菸害防制多元介入計畫對於偏遠地區國小學童之成效 Effectiveness of Smoking Prevention Multicomponent Intervention for Elementary School Students in Rural Area

• Published in: Jiao yu ke xue yan jiu qi kan 2021-12, Vol.66 (4), p.183-215
• Main Authors: 黃素妃 Su-Fei Huang, 許伊婷 Yi-Ting Hsu, 廖容瑜 Jung-Yu Liao
• Format: Article
• Language: English
• Subjects: integrated behavior change model; multicomponent intervention; rural area elementary school students; smoking prevention program; 偏遠地區學童; 多元介入方案; 整合性行為理論; 菸害防制
• ISSN: 2073-753X
• DOI: 10.6209/JORIES.202112_66(4).0007

保護學童避免菸害是公共衛生重要課題，菸害防制教育應盡早施行。本研究依據整合性行為理論設計多元介入方式並評值對國小學童之改善情形。以準實驗研究設計之實驗組對照組前、後測設計，選取臺灣北部偏遠地區八所國小三到六年級學童為研究對象，四所學校為實驗組進行菸害防制介入計畫，另四所學校為對照組持續常規活動。兩組皆於介入前完成前測問卷，介入為期6個月，介入後同步進行後測，於6個月後再追蹤。本研究結果顯示，510位參與學童中，有64.5%學童暴露於二手菸環境；本介入計畫在「菸害知識」、「不吸菸的行為意圖」、「拒吸二手菸自我效能」於控制前測得分的前提下，實驗組顯著較對照組表現良好。本研究支持以整合性行為理論所發展的菸害防制介入計畫具有部分成效，此一整合學生、學校家庭與社區的多元介入方式，有助於作為未來公共衛生推動者菸害防制規劃之參考。 1. Both smoking and exposure to secondhand smoke (SHS) are associated with short-term and long-term health hazards. Protecting school students from smoking and SHS exposure is a key public health topic. Smoking prevention education should be introduced as early as possible to address smoking among students. Studies have suggested that implementing smoking prevention education in elementary schools can be an effective instrument for preventing smoking onset in adolescence. The integrated behavior change model (I-Change Model) is a well-known framework for preventing smoking among youths and adolescents. This model comprises attitude, social influences (comprising norms, modeling, and pressure) and self-efficacy. Although numerous European countries have used this model to implement smoke-free prevention programs, it has not yet been applied in Taiwan. Moreover, smoking prevention programs are lacking at the elementary school level in Taiwan and other countries, especially in rural areas. Therefore, we developed a multicomponent intervention based on the I-Change Model and evaluated its effect on elementary school students in a rural area. 2. In this quasiexperimental study, we applied a repeated-measurement design for the comparison and experimental groups. Students in grades 3 to 6 from four elementary schools in rural Southern Taiwan were enrolled as participants in the experimental group. Students for the comparison group were recruited from four other schools from the same area with similar school type and size as the schools selected for the experiment. In total, the 190 participants in the experimental group underwent a 6-month smoking prevention intervention program, whereas the 330 participants in the comparison group received routine health education. The multicomponent intervention, which was based on the I-Change Model, was focused on smoking and SHS prevention. We applied intervention strategies at the individual, family, school, and community levels. At the individual level, a six-session program (with each session being 45 min) named “Smoke-Free Co.” was implemented. At the school level