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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 高碧霞(Bih-Shya Gau) | |
| dc.contributor.author | Yu-Fen Tzeng | en |
| dc.contributor.author | 曾于芬 | zh_TW |
| dc.date.accessioned | 2021-06-08T02:38:36Z | - |
| dc.date.copyright | 2021-02-23 | |
| dc.date.issued | 2020 | |
| dc.date.submitted | 2020-11-13 | |
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A development and evaluation process for mHealth interventions: examples from New Zealand. J Health Commun, 17 Suppl 1, 11-21. doi:10.1080/10810730.2011.649103 Williams, J., Scarborough, P., Matthews, A., Cowburn, G., Foster, C., Roberts, N., Rayner, M. (2014). A systematic review of the influence of the retail food environment around schools on obesity-related outcomes. Obesity Reviews, 15(5), 359-374. doi:10.1111/obr.12142 World Health Organization (1998). Division of Health Promotion, Education and Communications Health Education and Health Promotion Unit. Health Promotion Glossary. World Health Organization, Geneva. World Health Organization (2016). Childhood overweight and obesity on the rise. Retrieved from http://www.who.int/dietphysicalactivity/childhood/en/ Yeo, S. C., Jos, A. M., Erwin, C., Lee, S. M., Lee, X. K., Lo, J. C., . . . Gooley, J. J. (2019). Associations of sleep duration on school nights with self-rated health, overweight, and depression symptoms in adolescents: problems and possible solutions. Sleep Medicine, 60, 96-108. doi: 10.1016/j.sleep.2018.10.041 Zarcadoolas, C., Pleasant, A., Greer, D. S. (2005). Understanding health literacy: An expanded model. Health Promotion International, 20. doi: 10.1093/heapro/dah609 Zenk, S. N., Schulz, A. J., Israel, B. A., James, S. A., Bao, S., Wilson, M. L. (2005). Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in Metropolitan Detroit. American Journal of Public Health, 95(4), 660-667. doi: 10.2105/ajph.2004.042150 | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/19999 | - |
| dc.description.abstract | 研究背景及目的：青少年體重過重與肥胖是全球的重要健康問題，隨著環境脈絡與生活型態改變，臺灣青少年過重與肥胖盛行率逐年上升，2010-2011年臺灣營養與健康調查資料顯示11-18歲體重過重與肥胖盛行率為12.4%與16.8%。青少年肥胖不僅會增加成年後肥胖風險，發生代謝症候群、糖尿病、心臟病等健康問題，更影響心理健康與生活滿意度。造成過重及肥胖的成因為多階層的脈絡因素，本研究由微觀至宏觀層次來探究青少年體重過重與肥胖問題，整體研究之目標在探究青少年健康素養程度對肥胖的影響效果，並進一步探討青少年所曝露的肥胖風險飲食環境在其中扮演的角色。本研究將健康素養與肥胖風險飲食環境列兩大主要影響變項，而其他個人特質、父母及家庭等因素列為共變項來進行分析與探討。 研究方法：本研究為追蹤性研究，以固定樣本進行四波的追蹤調查。每位研究對象分別在學期中與寒暑假進行四次資料收集，以捕捉隨時間變動的健康素養、肥胖風險飲食行為、肥胖風險飲食環境因素及其他共變項。分析方法以羅吉斯迴歸進行研究變項間機制關係的分析，以驗證研究所提出的假設。 研究結果：在本研究調查結果發現，男生過重與肥胖的比例是高於女生，在四次測量時間點。男生的身體質量指數為過重（BMI＞23.4）分別占17％、16％、22％、18％，肥胖（BMI＞25.6）分別占25％、26％、24％、30％；女生的身體質量指數為過重（BMI＞22.7）分別占17％、15％、18％、21％，肥胖（BMI＞25.3）分別占14％、18％、17％、19％。推論性統計分析結果發現，青少年健康素養程度對過重或肥胖是沒有直接或間接的影響，但健康素養會影響肥胖風險飲食行為的表現。肥胖風險飲食環境部分，record 3之高與低肥胖風險飲食環境對過重或肥胖是有顯著的影響，但不作為健康素養與過重或肥胖之間的調節效應。然而，低肥胖風險飲食環境於record 1在健康素養對肥胖風險飲食行為的影響關係中存有調節效應，意旨健康素養對飲食行為的影響會因不同程度的低肥胖風險飲食環境而有差異。 結論：本研究從生態環境觀點探究影響青少年體重過重與肥胖問題，微觀層次中個人健康素養能力會影響一個人的飲食行為表現，宏觀層次中低肥胖風險飲食環境作為健康素養與飲食行為間的調節角色。本研究結果可作為以學校為基礎的健康素養培養課程之參考，培育學生健康體位控制與健康飲食之素養，增強青少年正向健康的飲食行為與決策能力，減少受到肥胖風險飲食環境誘惑之機會。此外建議未來研究仍須以長期追蹤調查方法以釐清與驗證健康素養與健康行為對過重與肥胖的影響效果。 | zh_TW |
| dc.description.abstract | Background and purpose: Overweight and obesity among adolescents are important global health issues. With changes in the environment and lifestyle, the prevalence of overweight and obesity among adolescents in Taiwan has increased annually. According to a 2010–2011 nutrition and health survey in Taiwan, the prevalence of overweight and obesity among adolescent aged 11 to 18 years was 12.4% and 16.8%. Obese adolescents easily become obese adults and often have health problems, and often experience metabolic syndrome, diabetes, and heart disease in the future. Obesity can not only cause health problems but also influence life satisfaction. Overweight and obesity were