以計劃行為理論探討台灣大學生每日食用早餐之意圖及其食用早餐頻率與健康相關生活品質之關聯

Abstract

背景：早餐是一天中所進食的第一餐，是身體開始吸收營養的首個時間點，也經常被認為是一天中最重要的一餐，然而對於可掌握自己生活作息之台灣大學生，其實用早餐之頻率卻有待提升，培養每日食用早餐之習慣，對於其生理、心理、社交與學習皆能產生正面之影響。

目的：以計劃行為理論 (Theory of Planned Behavior, TPB)，探討影響台灣大學生每日食用早餐意圖之相關因素，並且分析比較不同早餐頻率之大學生，其健康相關生活品質於生理、心理、社會與環境等不同範疇，是否存有差異。

方法：本研究於2018年1月至2018年3月期間，使用以計劃行為理論為基礎之網路匿名自填式問卷，作為研究工具進行資料收集，有效樣本為1,037位，使用性別做為分層依據，以多變項羅吉斯迴歸分析台灣大學生未來每日食用早餐意圖之相關因素，多變項線性迴歸分析不同早餐頻率之台灣大學生，其健康相關生活品質四大範疇之相關影響因素。

結果：本研究發現，具有以下特質之女性台灣大學生，未來有較高之每日食用早餐意圖：對於正向結果評價之態度表示為相對正向 (AOR=5.13) 者、對於負向結果行為評價之態度表示為相對正向 (AOR=3.61) 者、主觀規範為相對中度支持 (AOR= 2.32) 與高度支持者 (AOR= 3.73)，以及於阻礙情境表示為相對高度自控 (AOR= 2.36) 者；而未來有較高之每日食用早餐意圖之男性台灣大學生，其特質如下：對於正向結果評價之態度表示為相對正向 (AOR=3.41) 者、對於負向結果行為評價之態度表示為相對中性 (AOR=3.11) 與相對正向 (AOR=4.02) 者，以及主觀規範為相對高度支持 (AOR= 2.43) 者。此外，於不同早餐頻率之台灣大學生，其健康相關生活品質存有差異，例如：於心理健康範疇，相較於不食用早餐者 (0天/週)，每週食用早餐4–6天者 (β=0.179) 與每日食用早餐者 (β=0.234)，具有較佳之生活品質；於社會健康範疇，相較於不食用早餐者，每日食用早餐者 (β=0.174)，具有較佳之生活品質；於環境健康範疇，相較於不食用早餐者 (0天/週)，每週食用早餐4–6天者 (β=0.194) 與每日食用早餐者 (β=0.248)，具有較佳之生活品質。

結論：本研究以TPB理論作為架構探討台灣大學生每日食用早餐之意圖，並發現行為態度、主觀規範或是自覺行為控制，皆為影響台灣大學生每日食用早餐之意圖，且性別具有調節作用；此外，本研究亦證實，不同食用早餐頻率者，其健康相關生活品質存有差異。本研究之結果可提供未來於早餐推廣與衛教上之實證參考數據，期盼能增加大學生之早餐頻率，並提升其健康相關生活品質。

Background and Objectives: Breakfast is often considered the most important meal of the day, as it plays a key role in people’s health and well-being. However, some college students in Taiwan do not eat breakfast daily, even though they have become more autonomous than they were before entering college. Therefore, this study aimed to explore the factors associated with daily breakfast consumption intention (DBCI) among college students in Taiwan, separately by gender, using the Theory of Planned Behavior (TPB) as a theoretical framework, and to examine the relationships between different breakfast consumption frequencies and the 4 domains of health-related quality of life (HRQOL).

Methods: Data from 1,037 college students in Taiwan were collected using an anonymous online survey from January through March 2018. Multivariate logistic regression, stratified by gender, was employed to explore the factors associated with higher DBCI among college students. Next, multivariate linear regression was used to examine the relationships between different breakfast consumption frequencies and the 4 domains of HRQOL.

Results: This study found that female college students with the following characteristics had significantly higher DBCI: having relatively positive ATB about positive outcomes (AOR=5.13), relatively positive ATB about negative outcomes (AOR=3.61), relatively neutral (AOR=2.32) and supportive (AOR=3.73) SN, and high PBC under constraining conditions (AOR=2.36). Among male college students, those having relatively positive ATB about positive outcomes (AOR=3.41), relatively neutral (AOR=3.11) and positive (AOR=4.02) ATB about negative outcomes, and relatively supportive SN (AOR=2.43) had higher DBCI. Further, college students with different breakfast consumption frequencies had differential HRQOL in various domains. The following frequencies were associated with better HRQOL: (1) psychological: 4–6 days/week (β=0.179) and 7 days/week (β=0.234); (2) social: 7 days/week (β=0.174); (3) environment: 4–6 days/week (β=0.194) and 7 days/week (β=0.248).

Conclusions: This study used the TPB as a theoretical framework to systematically examine DBCI among college students in Taiwan. For both males and females, positive ATB about positive and negative outcomes, as well as supportive SN, were linked to higher DBCI. Gender differences were noted. For females, neutral SN and high PBC under constraining conditions were also related to higher DBCI, whereas for males, neutral ATB about negative outcomes was associated with higher DBCI. Therefore, future breakfast promotion programs could be tailored by gender for optimal effectiveness. In addition, college students with higher breakfast consumption frequencies had better psychological, social, and environment HRQOL. These findings can provide empirical evidence to inform future breakfast promotion programs to improve college students’ HRQOL.