探討健康促進學校國際認證成效：從學生健康行為表現之觀點

Effectiveness of health promoting school international accreditation: a study from the perspective of students' health behaviors

10.6288/TJPH.202002_39(1).108094

陳富莉(FU-LI CHEN)；邱詩揚(SHY-YANG CHIOU)；陸玓玲(DIH-LING LUH)；王英偉(YING-WEI WANG)

健康促進學校 ； 國際認證 ； 健康行為 ； 國小 ； 國高中 ； health promoting school ； international accreditation ； health behavior ； elementary school ； junior and senior high school

台灣公共衛生雜誌

39卷1期（2020 / 02 / 26）

27 - 40

繁體中文

目標：本研究旨在探討健康促進學校國際認證成效，比較參與認證獲獎與未獲獎學校的學生健康相關行為表現差異。方法：研究樣本為第一屆（2012年）參與健康促進學校國際認證之國小、國中、高中（職）學校四、八、十年級的學生，共計192校。研究工具為自填式問卷，包括基本資料、認證獲獎與否、健康相關行為。2014年完成18,711人問卷施測，包含國小6,744人、國高中11,967人。研究資料採用SAS 9.4版套裝軟體進行描述性統計、卡方檢定及羅吉斯迴歸分析。結果：控制學生背景資料後，發現國小獲獎學校學生在吃蔬菜、運動、熬夜三項行為表現顯著優於未獲獎學校學生；國高中獲獎學校學生在刷牙、運動、睡眠及被霸凌經驗等四項行為表現顯著優於未獲獎學校學生；然而，吃早餐、水果攝取、看牙醫、吃甜食、吸菸等行為表現，獲獎與未獲獎學校學生並無顯著差異。結論：參與認證獲獎學校的學生多項健康相關行為比未獲獎學校表現好，建議未來應積極落實並推動健康促進學校計畫的永續發展。

Objectives: This study compared the health-related behaviors of Taiwanese students' in health promoting school(HPS) international accreditation award and non-award schools to assess the effectiveness of implementing the health promoting school program. Methods: Samples of 4th, 8th, and 10th grade students in 192 elementary, junior high, and senior high schools were recruited from participation in the first health promoting school international accreditation in 2012. The research instrument was a self-administered questionnaire which included demographic information, awards for HPS international accreditation, and health behaviors. A total of 18,711 respondents, including 6,744 elementary school students and 11,967 junior and senior high school students, completed the questionnaire in 2014. Descriptive statistics, chi-squared test, and logistic regression were conducted using SAS 9.4 software. Results: While controlling the personal' demographic variables, the study showed that elementary schools students from HPS accreditation award schools were significantly better than non-award schools students in vegetable intake, exercise, and staying up late; and junior and senior high school students from accredited award schools exhibited significantly better than non-award schools students in teeth brushing habits, exercise, sleep, school bullying experience. Students from award and non-award schools had no significant difference in eating breakfast, fruit intake, dental checkup, eating sweets, and smoking behavior. Conclusions: Students from HPS accreditation award schools exhibited more favorable health-related behaviors than non-awards schools students. The findings suggest that implementing the health promoting school program is a necessary move and ensuring the sustainable development.

