以計劃行為理論為基礎比較台灣之男女中學教師達到身體活動建議量之行為意圖與相關因素

Abstract

背景：隨著科技快速低地進步，現代人越來越容易成為坐式生活型態，導致身體活動量不足。根據世界衛生組織（World Health Organization, WHO）的報告顯示，身體活動量不足已被定義為全球第四大死因。因此，WHO提出了身體活動建議量，又稱週週150，希望能預防身體活動量不足所導致的傷害。在台灣，中學教師是教育現場的重要推手。因為他們的職業特性，導致他們容易受到特定的疾病及健康問題的困擾。然而，這些身理及心理的健康問題，都可以藉由從事身體活動得以舒緩。 目的：本研究係以計劃行為理論（Theory of Planned Behavior, TPB）為架構，透過問卷調查及系統性分析，檢視中學教師做到週週150意圖之相關因素，以提供未來發展衛教介入之實證參考依據。 方法：本研究於2020年2月至2020年4月期間，同時透過網路問卷進行調查。共計1061位中學教師參與並納入最終統計分析。本研究為匿名調查，問卷題項係依據TPB之理論構念設計而成。分析階段使用探索性因素分析，以了解量表之因素結構，並使用多變項羅吉斯迴歸，進行性別分層分析，探討影響中學教師做到週週150意圖之相關因素。 結果：研究發現在背景特質中，有運動習慣之變項在所有四個模式中皆呈顯著。在TPB直接測量部分，行為態度為相對正向（AOR= 2.28）、主觀規範為相對中立（AOR= 1.72）和相對支持（AOR= 1.84）以及自覺行為控制為相對中度（AOR= 14.16）和相對高度（AOR= 52.13）者，其為高意圖族群可能性更高。在TPB間接測量部分，正面行為結果評價為相對中立（AOR= 1.64）、相對正向（AOR= 2.93）、負面行為結果評價為相對中立（AOR= 1.84）、相對正向（AOR= 1.67）、主觀規範為相對中立（AOR= 1.59）、相對支持（AOR= 1.82）以及阻礙情境下之自覺行為控制為相對中度（AOR= 2.13）和相對高度（AOR= 3.44）者其為高意圖族群可能性更高。此外，研究亦發現週週150意圖具性別間之差異。 結論：本研究發現，正面與負面行為結果評價、主觀規範和阻礙情境下之自覺行為控制，均與週週150意圖具顯著關聯性，而女性之週週150意圖與正面與負面行為結果評價、主觀規範和阻礙情境下之自覺行為控制顯著相關，而男性之週週150意圖則與正面行為結果評價和阻礙情境下之自覺行為控制顯著相關。在背景特質部分本研究發現有運動習慣在男女中皆與週週150意圖呈顯著相關，可見過往行為經驗會影響行為意圖。此外，在授課領域與子女方面，女性因社會期待與傳統社會框架之影響，使得此二因子在女性中則顯著，而男性中則沒有。故未來研究應視不同性別，有相對應之著力點與方向。

Background: As technology advances in modern society, increasingly more people are living a sedentary lifestyle, thus leading to lack of physical activity (PA). According to the World Health Organization (WHO), physical inactivity has been identified as the fourth leading risk factor for global mortality. Therefore, WHO recommended physical activity levels (PA150) to prevent negative consequences. In Taiwan, high school teachers play an important role in education. Because of their job characteristics, they are at greater risk for certain diseases and health problems. Fortunately, these kinds of physical and mental health issues can be ameliorated by increased PA levels. Objectives: This study aimed to systematically examine the PA150 intention and associated factors among high school teachers, using the Theory of Planned Behavior (TPB) as a theoretical framework. Methods: An anonymous online survey was conducted between February and April 2020. Responses from 1,061 high school teachers were received. The survey items were developed on the basis of TPB and relevant literature. Multivariate logistic regression was used to explore factors associated with PA150 intention, separately for males and females. Results: This study found that, among the background characteristics, having exercise habits remained a statistically significant factor in all four models. As for the three TPB constructs, the analysis showed that people who had positive attitudes toward the behavior (ATB) (adjusted odds ratio [AOR]=2.28), neutral (AOR=1.72) or supportive (AOR=1.84) subject norms (SN), and intermediate (AOR=14.16) or high perceived behavioral control (PBC) (AOR=52.13) had greater odds of having high PA150 intention. Regarding the five TPB factors, this study found that people who had neutral (AOR=1.64) or positive (AOR=2.93) ATB about positive outcomes, neutral (AOR=1.84) or positive (AOR=1.67) ATB about negative outcomes, neutral (AOR=1.59) or supportive (AOR=1.82) SN, and intermediate (AOR=2.13) or high (AOR=3.44) PBC under constraining conditions, had greater odds of having high PA150 intention. Also, the stratified analysis discovered that these factors associated with PA150 intention appeared to be moderated by gender. Conclusions: The current study found that ATB about positive outcomes, ATB about negative outcomes, SN, and PBC under constraining conditions were significantly related to PA150 intention. Specifically, among female teachers, ATB about positive and negative outcomes, SN, and PBC under constraining conditions were significant. However, among male teachers, only ATB about negative outcomes and PBC under constraining conditions were significant. As regards background characteristics, this study found that exercise habits was significantly associated with PA150 intention in both males and females, which indicated that past experience may influence behavioral intention. Further, owing to social desirability and traditional gender role expectations, the teaching subject area and having a child or children were also significant factors for female teachers but not for male teachers. Accordingly, future efforts to promote PA should have different strategies tailored for different genders.