臺灣地區兒童身體活動量之先趨研究

Preliminary Study of Children’s Physical Activity in Taiwan

兒童及青少年的身體活動量與肥胖、心血管疾病、骨量及心理健康相關。本研究目的：（一）發展中文版自我執行身體活動問卷，並測試其信度及效度，（二）利用自我執行身體活動問卷，評估台灣地區國小、國中及高中兒童的身體活動量，並與教育部、美國2010健康國民的新政策及澳洲健康及老化部門建議的身體活動量比較。方法：將英文版的自我執行身體活動問卷發展為中文版，對國小34名五年級及22名三年級的學童進行再測信度，9名三至六年級兒童以加速規為效標作效度檢定，並評估國小三和五年級、國中一和三年級、以及高中二年級共154名學生的身體活動量。結果：國小三年級生之再測信度ICC值為0.36-0.86、五年級生為0.61-0.72，以加速規為效標，與自我執行身體活動量問卷測得的中度至費力及費力身體活動時間具有顯著之相關性（r=0.70， 0.71， p<0.05）。國中一年級生每日中度至費力身體活動時間最低（40.0±57.7分鐘）。每個年級受測者看電視時間≦2小時的比率（77.4-97.3％）已達美國2010健康國民的新政策預期目標（75％），但國中一年級生達到國際身體活動量建議的比率僅有22.6-45.2％，所有年級費力身體活動有29.0-78.4％達到建議量。結論：中文版自我執行身體活動問卷有合適至良好之再測信度及良好效度，唯國小三年級在玩電動或電腦遊戲時間的再測信度較差。我國兒童和青少年達國際建議費力身體活動量標準的比率明顯偏低，國中一年級生中度至費力身體活動時間最少，符合國家或國際建議標準的比例也最低。

Children’s physical activity (PA) is related to obesity, cardiovascular disease, bone mass and mental health. The purposes of this study were to develop Self Administered Physical Activity Checklist (SAPAC) Chinese version and to test the reliability and validity of SAPAC. The PA of elementary, junior and senior high school students were assessed using the SAPAC Chinese version (SAPAC-C) and compared with the recommendation proposed by our Ministry of Education, U.S. Department of Health and Human Services (Healthy People 2010) and Department of Health and Aging, Australia. Methods: We developed the SAPAC-C by using and modifying the original version. Thirty-four children of grade 5 and 22 children of grade 3 participated in this study to test the reliability of SAPAC-C, and 9 students to test the validity with accelerometer. One hundred and fifty-four subjects from elementary school, junior and senior high school were included for the PA assessment with SAPAC-C in class. Results: Test-retest reliability of SAPAC-C was 0.36-0.86 in grade 3 students and 0.61-0.72 in grade 5 students of elementary school. Time spent in moderate to vigorous PA (MVPA) and vigorous PA (VPA) from SAPAC-C significant correlated with results from accelerometer (r=0.70, 0.71, p< 0.05). Junior high school grade 1 students had lowest minutes in MVPA (40.0±57.7 mins). About 77.4-97.3% of students in all grades watched television ≤ 2 hours a day that reach the objective of Healthy People 2010. There was 22.6-45.2% of junior high school grade 1 students met the recommendation for moderate and vigorous PA by international or national standards. For VPA, 29.0-78.4% of all grade students reached the objective of Healthy People 2010. Conclusion: The test-retest reliability of SAPAC-C was adequate to excellent in general except the screen time (playing video and computer games) in grade 3 students, and its validity was excellent in physical activity evaluation for children. The percentage of participating VPA was relatively low according to the national or international recommendations. The junior high school grade 1 students had least time spent in MVPA and had the lowest rate of persons who met the PA recommendations.