台灣大學生蔬果攝取改變階段與蔬果飲食頻率之研究－跨理論模式之應用

Stages of Change and Food Frequency for Fruit and Vegetable Intake among College Students in Taiwan: An Application of the Transtheoretical Model

10.7022/JHPHE.200912.0043

魏米秀(Mi-Hsiu Wei)；呂昌明(Chang-Ming Lu)

大學生 ； 水果 ； 改變階段 ； 飲食頻率 ； 蔬菜 ； college student ； food frequency ； fruit ； stages of change ； vegetable

健康促進與衛生教育學報

32期（2009 / 12 / 01）

43 - 64

繁體中文

本研究目的在瞭解台灣地區大學生的蔬果攝取改變階段及飲食頻率，並探討其與背景變項及跨理論模式變項間的關係。採橫斷式問卷調查，樣本為來自30所大學校院的1051位學生。研究結果發現樣本在蔬菜及水果攝取改變階段的分佈皆以無意圖期及準備期佔多數，行動期及維持期人數較少。蔬菜、水果攝取頻率為平均每日2.16次、0.92次。蔬菜／水果攝取改變階段不同，攝取頻率呈顯著差異，處於較高改變階段者，有較高的攝取頻率。處於較高蔬菜／水果攝取改變階段者，其自我效能、決策權衡整體變項及個別變項的得分均有愈高的趨勢。研究結果支持衛生教育可依目標對象所處的蔬果攝取改變階段設計合適的介入方案。

The purpose of this study was to understand the stages of change and food frequencies for fruit and vegetable intake among college students in Taiwan. Associations were examined between stages of change, food frequencies, and demographic and psychosocial factors. We used a cross-sectional questionnaire design. A sample of 1051 students enrolled in 30 colleges or universities completed a questionnaire. The results revealed that most subjects were in the precontemplation and preparation stages, and a relatively small percentage of students were in the action and maintenance stages. The average daily fruit and vegetable consumption frequencies were 0.92 and 2.16 times. Fruit/vegetable consumption frequencies were positively associated with more advanced stages of change. There was an overall stage effect on self-efficacy and decisional balance, and significant univariate effects for these two variables. The findings of this study imply a utility for the design of stage-tailored interventions for promoting college students' fruit and vegetable intake.