caused by multi-level contextual factors. This study explored the issues of overweight and obesity in adolescents from the micro to the macro level, we considered the two main variables: health literacy and the exposure to obesity-related dietary risk environment. The purpose of this study was to explore the effect of adolescents’ health literacy on obesity, and to further explored the role of the obesity-related dietary risk environment that adolescents were exposed to. Methods: This research was a longitudinal study, and a four-wave follow-up survey was conducted with a fixed sample. Each research subject conducted data collection four times during the semester, winter and summer vacations, to capture the time-varying health literacy, obesity-related dietary risk environment factors, and other covariates. We applied the Logistic regression to analyze the mechanism between the research variables as to verify the hypothesis proposed by the research. Results: The results of this study found that the ratio of overweight and obesity among boys was higher than that of girls. At the four measurement time, boys’ body mass index was overweight (BMI>23.4), accounting for 17%, 16%, 22%, and 18% respectively. Obesity (BMI>25.6) accounted for 25%, 26%, 24%, 30%; for girls, overweight (BMI> 22.7) accounted for 17%, 15%, 18%, 21%, obesity (BMI > 25.3) accounted for 14%, 18%, 17%, and 19% respectively. In the part of inferential statistics, the study found that the level of adolescent health literacy has no direct or indirect effect on overweight or obesity, but health literacy affected the performance of dietary behavior. In the record 3 data analysis, both high and low obesity-related dietary risk environments affected on overweight or obesity, but were not as a moderator between health literacy and obesity. However, the low obesity-related dietary risk environment was as a moderater between health literacy and dietary behavior in the record 1 data analysis. Conclusions: Based on the perspective of ecological environment, this study explored the impact of overweight and obesity among adolescents. In the micro level, adolescents’ health literacy affected ones dietary behavior. The low obesity risk diet environment as the macro level was a moderator role beteween health literacy and dietary behavior. The results of this study advised as a reference for school-based health literacy program to cultivate adolescents’ healthy body weight control and healthy dietary literacy, enhance the ability for healthy dietary behaviors and decision making, and reduce the chance of being lured by the obesity risk diet environment. In addition, it is recommended that future studies need long-term follow-up investigation methods to clarify and verify the effects of health literacy and health behaviors on overweight and obesity. | en |
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| dc.description.tableofcontents | 口試委員審定書…………………………………………………………………………………………………………………………………………I 致謝………………………………………………………………………………………………………………………………………………………………II 中文摘要……………………………………………………………………………………………………………………………………………………III ABSTRACT ……………………………………………………………………………………………………………………………………………………V 第壹章 緒論…………………………………………………………………………………………………………………………………………………1 第一節 研究背景與重要性……………………………………………………………………………………………………………………1 第二節 研究目的………………………………………………………………………………………………………………………………………5 第三節 研究問題………………………………………………………………………………………………………………………………………5 第貳章 文獻探討………………………………………………………………………………………………………………………………………7 第一節 健康素養與肥胖…………………………………………………………………………………………………………………………7 一、健康素養定義與概念………………………………………………………………………………………………………………………7 二、健康素養與健康結果的關係………………………………………………………………………………………………………10 三、健康素養、飲食行為及肥胖的關係…………………………………………………………………………………………12 四、健康素養的測量………………………………………………………………………………………………………………………………14 第二節 