青少年自主體重管理計畫效果研究──以澳門肥胖的中學生為例

Evaluation of the effectiveness of the adolescent self-monitoring weight management program

鑒於澳門近年來經濟急速發展，青少年肥胖的問題日趨嚴重，然而國際針對青少年肥胖的介入研究卻不多，加上往往採取學校、政府或衛生單位主導的單一方面介入方式，成本高卻收效不佳，欠缺讓青少年有效持續推動的方法。本研究目的是建立出一套讓學校及青少年可實際應用自我監察體重管理的方式來進行體重管理。本研究採用立意取樣方式，從澳門眾多中等學校中隨機抽取4所同質性高而願意參與研究的學校，並從中招募過重或肥胖的學生一共128位參與研究，並透過隨機分配，分成實驗組及控制組。兩組皆接受前測，其後實驗組接受2個月的「青少年自主體重管理計畫」(控制組無任何介入)，俟實驗組介入後1個月時，兩組再進行後測(立即效果)，在2個月時進行後後測(延宕效果)。研究發現「青少年自主體重管理計畫」在增加學生體重管理知識、改善體重管理態度及促進體重管理正確行為三方面上皆具有顯著的立即效果及延宕效果；然而由於研究時間的局限，身體質量指數(BMI)在立即及延宕測試上均未見明顯的改善；在體脂肪比(BF%)上雖無立即效果，但在介入計畫後2個月就顯現出效果。研究結果顯示「青少年自主體重管理計畫」雖然未能短時間內改善肥胖生理問題，但這種讓學生自主決策的體重管理模式更能讓過重或肥胖的青少年所接受，不單在改變體重管理知識及態度上作用明顯，更能協助他們建立出適合自己持久的體重管理行為。本研究結果值得相關單位及學校在日後推動青少年體重管理等健康促進工作上之參考，本文亦就增加青少年體重管理的成效上提出具體可行的建議。

Due to the increasing obesity thread in adolescents of Macau, this research aims to establisha sustainable, effective and practical intervention program for schools and adolescents. By combining the self-monitoring concept and many successful approaches that have been commonly used in adult weight management, the researcher had designed an intervention program including 1)After-School Fitness Club, 2)Fit-Fit workshop, 3)Self-monitoring daily report and 4) Short message service (SMS) health reminder. Students were recruited from four middle schools randomly selected. 128(n=128) overweight or obese students were divided into the intervention group and the control group. The weight management intervention program, a school-based setting intervention, was conducted among the intervention group for two months. Then there were assessment tests to evaluate the immediate and sustainable effects of the program after 1 month and 2 months. The results showed that the “adolescent self-monitoring weight management program” had a statistically significant effect on knowledge, attitude and behavior. However, due to the shortage of intervention time, neither the BF% nor the BMI has significant effect in the immediate effect assessment, but there was a significant improvement of Body Fat percentage (BF%) in the sustainable effect assessment after two months of the intevention. This may indicate that the influence on the physiological obesity indices (BMI and BF%) may need a long- term monitoring research to confirm the sustainable effect. Generally, the adolescent self-monitoring weight management program had proven to be practical and effective in improving the adolescent weight management capability and attitude. The results of this study can provide health related departments and schools with a useful tool for obesity prevention program.