意圖(T3: β =0.50, p = 0.045)，拒吸二手菸自我效能(T2: β =4.55, p = 0.010)。然而學童在吸菸決策利益、決策障礙、社會模範、社會壓力、不吸菸的自我效能、二手菸暴露、拒吸二手菸的行為意圖則無統計上顯著差異。結論：在幾乎所有學童不吸菸，但二手菸暴露仍高的情況下，本菸害防制多元介入計畫仍具部分成效，本研究有助於提供未來推動菸害預防教育多元介入計畫之參考。Background: Preventing children from smoking and the risk of second-hand smoke (SHS) is considered as a priority issue for public health. This study aimed to evaluate the effectiveness of a smoking prevention intervention based on behavior change model among elementary school students. Method: We applied a quasi-experimental research design. The third to sixth graders from eight elementary schools in New Taipei City were recruited. Four of them were allocated as the intervention group, in which we conduct the intervention program, while the other ones were the comparison group, in which the regular activities were implemented. Questionnaires were used to collect the information at the baseline (T1), after the end of intervention (T2), and six-month follow-up (T3). Result: There are 510 students participating this research. 94.1% of them never smoke (even one puff), and 64.5% are exposed to the second-hand smoke. Using generalized estimating equations, we found the effectiveness of intervention on smoking knowledge (T2: β = 0.65, p< 0.001, T3:β = 0.41, p = 0.027), intention to non-smoke (T3:β=0.50, p = 0.045)，and SHS refusal self-efficacy (T2: β =4.55, p = 0.010). No statistical significant difference was obtained on pros and cons, social norms, social modelling, social pressure, smoking resistance self-efficacy, intention to smoke, SHS exposure, and intention to avoid SHS exposure. Conclusion: For children who do not smoke but are exposed to SHS, it suggests that a smoking prevention intervention based on behavior changemodel is partially effective. This research provide some information for the promotion of multicomponent smoking prevention programs in the future.