促進學生健康體位之全國性整合計畫經驗

Experiences of a Nation-Wide Integrated Program for Healthy Body Weight among Students

台灣有良好的健康體位支持系統，但由於身體活動不足；有不安的體型意識；飲食攝取不當；及不利的環境因素，國小學生體位適中者持續下跌至五成五，雖然過重、肥胖上升比率得到控制，唯女生過瘦者達28%。因此由護理人員主導、教育部支持的全國中小學生健康體位計劃同時關注過重、過瘦議題，期待營造優質環境、改變生活型態及增加自信心。作者提出Aid students to fit及AID（Active, Image, Diet）金三角觀念和五大策略，包括：(1)發展符合家長、學生、教師理念的說帖。(2)訂定可監測的具體行為指標、口號：活躍的生活為「333再升級，210增活力」；健康體型意識為「理解接受、優雅自信」；健康飲食是「減脂五蔬果、均衡聰明吃」。(3)建置中央級互動式健康體位監測系統。(4)發展數位化量身訂做之過重學生個案管理系統。(5)發展符合健康促進學校理念的教案、教材、教具及示範學校模式，並建制健康體位網（www.ym.edu.tw/active/aid）以供下載。本計畫結合八校學者完成上述工作，教育部也因此提出學生身體活動新指標：活力210（每天都要累積30分鐘中等費力的身體活動），並將此一獨特的亞洲經驗與國際分享，建立國際兒童肥胖防治立場聲明。

Taiwan has good support systems for obesity prevention and management. The percentage of elementary school students with normal body weight, however, has undergone a sustained decrease to 55%. Many factors are associated with this trend, such as lack of physical activity, dissatisfaction with body image, unbalanced dietary pattern, and unsupportive environment. Even though the rate of overweight and obesity is under control, the rate of underweight among girls has undergone a sustained increase, to 28%. Nurses therefore organized the ”Aid students to fit” project, which emphasizes the bipolar issue of overweight and underweight. This national project is sponsored by the Ministry of Education and is expected to establish a beneficial environment, in which students can easily adopt healthy lifestyles and increase self-esteem. The program incorporates the AID triangle concept (Active, Image, Diet) and five strategies for achieving the goals. These strategies are: 1. Develop a persuasive statement to fit in with the philosophies of parents, students and teachers. 2. Set up measurable behavior indices and slogans. (Active life: 210 minutes per week. Image: confident and elegant. Diet: balanced and wise choice of low fat and high fiber foods.) 3. Establish a nation-wide interactive surveillance system for body weight control. 4. Develop an internet system that emphasizes tailored case management for overweight students. 5. Develop a supportive teaching plan, material, and aids to promote a healthy school environment. Five modeling schools, moreover, can be used to demonstrate the program. Educators can also download a free teaching plan, material, and aids at the website for healthy weight management (www.ym.edu.tw/active/aid). The authors brought together scholars from eight universities to accomplish the program. In support of the program, the Taiwan Ministry of Education addressed the new recommendation for physical activity which is to engage in moderate intensity physical activity every day for 30 minutes. We also shared this unique Asian experience at the round table discussion addressing the practical and policy issues of implementing public health strategies to reduce physical inactivity and prevent obesity in children. This was hosted by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) Collaborating Center for Physical Activity in order to establish declarations and recommendations for the prevention of obesity in children.