1. 魏米秀、呂昌明(2006)。以焦點團體訪談探討大學生蔬果攝取行爲的影響因素。衛生教育學報，26，125-145。
   連結：
2. 魏米秀、陳建宏、呂昌明(2005)。應用市場區隔分析大專生蔬果攝取行爲之研究－以某技術學院二專部學生爲例。衛生教育學報，23，1-18。
   連結：
3. Bazzano, L.A.,He, J.,Ogden, L.G.,Loria, C.M.,Vupputuri, S.,Myers, L.(2002).Fruit and vegetable intake and risk of cardiovascular disease in US adults: the first National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.American Journal of Clinical Nutrition,76,93-99.
4. Block, G.,Patterson, B.,Subar, A.(1992).Fruit, Vegetables, and cancer prevention: a review of the epidemiological evidence.Nutrition and Cancer,18(1),1-29.
5. Campbell, M.K.,Reynolds, K.D.,Havas, S.,Curry, S.,Bishop, D.,Nicklas, T.(1999).Stages of change for increasing fruit and vegetable consumption among adults and young adults participating in the national 5-a-Day for Better Health community studies.Health Education and Behavior,26(4),513-534.
6. Curry, S.J.,Kristal, A.R.,Bowen, D.J.(1992).An application of the stage model of behaviour change to dietary fat reduction.Health Education Research,7,97-105.
7. De Oliveira, M.C.F.,Anderson, J.,Auld, G.,Kendall, P.(2005).Validation of a tool to measure processes of change for fruit and vegetable consumption among male college students.Journal of Nutrition Education and Behavior,37(1),2-11.
8. Devine, C.M.,Connors, M.,Bisogni, C.A.,Sobal, J.(1998).Life-course influences on fruit and vegetable trajectories: qualitative analysis of food choices.Journal of Nutrition Education,30,361-370.
9. Dittus, K.L.,Hillers, V.N.,Beerman, K.A.(1995).Benefits and barriers to fruit and vegetable intake: relationship between attitudes and consumption.Journal of Nutrition Education,27,120-126.
10. Glanz, K.,Basil, M.,Maibach, E.,Goldberg, J.,Snyder, D.(1998).Why Americans eat what they do: taste, nutrition, cost, convenience, and weight control concerns as influences on food consumption.Journal of the American Dietetic Association,98(10),1118-1126.
11. Greene, G.W.,Fey-Yensan, N.,Padula, C.,Rossi, S.,Rossi, J.S.,Clark, P.G.(2004).Differences in psychosocial variables by stages of change for fruits and vegetables in older adults.Journal of the American Dietetic Association,104,1236-1243.
12. Harnack, L.,Block, G.,Subar, A.,Lane, S.,Brand, R.(1997).Association of cancer preventionrelated nutrition knowledge, beliefs, and attitudes to cancer prevention dietary behavior.Journal of the American Dietetic Association,97,957-965.
13. Havas, S.,Treiman, K.,Langenberg, P.,Ballesteros, M.,Anliker, J.,Damron, D.(1998).Factors associated with fruit and vegetable consumption among women participating in WIC.Journal of the American Dietetic Association,98(10),1141-1148.
14. Henry, H.,Reimer, K.,Smith, C.,Reicks, M.(2006).Associations of decisional balance, processes of change, and self-efficacy with stages of change for increased fruit and vegetable intake among low-income, African-American mothers.Journal of the American Dietetic Association,106,841-849.
15. Horacek, T.M.,Greene, G.,Georgiou, C.,White, A.,Ma, J.(2002).Comparison of three methods for assessing fruit, vegetable, and grain stage of change for young adults.Topics in Clinical Nutrition,17(5),36-61.
16. Jansen, M.C.J.F.,Bueno-de-Mesquita, H.B.,Feskens, E.J.M.,Streppel, M.T.,Kok, F.J.,Kromhout, D.(2004).Quantity and variety of fruit and vegetable consumption and cancer risk.Nutrition and Cancer,48(2),142-148.
17. Kerlinger, F.N.,Lee, H.B.(2000).Foundations of Behavioral Research.Toronto:Thomson Learning.
18. Kloek, G.C.,Van Lenthe, F.J.,Van Nierop, P.W.M.,Mackenbach, J.P.(2004).Stages of change for fruit and vegetable consumption in deprived neighborhoods.Health Education and Behavior,31(2),223-241.
19. Krebs-Smith, S.M.,Heimendinger, J.,Patterson, B.H.,Subar, A.F.,Kessler, R.,Pivonka, E.(1995).Psychosocial factors associated with fruit and vegetable consumption.American Journal of Health Promotion,10(2),98-104.
20. Lechner, L.,Brug, J.,Vries, H.D.,Assema, P.V.,Mudde, A.(1998).Stages of change for fruit, vegetable and fat intake: consequences of misconception.Health Education Research,13(1),1-11.
21. Levine, E.(1999).Intergenerational influences on teenagers'healthy food choices (Doctoral Dissertation, the George Washington University, 1999).Dissertation Abstracts International,60(2),485.
22. Liebman, M.,Propst, K.,Moore, S.A.,Pelican, S.,Holmes, B.,Wardlaw, M.K.(2003).Gender differences in selected dietary intakes and eating behaviors in rural communities in Wyoming, Montana, and Idaho.Nutrition Research,23,991-1002.
23. Lien, N.,Lytle, L.A.,Klepp, K.I.(2001).Stability in consumption of fruit, vegetable, and sugary foods in a cohort from age 14 to age 21.Preventive Medicine,33,217-226.
