原住民學生菸、酒、檳榔預防性衛生教育計劃介入之成效評價

Evaluation of an intervention program to prevent aboriginal adolescents from using tobacco, alcohol and betel quid

目前國內缺乏以原住民學生為對象的菸、酒、檳榔衛生教育介入研究，尤其採準 實驗研究設計更是寥寥可數。考量原住民前三大死因與其文化風格以菸、酒、檳榔使用較高，因此本研究主旨為瞭解針對某兩所不同原住民國中學生的「團體衛生教育介入」對其菸、酒、檳榔之「認知」、「主觀規範」、「態度」、「自我效能」與「行為」的影響。結果顯示，經衛生教育介入，學生在對菸、酒、檳榔方面的相關知識、主觀規範、態度、自我效能與行為進步不大，僅對檳榔的知識部分，實驗組有顯著高於對照組。在行為上，少數實驗組學生曾使用過菸、酒、檳榔，在衛教介入後轉變為停止或減量使用。在衛教介入過程評價部分，學生普遍認為課程是有幫助的且滿意課程活動與時間安排。本研究因樣本數有限影響檢力，為主要研究限制，而學生程度及講師經驗亦可能影響介入成效。建議將來可以擴充研究的學校數，更重要的是將菸、酒及檳榔之防治教育成為學校推行之衛生保健年度業務之一，才能永續經營，達到無菸、酒及檳榔校園之目標。

There is a scarcity in quasi-experimental studies focusing on the preventive health education for aboriginal adolescents. The death registry shows the first three death causes among Taiwan aboriginals are strongly associated with tobacco, alcohol and betel quid use. The purpose of this study is to explore the effects of health educational intervention program on knowledge, subjective norm, attitude, self-efficacy and behaviors regarding tobacco, alcohol and betel quid for aboriginal adolescents. Two different aboriginal junior high schools were included in this study. The results indicate that the knowledge, subjective norm, attitude, self-efficacy and behaviors regarding tobacco, alcohol and betel quid did not improve significantly. Only the knowledge regarding betel quid use, the score of experimental group was significantly higher than that of control group. Few students in experimental group reported that they have use tobacco, alcohol and betel quid at pre-test, however, they stop using or decreasing use amount at post test. Most students agree that the course is helpful and are satisfied with course activities and time arrangement. The major limitation of this study is study sample too small, so lack of enough power to detect the intervention effects. Students' level of literacy and educators' teaching experiences may also influence the intervention effects. We suggested that future studies could expand the number of study schools and integrate the preventive health educational program into regular school calendar to fulfill the goal of tobacco-, alcohol- and betel guid-free campus.