社區長者參與失智預防課程之看法與6C行銷模式對長者未來參與課程之模式驗證

Abstract

目的：本研究運用6C行銷模式探討社區長者參加預防失智症課程意圖。透過可靠且有效的方式測量臺灣社區長者參加預防失智症課程之可能性。並發展適用於臺灣社區長者參加預防失智症課程可能性之預測模式。方法：本研究共分三階段進行，第一階段採用深度訪談，以6C行銷模式為架構設計訪談大綱，訪談逐字稿以直接內容分析法進行分析；第二階段採用Q方法，Q分類排序所得之資料以主成份分析（Principle Components Analysis）及最大變異轉軸法（Varimax Rotation）進行因素抽取及類型區分；第三階段採用量性問卷調查，以深度訪談資料為基礎及參考相關文獻，建構量化測量工具及進行資料收集，再以結構方程模式（Structure Equation Modeling, SEM）進行預測模式驗證分析。結果：第一階段研究邀請30位社區長者進行深度訪談，以逐字稿方式進行彙整，找出32個關鍵詞，再依據6C行銷模式進行歸類，結果如下：記憶衰退、腦部空白、表達障礙、家人照顧負擔及年紀增長等5個關鍵詞歸類「老化影響」；認識新朋友、朋友在一起互動、增進身心健康、增加身體活動量、增加知識、利用時間及保持獨立等7個關鍵詞歸納「消費者本身」；交通便利與否、上課學費多寡、上課次數多寡、上課時間長短及生病醫療費用等5個關鍵詞歸納「成本考量」；團體上課方式、線上上課方式、學習負荷及體力負荷等4個關鍵詞歸納「方便採用」；失智症相關資料、危險因子（跌倒、三高、憂鬱、社會互動）、朋友建議、媒體、老人機構人員介紹及醫護人員建議等6個關鍵詞歸納「溝通管道」；子女期待、朋友邀約、實際接觸、家人生病及造成別人困擾等5個關鍵詞歸納「人際影響」。第二階段研究共招募33位社區長者參與Q-分類排序，根據Q分類結果之分析共歸納出四種因素類型社區長者，各因子如下：因子 1：認同參加課程能認識新朋友並善用時間、因子2：擔心自己會因為失智而造成別人的負擔、因子 3：考量風險、成本及專家建議、因子 4：多種需求綜合考量。第三階段研究共收回282份有效問卷，根據SEM分析整體模式適配性良好，路徑分析顯示以老化影響的影響力最大，其次為消費者本身的想法，整體模式對於行為意圖解釋力為60.4%，表示當社區長者自覺老化，以及消費者本身的想法越認同預防失智症課程時，其採取參加預防失智症課程的意圖就越高。結論：本研究同時結合6C行銷模式與被介入者（社區長者）的觀點來探討老人參與預防失智症課程意圖，並以Q方法成功的將社區長者區分為四種不同類型，也發展出適合於社區長者參與預防失智症課程可能性之測量工具，可提供未來在設計參與預防失智症課程行銷方案之應用，使方案內容更能符合社區長者的心理與實際需求，以促進社區長者對參與預防失智症課程的參與率。Objective: This study investigated the intention of elderly individuals of the Taiwanese community to participate in dementia prevention program. The study used the 6C model of marketing. It adopted a reliable and effective method to measure the likelihood of the Taiwanese community elderly participating in dementia prevention program. In addition, a model that could predict their intention was developed.Methods: This study was carried out in 3 stages. The 1st stage consisted of in-depth interviews, the outline of which was designed using the 6C model of marketing as the framework. The resultant interview transcript was explored by content analysis. The 2nd stage was completed using the Q-methodology. Factor extraction and categorization of the data obtained from Q-sorting was achieved via principal components analysis and varimax rotation. The 3rd stage, which consisted of a quantitative questionnaire survey, established a quantitative measurement tool for data collection based on the in-depth interview data and associated literature. Subsequently, structural equation modelling (SEM) was adopted to verify and analyze the prediction model.Results: During the 1st stage of the study, 30 elderly people of the community were recruited for in-depth interviews. After compiling the interview transcripts, 32 keywords were identified and categorized according to the 6C model of marketing. More specifically, the 5 keywords of memory decline, blank mind, expression disorder, burden of family care, and age growth were categorized as “Aging effects”; the 7 keywords of knowing new friends, interacting with friends, improving physical and mental health, increasing physical activity, enhancing knowledge, utilizing time, and maintaining independence were categorized as “Consumers’ opinions”; the 5 keywords of traffic convenience, cost of the course, number of classes, length of the course, and medical expenses were categorized as “Cost consideration”; the 4 keywords of group class, online class, learning load, and physical load were categorized as “Convenience to participate”; the 6 keywords of dementia-related information, risk factors (fall, hypertension/hyperlipemia/hyperglycemia, depression, social interaction), recommendation by friends, media, referral by aged care staff, and recommendation by medical staff were categorized as “Communication channel”; and the 5 keywords of children’s expectation, invitation by friend, actual experience, family member’s illness, and disturbing others were categorized as “Interpersonal influence”. Alternatively, during the 2nd stage of the study, 33 community elderly people participated in Q-sorting. According to the results of Q-sorting, the participating elderly people were divided into 4 types, the factors of which were: Factor 1. Acknowledge that participation in the course can help make new friends and use time wisely; Factor 2. Worry about the fact that one may impose an extra burden onto others due to dementia; Factor 3. Consider risks, costs, and expert advice; and Factor 4. Comprehensively consider the needs from multiple perspectives. In the 3rd stage of the study, a total of 282 valid questionnaires were collected. SEM suggested that the adaptability of the overall model was superior. Path analysis showed that the most influencing factor was Aging effects, followed by Consumers’ opinions. In addition, the explanatory power of the overall model was 60.4%, which indicated that the more the community elderly felt that they were aging, or the more the consumers acknowledged the usefulness of dementia prevention program, the higher their intention to enroll in the program.Conclusion: This study combined the 6C model of marketing with the opinions of the intervened (the community elderly) to explore elderly people’s intention to participate in dementia prevention courses. In addition, the study successfully divided the community elderly into 4 types using the Q-methodology, and on this basis developed a tool that could accurately measure the likelihood of the community elderly participating in dementia prevention program. The application of this tool in designing the marketing plan for dementia prevention program can make its content more tailored to the mental and the physical needs of the community elderly, thereby promoting their participation rates in the program.