24. Ling, A.M.C.,Horwath, C.(2001).Perceived benefits and barriers of increased fruit and vegetable consumption: validation of a decisional balance scale.Journal of Nutrition Education,33(3),257-265.
25. Lock, K.,Pomerleau, J.,Causer, L.,Altmann, D.R.,McKee, M.(2005).The global burden of disease attributable to low consumption of fruit and vegetables: implications for the global strategy on diet.Bulletin of the World Health Organization,83(2),100-108.
26. Ma, J.,Betts, N.M.,Horacek, T.,Georgiou, C.,White, A.(2003).Assessing stages of change for fruit and vegetable intake in young adults: a combination of traditional staging algorithms and food-frequency questionnaires.Health Education Research,18(2),224-236.
27. Ma, J.,Betts, N.M.,Horacek, T.,Georgiou, C.,White, A.,Nitzke, S.(2002).The importance of decisional balance and self-efficacy in relation to stages of change for fruit and vegetable intakes by young adults.American Journal of Health Promotion,16(3),157-166.
28. 5 A Day for Better Health Program Evaluation Report: Evaluation
29. National Center for Health Statistics(2001).Healthy People 2000 Final Review.Hyattsville, Maryland:Public Health Service.
30. Neumark-Sztainer, D.,Hannan, P.J.,Story, M.,Croll, J.,Perry, C.(2003).Family meal patterns: associations with sociodemographic characteristics and improved dietary intake among adolescents.Journal of the American Dietetic Association,103,317-322.
31. Neumark-Sztainer, D.,Story, M.,Dixon, L.B.,Resnick, M.D.,Blum, R.W.(1997).Correlates of inadequate consumption of dairy products among adolescents.Journal of Nutrition Education,29,12-20.
32. Nothwehr, F.,Snetselaar, L.,Yang, J.,Wu, H.(2006).Stage of change for healthful eating and use of behavioral strategies.Journal of the American Dietetic Association,106,1035-1041.
33. Prochaska, J.O.,Redding, C.A.,Evers, K.E.,K. Glanz (Eds.),B.K. Rimer (Eds.),F.M. Lewis (Eds.)(2002).Health Behavior and Health Education: Theory, Research, and Practice.San Francisco, CA:Jossey-Bass.
34. Prochaska, J.O.,Velicer, W.F.,Rossi, J.S.,Golstein, M.G.,Marcus, B.H.,Rakowski, W.(1994).Stages of change and decisional balance for 12 problem behaviors.Health Psychology,13(1),39-46.
35. Pullen, C.,Walker, S.N.(2002).Midlife and older rural women's adherence to U.S. Dietary Guidelines across stages of change in health eating.Public Health Nursing,19(3),170-178.
36. Shaikh, A.R.,Yaroch, A.L.,Nebeling, L.,Yeh, M.C.,Resnicow, K.(2008).Psychosocial predictors of fruit and vegetable consumption in adults.American Journal of Preventive Medicine,34(6),535-543.
37. Steinmetz, K.A.,Potter, J.D.(1996).Vegetables, fruit, and cancer prevention: a review.Journal of the American Dietetic Association,96(10),1027-1039.
38. Story, M.,Neumark-Sztainer, D.,Resnick, M.D.,Blum, R.W.(1998).Psychosocial factors and health behaviors associated with inadequate fruit and vegetable intake among American-Indian and Alaska-Native adolescents.Journal of Nutrition Education,30(2),100-106.
39. Thompson, F.E.,Byers, T.(1994).Dietary assessment resource manual.Journal of Nutrition,124,2245-2317.
40. Trudeau, E.,Kristal, A.R.,Li, S.,Patterson, R.E.(1998).Demographic and psychosocial predictors of fruit and vegetable intakes differ: implications for dietary interventions.Journal of the American Dietetic Association,98,1412-1417.
41. U.S. Department of Health and Human Services(1991).Healthy People 2000: National Health Promotion and Disease Prevention Objectives.Washington, D.C.:U.S. Government Printing Office.
42. Van Duyn, M.A.S.,Heimendinger, J.,Russek-Cohen, E.,Diclemente, C.C.,Sims, L.S.(1998).Use of the transtheoretical models of change to successfully predict fruit and vegetable consumption.Journal of Nutrition Education,30,371-380.
43. Vereecken, C.A.,Damme, W.V.,Maes, L.(2005).Measuring attitudes, self-efficacy, and social and environmental influences on fruit and vegetable consumption of 11- and 12-year-old children: Reliability and validity.Journal of the American Dietetic Association,105(2),257-261.
44. 行政院衛生署(2002)。每日飲食指南。台北:行政院衛生署。
45. 成人肥胖定義及處理原則
46. 食物份量代換表
47. 吳幸娟、章雅惠、方佳雯、潘文涵(1999)。Food sources of weight, colories, and three macronutrients-NAHSIT 1993-1996。中華民國營養學會雜誌，24(1)，41-58。
48. 曾明淑、高美丁、葉文婷、潘文涵(1999)。Food consumption frequency and eating habit among Taiwanese-NAHSIT 1993-1996。中華民國營養學會雜誌，24(1)，59-80。
49. 黃伯超、潘文涵(1994)。國民營養健康狀況變遷調查。台北:行政院衛生署。
50. 蔡晏儒、鄭惠美(2006)。運用跨理論模式於職場員工蔬菜攝取行爲之探討：以某企管顧問有限公司往來客戶爲例。健康促進暨衛生教育雜誌，26，17-30。

1. 蘇聖珠,趙丹平(2020)。大學生蔬果攝取行為及其影響因素之探討－以新竹縣某科技大學為例。台灣公共衛生雜誌，39(5)，493-508。
2. 顏誠,謝孟志,連文彬,施承典(2017)。飲食習慣對藥學生身體質量指數之作用。大仁學報，51，25-40。