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Title: | 探討「我的均衡餐盤」餐廳介入計畫對職場員工健康意識、健康飲食知識與態度及健康飲食行為階段的影響 The effects of “My Balanced Plate” worksite intervention in public setting on employees' health consciousness, nutrition knowledge and attitude, and stage of healthy eating behavior |
Authors: | Yu-Ting Chiang 江昱霆 |
Advisor: | 潘文涵(Wen-Harn Pan) |
Keyword: | 健康體位,職場健康促進計畫,健康餐盤,熱量需求,六大類食物分配,健康識能,健康飲食行為階段, healthy body,worksite health promotion program,health plate,energy requirement,distribution of six food groups,health literacy,stages of healthy eating behavior, |
Publication Year : | 2018 |
Degree: | 碩士 |
Abstract: | 摘要
背景與目的 職場是最重要的健康體位介入場域之一。WAKE.Taiwan職場健康體位促進計劃,立基於社會生態模型,藉由改變環境與文化氛圍,提升個人的健康識能,促進健康體位。本研究聚焦在「認識自己熱量需求與六大類食物份數」之健康飲食主題,參考布魯姆分類學(Bloom’s Taxonomy)概念,設計「我的均衡餐盤」餐廳介入計畫(包含餐盤展示及兩個衛教活動);以社會行銷策略,在公共場合以遊戲活動方式吸引職場員工參與活動,並在活動中藉由實際操作深化知識、減少障礙,進而提高生活實踐的意願。探討施行「我的均衡餐盤」餐廳介入計畫前後職場員工健康意識、健康飲食知識與態度,及健康飲食行為階段的狀況以及改變。 方法 本研究選定某研究機構,以在機構內中餐廳用膳之職場員工為介入對象。以複合式介入來設計,結合了自助式教材、團體活動、改變職場環境等方式。首先於2016/4/20開始在中餐廳入口,以社團法人中華民國糖尿病衛教學會設計之定量餐具(簡稱糖尿病衛教餐盤)搭配塑膠食物模型與衛教海報,進行「我的均衡餐盤」展示(簡稱餐盤展示),呈現「每日飲食指南」中不同熱量需求等級之六大類食物分配原則,並在2016年11月底到12月初進行兩次衛教活動:「六大類食物連連看」與「我的餐盤DIY」,帶入「每日飲食指南」及「國民飲食指標」的概念。為評估介入之影響,本研究於介入開始的初期與介入結束後進行兩次問卷調查,以評估職場員工在介入前後健康意識、健康飲食知識與態度,及健康飲食行為階段的狀況以及改變。兩次問卷調查均採填問卷送水果之自願參與方式取樣,時間為2016/5/11-13、2017/1/10-12之中午用餐時段11:30~13:00,其中兩次都有參與並願意留下身份證字號末5碼者,成為探討介入之影響之研究對象。 結果 兩次問卷調查分別收集到260與307份有效問卷,皆納入分析。兩次問卷調查中有接觸過餐盤展示的比例都有近八成,其中第二次問卷調查比起第一次問卷調查,仔細看過餐盤展示的比例有提高(14%22%),且有參與過「六大類食物連連看」者佔四成,參與過「我的餐盤DIY」者佔三成。填答者「熱量需求」的知識是來自於「我的均衡餐盤」餐廳介入計畫者佔三成,「六大類食物分類」的知識則佔七成。 在第一次問卷調查中詢問對於餐盤展示的意見,對於展示的清楚程度有七成填答者表示認同,另外僅有四成的填答者對於「以糖尿病衛教餐盤取代目前餐廳所使用的一般餐盤」表示認同。 在第一次問卷調查中,健康意識總分(滿分15分)為10.80±1.80,健康飲食知識(總分4分)為2.5±0.9,健康飲食行為階段位於準備期(含)以上佔29%;在第二次問卷調查中,健康意識總分為10.76±1.76,健康飲食知識總分為2.7±0.7,健康飲食態度總分為34.9±3.7(滿分50分),健康飲食行為階段位於準備期(含)以上佔16%。 兩次橫斷面研究中,健康意識高的填答者,健康飲食知識、健康飲食行為階段也會顯著較高;健康飲食態度較高的填答者,健康飲食行為階段也會顯著較高;但健康飲食知識較高的填答者之健康意識、健康飲食行為階段和不高者並無分別。 縱貫面研究中,針對兩次問卷調查都有參與之填答者(n=91),用羅吉斯回歸校正過共變項與基線健康意識後,參與過一個(含)以上介入(包含餐盤展示與兩個衛教活動)的組別相較於一個都沒有參與過的組別,健康意識會成長或維持在較高的水準的勝算比為5.8(95% C.I.=[1.5,21.7],p=0.010);健康飲食知識沒有顯著改變;校正過共變項與基線健康飲食行為階段後,參與過一個(含)以上的組別相較於一個都沒有參與過的組別,健康飲食行為階段會成長或維持在較高的水準的勝算比為5.2(95% C.I.=[1.1,25.2],p=0.042)。 同樣針對兩次問卷調查都有參與之填答者(n=91),用廣義線性模型校正共變項並分別校正基線健康意識/健康飲食知識分數後,參與餐盤展示與衛教活動的數量與健康意識/健康飲食知識的成長都沒有顯著的正相關性(p=0.170、0.583);不過,校正過共變項與基線健康飲食行為階段後,參與餐盤展示與衛教活動的次數與健康飲食行為階段的成長都有顯著的正相關性(p=0.003),且隨著參與餐盤展示與衛教活動的數目增多,健康意識、健康飲食行為階段會顯著成長(p for trend=0.018)。 結論 「我的均衡餐盤」餐廳介入計畫能吸引多數到中餐廳用餐的職場員工注意,且多數職場員工予以正面評價。「我的均衡餐盤」餐廳介入計畫後,雖然參與員工健康飲食知識無顯著增加,但健康意識與健康飲食行為階段均顯著提升,。因此,「我的均衡餐盤」餐廳介入計畫在職場的推廣是可行且有效益的。未來需進一步研究,評估其長期效應。 英文摘要 Background and Object Worksite is one of the most important public settings for intervening on promoting healthy body.Grounded on the Socio-ecological Model, WAKE.Taiwan Program (Worksite Active living: Keep-up and Empower Program in Taiwan) intends to improve individuals’ health literacy and to promote healthy body movement through changing environment and culture at worksites. This particular research focused on one of the healthy diet-related themes: “knowing one's energy requirement and distribution of the Six Food Groups”. Adopting the concept of Bloom’s Taxonomy, we designed “My Balanced Plate” intervention