從偏鄉年長居民視角評估健康政策資訊傳播效果與落差：以南庄鄉文化健康站為例

Abstract

臺灣正面臨快速高齡化的挑戰，健康政策的傳遞與資訊可及性成為影響年長者健康福祉的關鍵因素。然而，在偏鄉地區，年長者獲取健康政策資訊的過程中仍面臨諸多障礙，包括語言與文化差異、數位落差、資訊管道有限以及健康識能不足等問題。這些障礙使得年長者無法充分理解並應用健康政策資訊，進而影響其醫療決策與健康行為，甚至可能加劇健康不平等的現象。 為了縮小資訊落差並提升年長者的健康識能，政府設立文化健康站，希望透過在地化的健康促進與長期照護服務，提高健康政策的可及性。然而，文化健康站的資訊傳遞成效是否符合當地年長者的實際需求，仍缺乏深入探討。目前的健康資訊傳遞模式往往未能充分考慮偏鄉族群的語言與文化背景，使得資訊的傳遞效果大打折扣。此外，資訊的數位化推動雖有助於提升傳遞效率，但對於不熟悉數位工具的偏鄉年長者而言，反而可能進一步增加資訊落差。因此，如何改善健康資訊的傳遞方式，使其更具文化適應性與可理解性，成為亟待解決的課題。 本研究旨在探討年長者在獲取健康政策資訊時所面臨的挑戰，並分析文化健康站在資訊傳遞過程中的角色與實際成效。本研究透過質性研究方法，包括深度訪談、參與觀察，來剖析影響資訊落差的關鍵因素，特別關注語言障礙、健康識能與資訊管道的適應性等面向。此外，本研究也探討文化健康站的工作人員與文化健康站服務志工如何看待資訊傳遞的問題，以及現有的改善措施是否真正有效，以期提供更具體的優化建議。本研究旨在探討年長者在獲取健康政策資訊時所面臨的挑戰，並分析文化健康站在資訊傳遞過程中的角色與實際成效。本研究透過質性研究方法，包括深度訪談、參與觀察，來剖析影響資訊落差的關鍵因素，特別關注語言障礙、健康識能與資訊管道的適應性等面向。此外，本研究也探討文化健康站的工作人員與政策推動者如何看待資訊傳遞的問題，以及現有的改善措施是否真正有效，以期提供更具體的優化建議。 本研究的貢獻在於補足現有健康政策資訊傳遞研究的不足，為政策制定者提供更具體的實證基礎，以最佳化目前健康資訊的傳播模式。此外，本研究亦將為地方政府與文化健康站提出具體可行的改善策略，例如發展更符合偏鄉語言與文化需求的健康資訊宣導方式、提升健康識能教育、改善資訊傳遞的可及性，以及促進跨部門合作，以確保健康政策資訊能夠準確傳遞至需要的族群。透過這些努力，本研究希望能夠有效提升偏鄉年長者的健康福祉，縮小因資訊落差導致的健康不平等問題，並促進更公平且有效的健康政策實施模式。 本研究採質性取向，於南庄鄉四個文化健康站進行參與觀察並深度訪談文化健康站服務使用者15名與照服員3名。研究發現：年長者多以被動與片段方式接收政策資訊；政策語言與在地語境落差顯著；照服員肩負轉譯角色但面臨資訊負荷與訓練不足；標準化宣導在多族群場域產生隱性排除。結論建議包括：強化雙語／多語與圖像化素材、建立個別諮詢與小組解說、提升照服員文化敏感與政策轉譯訓練，以及以數位素養教育搭配紙本與面對面溝通的雙軌策略。 最終，本研究透過深入的分析與具體建議，期望能夠促進更具文化適應性的健康政策傳遞方式，使偏鄉年長者能夠更充分地理解與運用健康政策資訊，進而提升其健康行為與生活品質。

Taiwan is facing the challenges of rapid population aging, making the dissemination and accessibility of health policy information a crucial factor influencing the well-being of elderly populations. However, older adults in rural areas continue to encounter multiple barriers to accessing such information, including language and cultural differences, the digital divide, limited information channels, and low health literacy. These obstacles hinder their ability to fully comprehend and apply health policies, affecting medical decisions and health behaviors and potentially exacerbating existing health inequalities. To narrow the information gap and enhance health literacy, the government has established Cultural Health Stations to improve health policy accessibility through localized health promotion and long-term care services. Yet, whether these stations effectively meet the practical needs of local elderly residents remains underexplored. Current models of health information dissemination often fail to account for the linguistic and cultural contexts of rural populations, significantly reducing communication effectiveness. Moreover, while digitalization has improved dissemination efficiency, it may unintentionally widen the information gap for elderly individuals unfamiliar with digital tools. Thus, developing more culturally adaptive and accessible dissemination strategies has become an urgent priority. This study aims to investigate the challenges elderly individuals face in accessing health policy information and to assess the role and effectiveness of Cultural Health Stations in the dissemination process. Using qualitative research methods, including in-depth interviews and participant observation, the study analyze key factors contributing to information disparities, focusing on language barriers, health literacy, and the adaptability of information channels. It also explores how station staff and volunteers perceive dissemination challenges and evaluate the effectiveness of current improvement measures, offering concrete strategies for optimization. The contribution of this study lies in addressing critical gaps in research on health policy communication and providing empirical evidence for improving current models. It presents actionable recommendations for local governments and Cultural Health Stations, such as developing culturally and linguistically appropriate health education materials, enhancing health literacy programs, improving access to information channels, and promoting cross-sector collaboration. These efforts aim to ensure that health policy information reaches the populations most in need. Ultimately, through in-depth analysis and practical recommendations, this study aspires to promote a more culturally adaptive approach to health communication. By enabling rural elderly populations to better understand and use health policy information, it aims to enhance their health behaviors and quality of life, contributing to a more equitable and effective model of health policy implementation. Findings show older adults receive policy information passively and often struggle with linguistic and cultural mismatches; CHS caregivers act as critical intermediaries but face heavy information loads and limited training; standardized one-size-fits-all communication can inadvertently exclude minority groups. We recommend multilingual and visual materials, dedicated Q&A or small-group sessions, capacity building for caregivers on policy translation and cultural sensitivity, and a dual-track approach that pairs digital literacy support with paper-based and in-person communication.