肥胖風險飲食環境…………………………………………………………………………………………………………………18 一、肥胖風險飲食環境對健康素養效果的調解…………………………………………………………………………18 二、肥胖風險飲食環境曝露之定義…………………………………………………………………………………………………21 三、肥胖風險飲食環境曝露的測量方法………………………………………………………………………………………22 四、時間動態效應……………………………………………………………………………………………………………………………………23 第三節 其他肥胖干擾因素…………………………………………………………………………………………………………………25 第四節 文獻總結……………………………………………………………………………………………………………………………………29 第參章 研究方法……………………………………………………………………………………………………………………………………31 第一節 研究設計與概念架構……………………………………………………………………………………………………………31 第二節 研究假設……………………………………………………………………………………………………………………………………34 第三節 名詞界定……………………………………………………………………………………………………………………………………35 一、健康素養……………………………………………………………………………………………………………………………………………35 二、肥胖風險飲食環境曝露………………………………………………………………………………………………………………36 三、飲食行為……………………………………………………………………………………………………………………………………………37 四、體重過重與肥胖……………………………………………………………………………………………………………………………38 第四節 研究工具……………………………………………………………………………………………………………………………………39 一、健康素養評估量表…………………………………………………………………………………………………………………………42 二、飲食行為評估量表…………………………………………………………………………………………………………………………44 三、飲食環境曝露之GPS追蹤定位……………………………………………………………………………………………………45 四、肥胖風險飲食環境分類…………………………………………………………………………………………………………………47 第五節 研究對象及取樣方法………………………………………………………………………………………………………………50 第六節 研究情境與資料收集過程……………………………………………………………………………………………………51 第七節 資料分析方法……………………………………………………………………………………………………………………………52 第八節 研究倫理………………………………………………………………………………………………………………………………………61 第肆章 研究結果………………………………………………………………………………………………………………………………………63 第一節 描述性統計………………………………………………………………………………………………………………………………63 第二節 人口學特性與健康素養及BMI之關聯性分析…………………………………………………………………80 第三節 推論性統計…………………………………………………………………………………………………………………………………101 第伍章 討論………………………………………………………………………………………………………………………………………………119 第一節 健康素養與飲食行為對肥胖的影響………………………………………………………………………………120 第二節 肥胖風險飲食環境的影響…………………………………………………………………………………………………125 第三節 其他控制變項對BMI的影響………………………………………………………………………………………………132 第陸章 結論與建議……………………………………………………………………………………………………………………………141 第一節 結論……………………………………………………………………………………………………………………………………………141 第二節 研究範圍與限制……………………………………………………………………………………………………………………144 第三節 研究應用與貢獻……………………………………………………………………………………………………………………146 參考文獻……………………………………………………………………………………………………………………………………………………149 一、中文文獻…………………………………………………………………………………………………………………………………………149 二、英文文獻…………………………………………………………………………………………………………………………………………150 附錄……………………………………………………………………………………………………………………………………………………………167 附錄一、人口學資料調查問卷………………………………………………………………………………………………………167 附錄二、健康素養評估量表……………………………………………………………………………………………………………172 附錄三、飲食行為評估量表……………………………………………………………………………………………………………176 附錄四、手機應用程式………………………………………………………………………………………………………………………178 附錄五、研究倫理證明………………………………………………………………………………………………………………………183 附錄六、研究受訪者說明及同意書………………………………………………………………………………………………184 附錄七、飲食環境分類摘錄………………………………………………………………………………………………………………190 附錄八、NVS量表之授權證明……………………………………………………………………………………………………………193 | |
| dc.language.iso | zh-TW | |
| dc.title | 青少年健康素養與肥胖風險飲食環境曝露對其肥胖的影響 | zh_TW |
| dc.title | The Effects of Health Literacy and Exposure to Obesity-related Dietary Risk Environment on Obesity among Adolescents | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 109-1 | |
| dc.description.degree | 博士 | |
| dc.contributor.oralexamcommittee | 謝雨生(Yeu-Sheng Hsieh),黃俊豪(Jiun-Hau Huang),賴飛羆(Fei-pei Lai),楊曉玲(Hsiao-Ling Yang) | |
| dc.subject.keyword | 青少年,過重及肥胖,健康素養,飲食環境,飲食行為, | zh_TW |
| dc.subject.keyword | Adolescents,overweight and obesity,health literacy,dietary environment,dietary behavior, | en |
| dc.relation.page | 193 | |
| dc.identifier.doi | 10.6342/NTU202004327 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2020-11-13 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 護理學研究所 | zh_TW |
| 顯示於系所單位： | 護理學系所 | |
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| U0001-0511202021553500.pdf 未授權公開取用 | 4.37 MB | Adobe PDF |
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