contents which included the plate display and two educational activities. Using Social Marketing strategies, we held DIY activities in public settings to draw attention from employees and to help them retain the intended nutrition knowledge, reduce obstacles and enhance willingness to take actions in everyday life. This study was evaluated by examining the status and changes of employees' health consciousness, nutrition knowledge and attitude, and stages of healthy eating behavior before and after the intervention program. Materials and Methods The studied subjects were employees who dined in the worksite Chinese restaurant of a selected research institute.We designed a complex intervention, incorporating self-help educational materials, group activities, and changes in physical environment. First, from April 20th, 2016 on; we displayed“My Balanced Plate”materials at the entrance of the Chinese restaurant. Presenting how the six food groups should distribute at different energy levels according to the Taiwanese “Daily Food Guide”. The exhibition included health education posters along with the Quantitative tablewares of the Taiwanese Association of Diabetes Educators (abbreviated as Diabetes Educational Plate) filled with plastic food models. And from late November to early December 2016, we conducted two educational activities: “Matching Game of the Six Food Groups” and “My Healthy Plate DIY”, bringing to participants the concept of Taiwanese “Daily Food Guide” and “Dietary Guidelines”. Two self-administered questionnaire surveys were conducted, one at the beginning and the other after the intervention, to examine the status and changes of employees' health consciousness, nutrition knowledge and attitude, and stages of healthy eating behavior. A piece of fruit was used to reward the volunteers. Those who had completed the two questionnaires and were willing to leave the last 5 digital numbers of their IDs, became the study subjects of the longitudinal study. Results A total of 260 and 307 valid questionnaires were collected at the first survey and at the second survey, respectively. Nearly 80% of the participants have been exposed to the plate display according to either one of the two questionnaires. The percentage of those who carefully read the contents of plate display was higher in the second questionnaire than that in the first questionnaire (14%22%). There were 40% of the participants who had played the “Matching Game of the Six Food Groups”, and 30% who had joined the“My Healthy Plate DIY”. For 30% of the participants, their knowledge of the “energy requirement” came from the “My Balanced Plate” intervention, so did their knowledge of the “Six Food Groups” for 70% of participants. Although there were about 70% of the participants satisfied with the clarity of the plate display, only 40% of them agreed to replace the current plate with the Diabetes Educational Plate. In the first survey, the mean score of health consciousness (out of 15) was 10.80 (± 1.80) and the mean score of nutrition knowledge (out of 4) was 2.5 (± 0.9). In terms of healthy eating behavior, 29% of the participants were above the preparation stage. In the second survey, the mean