母親原生國籍與青少年健康之相關：家庭社會排斥經歷的中介效果

Maternal nationality and adolescent health: the mediating effect of families’social exclusion experiences

目標：本研究旨在探討母親原生國籍與青少年健康之關係，並分析家庭社會排斥經歷的中介效果。方法：採分層叢集抽樣法，針對台灣就讀大學一年級的18-19歲青少年進行線上匿名問卷調查，共回收313份有效問卷。依變項為青少年健康，包含自覺健康、心理困擾和健康行為。其中，心理困擾和健康行為分別採用簡式健康量表（Brief Symptom Rating Scale, BSRS-5）和健康促進生活型態中文簡式量表（Health-Promoting Lifestyle Profile-short-form, HPLP-S）測量。自變項為母親原生國籍，母親為中國/港澳或東南亞籍者定義為新住民子女。中介變項為家庭社會排斥經歷，由本研究自編「家庭社會排斥經歷量表」進行測量，涵蓋經濟、文化生活、社會和政治面向。首先以多元迴歸分析檢驗母親原生國籍、家庭社會排斥經歷與青少年健康之關係，接著以拔靴法檢視家庭社會排斥經歷的中介效果。結果：在313位樣本中，母親為外國籍者佔11.2%。迴歸分析顯示，母親為外國籍者比起母親為本國籍者，自覺健康較差（β=-0.081，p=0.151）、心理困擾程度較高（β=0.125，p=0.026）且健康行為較少（β=-0.134，p=0.018）。中介分析結果發現，家庭社會排斥經歷在母親原生國籍與青少年健康關係間具顯著完全中介效果。結論：新住民子女成長過程中經歷與感受較多的家庭社會排斥，進而提高其青少年時期的健康風險。政府應關注新住民家庭的困境，提供多面向的社會支持或補助以確保新住民子女的健康發展。

Objectives: This study examined the relationship between maternal nationality and adolescent health and explored the mediating effects of families’social exclusion experiences. Methods: A stratified cluster sampling approach was used to conduct an anonymous online survey on first-year university students aged 18 to 19 years enrolled in Taiwanese universities. A total of 313 valid responses were collected. The dependent variable was adolescent health, measured through self-rated health, psychological distress, and health behaviors. Psychological distress and health behaviors were measured using the Brief Symptom Rating Scale and the Chinese version of the Health Promoting Lifestyle Profile, Short Form, respectively. The independent variable was maternal nationality. Participants whose mothers were from China or Southeast Asia were categorized as the offspring of newcomer families. The mediator was families’social exclusion experiences, measured using the proposed Family Social Exclusion Experiences Scale, which covers economic, cultural, social, and political dimensions. Multiple regression analysis was conducted to evaluate the associations between maternal nationality, social exclusion experiences, and adolescent health. A bootstrapping approach was used to test the mediating effects of social exclusion experiences. Results: Of the 313 adolescents surveyed, 11.2% had mothers who were foreign nationals. Compared with adolescents with Taiwanese mothers, those with foreign-born mothers reported poorer self-rated health (β=−0.081, p = .151), higher psychological distress (β= 0.125, p = .026), and fewer health-promoting behaviors (β=−0.134, p = .018). Mediation analysis revealed that families’social exclusion experiences fully mediated the relationship between maternal nationality and adolescent health. Conclusions: Adolescents from newcomer families are likely to experience and perceive social exclusion, which increases their risk of adverse health outcomes. The Taiwanese government should recognize the challenges faced by these families and provide multidimensional social support and subsidies to promote the healthy development of their children.