PRECEDE模式於社區民眾B型與C型肝炎防治評估

Assessment of Hepatitis B and C Prevention in Community Populations Using the PRECEDE Model

背景：肝炎病毒逐漸成為全球健康關注的焦點，世界衛生組織訂定2030年前消除病毒性肝炎對全球公共衛生造成重大威脅之目標。
方法：PRECEDE模式是以健康促進和疾病預防為目標的評估及計劃模式，本文應用其社會評估、流行病學及行為與環境評估、教育與生態學評估、行政與政策評估四個階段做為評估架構與資料分析。進行基隆市安樂區某社區的成年民眾對B型與C型病毒性肝炎的預防現狀及風險因素調查；透過觀察、深度訪談、問卷調查和文獻考察等方法，評估社區民眾的人口結構及特徵、社區健康指標以及社區醫療保健資源。
結果：社區健康評估結果顯示，該社區B型與C型肝炎防治健康問題在於「肝炎防治的照護能力不足」和「肝炎篩檢政策的醫療利用不佳」，相關因素主要由於社區缺乏提供肝炎防治衛教宣導管道，及缺乏傳遞肝炎篩檢相關政策訊息來源，造成民眾對防治肝炎資訊的不瞭解和忽視其重要性。
結論：應強化與社區合作，加強宣傳與篩檢站的設置，推動社區參與，透過社區活動提升居民對肝炎防治的興趣，並成立志工團隊，增強社區內衛生教育和支持性，以實現世界衛生組織消除病毒性肝炎之目標。

Background: Hepatitis viruses have become an increasing global health concern. In response, the World Health Organization has set a target to eliminate viral hepatitis as a major public health threat by 2030.
Methods: The PRECEDE model was used as the assessment and planning framework, emphasizing health promotion and disease prevention. This article applied its four phases—social assessment; epidemiological, behavioral, and environmental assessment; educational and ecological assessment; and administrative and policy assessment—to guide data analysis. A community-based survey was conducted to examine the status of hepatitis B and C prevention and associated risk factors among adults in a community in Anle District, Keelung City. Multiple data collection methods—observation, in-depth interviews, questionnaire surveys, and literature review—were used to assess community demographics, health indicators, and available healthcare resources.
Results: The community health assessment revealed two primary health problems related to hepatitis B and C prevention: inadequate community capacity for hepatitis prevention and poor utilization of hepatitis screening policies. These issues largely stem from insufficient health education and promotional channels within the community, as well as a lack of accessible information regarding hepatitis screening services. As a result, residents have limited understanding of hepatitis prevention and tend to underestimate its importance.
Conclusion: Strengthening partnerships with community stakeholders, increasing public outreach, and establishing accessible screening stations are critical to enhancing community participation in hepatitis prevention. Community-based activities can improve residents’awareness and engagement in hepatitis prevention and control. Additionally, forming volunteer teams can further expand health education efforts and support within the community. Such efforts will contribute to achieving the World Health Organization’s goal of eliminating viral hepatitis..