偏鄉民眾攝取，我的餐盤政策之概況與影響因素

The Adoption of My Plate Policy and Associated Factors in Rural Adults

背景：文獻顯示多數慢性病源自不健康的生活方式，尤其攝取不均衡飲食是重要原因之一。政府近年透過各種媒體推動我的餐盤政策，它是一種圖像式的飲食種類與份數概念，希望提升國人均衡飲食的識能；然而偏鄉居民健康識能普遍較低，是否認識和實踐於日常生活中，相關研究仍不足。 目的： 探討偏鄉民眾認識及攝取我的餐盤政策之概況及其影響因素。 方法： 採橫斷面及描述性的研究方法，以方便取樣自參與雲林縣沿海社區篩檢之成年民眾。收集基本人口學資料、攝取六大類均衡飲食種類與份數、影響民眾攝取均衡飲食習慣的因素，包括口腔健康狀況、攝取均衡飲食的困難，資料以統計軟體SPSS（17 版）進行描述性及推論 性之分析。 結果： 共92 位民眾參與本計畫，平均55 歲(SD=21)，女性佔53.3%，國中教育程度及以下佔58.7%。多數參與者真牙平均18.5 顆、73.9% 表示睡前無使用牙線習慣、63% 無定期接受牙科檢查與洗牙。多數參與者(78.3%) 未聽過我的餐盤之政策宣導，多數參與者在蔬菜、水果與奶類之攝取份數皆嚴重不足。表示無法採取均衡飲食的主因有過去飲食習慣(99%)與生理因素(85%)，而生理因素主要是真牙過少有關。利用多變量迴歸分析發現，真牙顆數>20 (p<0.01)、身體質量指數>24 (p< 0.05)、以及聽過我的餐盤者 (p<0.05)，攝取較多項適當份數的均衡飲食；此外睡前有使用牙線與定期牙科檢查者，其真牙20 顆以上的機率也較高 (p<0.05)。 結論： 在偏鄉宣導我的餐盤政策及適當份數的均衡飲食仍待加強，同時也需強化口腔衛生行為的策略，並及早落實於日常生活中，才可能提升民眾攝取適當份數的均衡飲食識能。

Background: Empirical evidence has shown that many chronic diseases are closely related to an unhealthy lifestyle; especially an unbalanced diet. The government has progressively promoted [My Plate] through media to improve the health literacy of balanced diets in Taiwan. [My Plate] is an image-based concept of diet varieties and servings. However, rural adults generally have low health literacy. Few studies had explored whether the rural adults could adopt the balanced diets in life. Purpose: To explore the awareness and adoption rate of [My Plate] policy in rural adults. Method: The cross-sectional study included adults who participated in the health screening program in western coastal communities in Yunlin County. We collected the basic demographic data, six types of a balanced diet and the number of servings, factors that affect balanced diet habits, including oral health, balanced diet practices, and difficulties. Results: In a total of 92 participants, more than half were female (53.3%), the average age is 55 years (SD=21), the majority of education level was under junior high school (58.7%), with few natural teeth (average 18.5). Most of them did not use dental floss before sleep (73.9%) and did not have regular dental checks (63%). Most of them had never heard of [My Plate] policy (78.3%). Further, the adoption of vegetables, fruit, and milk was severely inadequate. Participants' failure to adopt a balanced diet was mainly due to their eating habits (99%) and physiological factors (85%), which were significantly correlated with a fewer number of real teeth. The multivariate regression analysis showed natural teeth >20, BMI>24, and have had ever heard of [My Plate] policy was significantly associated with having more appropriate servings. Besides, those who frequently used dental floss before sleep and had regular dental checks significantly had more than 20 natural teeth. Conclusions: The findings suggested that health literacy and oral hygiene are inadequate in rural areas in Taiwan. Promoting [My Plate] policy and balanced diet servings are needed.