score of health consciousness (out of 15) was 10.76 (±1.76) and the mean score of nutrition knowledge (out of 4) was 2.7 (±0.7). The mean score of nutrition attitude (out of 50) was 34.9 (±3.7).And 16% of the participantswere above the preparation stage. In the two cross-sectional studies, mean scores of nutrition knowledge and stage of healthy eating behavior were significantly higher in those with higher degree of health consciousness. Those with higher level of nutrition attitude also had significantly higher stages of healthy eating behavior. But levels of health consciousness and healthy eating behavioral stage were not significantly higher in those with higher levels of nutrition knowledge, compared to their counterpart. In the longitudinal study, we firstly used logistic regression to analyze data from employees who had participated in both surveys (n = 91). After adjusting for covariates and baseline health consciousness score, the odds ratio for health consciousness to grow or remain at high end was 5.8 (95% C.I. = [1.5, 21.7], p = 0.010) comparing those who had participated in more than one intervention activities (including the plate display and two educational activities) to those who had not in any one. Nutrition knowledge did not change significantly for these 91 participants from survey 1 to survey 2. After adjusting covariates and baseline healthy eating behavior stage, the odds ratio for healthy eating behaviorstage to grow or remain at high end was 5.2 (95% CI = [1.1, 25.2], p = 0.042) comparing those who had participated in more than one activities to those who had not in any one. Secondly, we applied general linear model to examine the association between the number of activities participated and the score or the stage changes. After adjusting covariates and the corresponding baseline health consciousness or nutrition knowledge scores, there were no significantly positive associations between the number of activities participated and the score changes on health consciousness (p = 0.170) or nutrition knowledge (p =0.583). However, after adjusting covariates and the baseline stage of the healthy eating behavior, there were significantly positive associations between the number of activities participated and the increment on healthy eating behavior stage (p = 0.003). Additionally, as the number of participated activities increased, the health consciousness and stages of healthy eating behavior increased significantly(p for trend=0.018). Conclusion “My Balanced Plate” intervention could attract the attention of majority of the employees who dined in the worksite Chinese restaurant and most of employees gave it a positive comment. “My Balanced Plate” intervention had improved participants’ health consciousness and stages of healthy eating behaviors, although not their nutrition knowledge.Therefore, it is feasible and effective to implement “My Balance Plate” intervention in worksite. Future research is needed to assess its long-term effects. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/69877 |
DOI: | 10.6342/NTU201800498 |
Fulltext Rights: | 有償授權 |
Appears in Collections: | 生化科技學系 |
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