臺北市社區健康營造推動的現況與困難之研究

Currant Status and Difficulties of Executing Healthy Community Building Project in Taipei City

本研究是以台北市社區健康營造之主要推動者為研究對象，以了解目前社區健康營造推動的現況與困難，作為社區健康營造政策推動的參考。以質性研究方法，面對面深入訪談方式收集資料。共計訪問台北市衛生局所與社區健康營造中心主要推動者三十人，研究結果發現：(1)非營利性的民間組織基於組織宗旨與社區健康營造的目的相符，以及因可獲得經費補助而承接這項計畫；營利性的機構則基於業務的行銷與機構形象的建立而承接。(2)有一半的衛生所不認同社區健康營造的計畫，逃避由衛生所本身來推動這項業務，並且質疑社區健康營造中心所能夠發揮的功能。(3)台北市衛生局以健康城市的策略來推動這項工作；營造中心的推動策略包括成立推動組織、尋求社區關鍵人物的支持、建立學習的團隊、落實健康的生活、進行志工招募、訓練與服務、進行社區評估和健康診斷、整合社區的資源、推動健康活動、進行衛教宣導、建立永續發展的模式等。(4)推動的困難主要在於衛生所的被動態度、健康非優先議題、社區的不支持、衛生署對計畫的規劃與管理不周全、都會社區的型態不易推動、志工的管理不易、推動者 的專業能力不足與特質不適任推動、缺乏辦公與活動場所、社區資源無法整合等。(5)主要推動者對於社區健康營造計畫的建議，包括整個計畫重新加以檢討並作完整的規劃；檢討政府在此計畫中應該扮演的角色，並從衛生行政機構本身先進行營造；進行營造中心的成效評估；容許各地方有不同的推動模式；建立促進衛生所與營造中心的互動的機制；培訓退休醫護相關人員參與；以及進行媒體行銷等。社區健康營造的理念受到大多人的肯定，只是都市社會異質性高，做法上需要更開放多元，更需要加強行政機關內部與營造中心之間的溝通。重新定位政府的角色，並從衛生行政機關內部先進行改造。

The purpose of this study was to understand the executing process and difficulties of the Healthy Community Building project in Taipei City. This was a qualitative study that interviewed face by face with the key executing persons in the Department of Health of the Taipei City, health centers and healthy community building centers. Total number of cases were thirty. The results revealed that. The nonprofit private organization applied the project for the reasons of supporting funds under the project and the concord of their organization mission. But the for-profit organizations were for the purpose of marketing. Half of the health centers did not recognize the project and to avoid executing the mission of the project, they did not feel confident of the function for the healthy community building centers. Department of Health of the Taipei City used the strategies of healthy city to execute the project. The strategies for healthy community centers were to establish the acting organization, to seek for the support of the community hinge persons, to establish the learning group to practice the healthy life, to recruit and to train the volunteers, to execute the community evaluation and community healthy diagnosis, to integrate the community resources, to practice the health and education activates and to establish the long-term executing model. The problems and difficulties about the project are the passive attitude of health centers, health issues themselves, the support from community, the uncertainty of the DOH project, the pattern of the urban community, the administration of the volunteers, the ability and personality of the forwarders, the lack of acting setting or office and the integration of community resources. Concluding the recommends about this project are to re-regulate this project, to define the role of government in this project and to build the health agency at fist, to evaluate the effect of the healthy community building centers, to design many different executing model, to push the interaction about health centers and healthy community building centers, to train the retired medical personnel to participate this project and to market this project by the mass medium.