1. 張鳳琴, FC,顏銓成, CC,劉潔心, CH(2013)。二代健康促進學校菸害防制行動研究計畫評價。中等教育，64，26-43。
   連結：
2. Breslow, L,Bresnlow, N.(1993).Health practices and disability: some evidence from Alameda County.Prev Med,22,86-95.
3. Busch, V,De Leeuw, RJ,Schrijvers, AJ(2013).Results of a multibehavioral health-promoting school pilot intervention in a Dutch secondary school.J Adolesc Health,52,400-406.
4. Chen, FL,Lee, A(2016).Health-promoting educational settings in Taiwan: development and evaluation of the Health-Promoting School Accreditation System.Glob Health Promot,23(1 Suppl),18-25.
5. Fung, C,Kuhle, S,Lu, C(2012).From "best practice" to "next practice": the effectiveness of school-based health promotion in improving healthy eating and physical activity and preventing childhood obesity.Int J Behav Nutr Phys Act,9,27.
6. John-Akinola, YO,Nic-Gabhainn, S(2014).Children’s participation in school: a cross-sectional study of the relationship between school environments, participation and health and well-being outcomes.BMC Public Health,14,964.
7. Lakin, L,Littledyke, M(2008).Health Promoting Schools: integrated practices to develop critical thinking and healthy lifestyles through farming, growing and healthy eating.Int J Consum Stud,32,253-259.
8. Langford, R,Bonell, C,Jones, H(2015).The World Health Organization’s Health Promoting Schools framework: a Cochrane systematic review and meta-analysis.BMC Public Health,15,130.
9. Langford, R,Bonell, C,Komro, K(2017).The Health Promoting Schools Framework: known unknowns and an agenda for future research.Health Educ Behav,44,463-475.
10. Laurence, S,Peterken, R,Burns, C(2007).Fresh Kids: the efficacy of a Health Promoting Schools approach to increasing consumption of fruit and water in Australia.Health Promot Int,22,218-226.
11. Lee, A,Cheng, FF,Fung, Y,St. Leger, L(2006).Can Health Promoting Schools contribute to the better health and wellbeing of young people? The Hong Kong experience.J Epidemiol Community Health,60,530-536.
12. Lee, A,Cheng, FF,Yuen, H(2007).Achieving good standards in Health Promoting Schools: preliminary analysis one year after the implementation of the Hong Kong Healthy Schools Award scheme.Public Health,121,752-760.
13. Lee, A,Lo, ASC,Keung, MW,Kwong, CMA,Wong, KK(2019).Effective Health Promoting School for better health of children and adolescents: indicators for success.BMC Public Health,19,1088.
14. Lee, A,Wong, MC,Keung, VM,Yuen, HS,Cheng, F,Mok, JS(2008).Can the concept of Health Promoting Schools help to improve students’ health knowledge and practices to combat the challenge of communicable diseases: case study in Hong Kong?.BMC Public Health,8,42.
15. Li, Y,Chen, PY,Chen, FL,Chen, YL(2017).Preventing school bullying: investigation of the link between antibullying strategies, prevention ownership, prevention climate, and prevention leadership.Appl Psychol,66,577-598.
16. Liao, LL,Liu, CH,Chang, FC,Cheng, CC,Niu, YZ,Chang, TC(2015).Evaluation of the Health-Promoting School supporting network in Taiwan.J Sch Health,85,487-495.
17. Liu, CH,Chang, FC,Liao, LL(2015).Expanding school-district/university partnerships to advance Health Promoting Schools implementation and efficacy in Taiwan.Health Educ Res,30,638-646.
18. McIsaac, JD,Penney, TL,Ata, N(2017).Evaluation of a Health Promoting Schools program in a school board in Nova Scotia, Canada.Prev Med Rep,5,279-284.
19. Nutbeam, D.(2017).Health literacy as a population strategy for health promotion.Japanese Soc Health Educ Promot,25,210-222.
20. Phaitrakoon, J,Powwattana, A,Lagampan, S,Klaewkla, J(2014).The diamond level health promoting schools (DLHPS) program for reduced child obesity in Thailand: lessons learned from interviews and focus groups.Asia Pac J Clin Nutr,23,293-300.
21. Shama, ME,Abdou, SS(2009).Evaluating the impact of Health Promoting School initiative on dietary habits and BMI of students in Oman.J Egypt Public Health Assoc,84,119-139.
