行動健康照護模式介入對健康行為及代謝症候群之影響-以台灣某計程車隊駕駛為例

Abstract

計程車駕駛是罹患代謝症候群的高風險族群，但因工作型態的關係不易接受傳統的衛教方式，故本研究想探討透過行動健康照護模式的介入，了解是否能提升計程車駕駛的相關健康行為及改善其代謝症候群的生理數值。本研究以行動健康照護模式介入，結合PRECEDE-PROCEED模式中「前傾因素」、「增強因素」和「使能因素」，三個月的時間針對計程車駕駛完成問卷前測、後測及生理數值收集以進行分析。共完成收案92位計程車駕駛具有至少一項代謝症候群的風險因子或BMI≥25，分派為實驗組和對照組。實驗組48位以行動健康照護模式介入十二週，介入前給予問卷、計步器、測量體位(身高、體重、腰圍)和生理數值(血壓、血糖、總膽固醇)以及利用社群媒體建立Line 群組，作為提供訊息並上傳活動記錄和溝通的管道;對照組44位給予傳統衛教手冊，介入前給予問卷、測量體位和生理數值，兩組在三個月後進行後測。主要的統計分析方法為廣義估計方程式。研究結果顯示，給予代謝症候群高風險的計程車駕駛行動健康照護模式介入後，能顯著提升健康行為、自我效能和運動量，但飲食行為和代謝症候群的相關生理數值並未達顯著改善，可能與介入時間較短及需更多的配套措施才能改善飲食行為和代謝症候群生理數值。本研究建議，針對代謝症候群的高風險族群給予符合需求的預防性衛生教育並結合行動裝置及社群軟體的行動健康照護模式是值得推廣的衛生教育方式。Background: Metabolic syndrome is the risk of developing cardiovascular disease at taxi drivers due to their unhealthy life style and working type. The traditional intervention is not available to approach. The study aims to improve taxi drivers’ healthy behavior, metabolic syndrome risk factors by mobile health care model(mHealth). Methods: Adults (N = 92) with at least one metabolic syndrome risk factor or BMI ≥ 25 were recruited from one taxi fleet in Taipei, Taiwan. All participants were assigned to either: (1) the intervention group(n=48) receiving mHealth with PRECEDE-PROCEED model and pedometer; or (2) the compared group(n=44) receiving only a metabolic syndrome health education manual. All participants underwent the data collection at baseline, and 12- week follow-up for questionnaires and measurement of anthropometrics, blood pressure, blood sugar and total cholesterol. We used the Generalized Estimating Equations to analyze. Results: After the intervention of the mHealth for taxi drivers, the health behavior, self-efficacy and physical activity can be significantly improved; however, the eating behavior and physiological values of metabolic syndrome did not achieve significant improvement. Conclusion: For the high-risk population of metabolic syndrome, providing preventive health education that meets the needs combined with the use of mobile devices and social media has a significant effect on improving the health behavior of taxi drivers.