運用社群媒體於消防隊員之健康飲食介入成效：準實驗研究

Effectiveness of a social-media-delivered healthy dietary intervention among firefighters: a quasi-experimental study

目標：運用健康信念模式作為基礎，以社群媒體進行介入，探討對新北市消防員的健康信念模式變項以及健康飲食行為之影響。方法：採準實驗設計，立意選取共80位消防員，其一分隊40位消防員為實驗組，另一分隊40位為對照組；實驗組以社群媒體進行12周介入，介入策略包括：定時推播提供健康飲食知識、簡易料理食譜、線上教練給予回饋、利用餐點照片上傳進行飲食記錄、集點活動進行競賽與獎勵。對照組給予健康飲食手冊一本。使用廣義估計方程式（GEE）來評估介入對各變項之測量分數的影響。結果：在前測時，實驗組和對照組之社會人口學變項和主要測量變項均無顯著的組間差異。實驗組的健康飲食知識、自覺健康狀態、自覺罹患性、自覺嚴重性自覺利益、自我效能以及健康飲食行為等後測得分均顯著高於前測，自覺障礙得分則是後測時顯著降低。GEE分析結果顯示，介入後，實驗組在「健康飲食知識」、「自覺健康狀態」、「自我效能」、「自覺利益」、「健康飲食行為」等變項相較對照組顯著進步。但本次介入對於提升自覺罹患性、自覺嚴重性、自覺障礙以及行動線索則無顯著效果。有73.3%的實驗組參與者對於介入策略表示滿意。結論：運用社群媒體進行健康飲食介入能有效改善健康飲食知識、自覺健康狀態、自我效能、自覺利益、健康飲食行為。建議未來善用社群媒體不受時間與空間限制之優點，持續為其他族群設計及進行健康飲食教育介入。

Objectives: This study used the Health Belief Model and a social media–delivered intervention to investigate changes in healthy eating behaviors among firefighters in New Taipei City. Methods: This quasi-experimental study recruited 40 firefighters from each of two fire station branches: Branch A (experimental group) and Branch B (control group). The experimental group participated in a 12-week intervention that entailed following recipes to prepare meals, receiving online health coach feedback, and completing a food diary. This group also received push notifications on information about healthy eating habits and collected reward points. The control group received a healthy eating manual. Generalized estimating equations were used to assess the influence of the intervention on the participants’scores. Results: The two groups differed significantly after the 12-week social media–delivered intervention. Specifically, the experimental group exhibited higher scores in healthy eating knowledge, superior perceived health status, greater self-efficacy, greater perceived benefits of healthy eating, and more positive changes in healthy eating behavior than did the control group. A satisfaction survey regarding the intervention revealed that 80% of the participants in the experimental group expressed satisfaction with the intervention strategies. Conclusions: The 12-week social media–delivered intervention effectively improved healthy eating knowledge, perceived health status, self-efficacy, perceived benefits of healthy eating, and healthy eating behaviors among the firefighters in the experimental group. Accordingly, the use of social media as an intervention tool holds promise for the implementation of nutritional education interventions in similar populations.