22. Solberg, ME,Olweus, D(2003).Prevalence estimation of school bullying with the Olweus Bully/Victim Questionnaire.Aggressive Behav,29,239-268.
23. Stokes, E,Pine, CM,Harris, RV(2009).The promotion of oral health within the Healthy School context in England: a qualitative research study.BMC Oral Health,9,3.
24. WHO. School health promotion-series 5: regional guidelines: development of health promoting schools: a framework of action. Available at: https://apps.who.int/iris/handle/10665/206847?locale-attribute=en&. Accessed July 30, 2019.
25. 邱弘毅, HY(2014)。,台北=Taipei:衛生福利部國民健康署=Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan)。
26. 教育部：學校衛生重大教育政策發展歷程。http://history.moe.gov.tw/policy.asp?id=10。引用2019/07/30。Ministry of Education, R.O.C. (Taiwan). Main hygienic educational policies in school. Available at: http://history.moe.gov.tw/policy.asp?id=10. Accessed July 30, 2019. [In Chinese]
27. 教育部國民及學前教育署：校園口腔保健資訊網-兒童(7-18歲)具科學實證之防齲措施。 https://ohpc.kmu.edu.tw/index.php。引用2020/01/12。K-12 Education Administration, Ministry of Education. Campus oral health webpage: evidence-based anti-cavity measures for children (7–18 years old). Available at: https://ohpc.kmu.edu.tw/index.php. Accessed January 12, 2020. [In Chinese]
28. 陳富莉, FL,陳映伶, YL(2016)。以健康促進學校模式建立友善無菸校園。新北市教育，19，13-18。
29. 臺灣健康促進學校：106學年度健康促進學校必選及自選議題之學生健康成效指標。http://hps.hphe.ntnu.edu.tw/topic/body/measure/list。引用2020/01/11。 Taiwan Health Promoting School. Student health performance indicators for the 2017 academic year compulsory and elective topics in health-promoting schools. Available at: http://hps.hphe.ntnu.edu.tw/topic/body/measure/list. Accessed January 11, 2020. [In Chinese]
30. 衛生福利部國民健康署, Ministry of Health and Welfare, R.O.C. (Taiwan)。,未出版
31. 衛生福利部國民健康署, Ministry of Health and Welfare, R.O.C. (Taiwan)(2018).台灣肥胖防治策略.台北=Taipei:衛生福利部國民健康署=Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan).
32. 衛生福利部國民健康署：國中學生健康行為調查報告。台北：衛生福利部國民健康署，2016Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Survey Report for Junior High School Students’ Health Behavior. Taipei: Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan), 2016. [In Chinese]
33. 衛生福利部國民健康署：青少年健康行為調查計畫。https://www.hpa.gov.tw/EngPages/List.aspx?nodeid=113。引用2019/07/30。Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Taiwan Youth Health Survey, TYHS. Available at: https://www.hpa.gov.tw/EngPages/List.aspx?nodeid=113. Accessed July 30, 2019. [In Chinese]
34. 衛生福利部國民健康署：青少年健康行為調查執行成果報告，2015。台北：衛生福利部國民健康署。Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Survey Report of Taiwan Youth Health Survey (TYHS). Taipei: Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan), 2015. [In Chinese]
35. 衛生福利部國民健康署：健康促進學校國際認證─金質校園健康飛揚。https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1405&pid=10071。引用2019/07/30。Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). International accreditation of health-promoting schools -- Healthy Campus, Healthy Takeoff. Available at: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=1405&pid=10071. Accessed July 30, 2019. [In Chinese]
36. 衛生福利部國民健康署：聰明飲食 / 健康五蔬果。https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=543&pid=715。引用2020/01/12。Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Smart diet: five healthy fruits and vegetables. Available at: https://www.hpa.gov.tw/Pages/Detail.aspx?nodeid=543&pid=715. Accessed January 12, 2020. [In Chinese]
37. 衛生福利部國民健康署：青少年吸菸行為調查GYTS/名詞定義。https://www.hpa.gov.tw/Pages/List.aspx?nodeid=1724。引用2020/01/12。Health Promotion Administration, Ministry of Health and Welfare, R.O.C. (Taiwan). Global Youth Tobacco Survey, GYTS/definition. Available at: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=1724. Accessed January 12, 2020. [In Chinese]

1. 洪端良,李學愚,李亞柔(2021)。家庭飲食型態與學校宣導對國小學童支持蔬食日態度之影響。健康促進與衛生教育學報，54，69-89。