金門縣政府配售酒政策於金門居民之飲酒意圖與飲酒行為之關聯

Abstract

研究背景：酒精飲料政策與可近性被廣泛認為是影響飲酒行為的關鍵因素，若酒精的可近性與可獲得性增加，則有可能增加飲酒行為，進而增加與酒精相關的健康問題 (Myran et al., 2019)。金門縣擁有獨特的配售酒福利政策，在籍居民長期皆有較高酒精可近性，但此政策對當地居民在飲酒行為與意圖所產生影響尚未被探討過。本研究運用計劃行為理論 (TPB)，透過其構念分析金門居民飲酒意圖，探討配售酒政策施行與飲酒行為之間的關聯，期望能提供更多當地健康調查的資料內容，並為相關公共衛生政策制定提供實證。 研究目的：本研究旨在了解金門縣政府配售酒政策對金門居民飲酒意圖與飲酒行為的影響，並探討該政策對計劃行為理論 (TPB) 相關構念——包括行為態度、主觀規範和自覺控制的關聯。 研究方法：本研究運用計劃行為理論 (TPB) 的框架設計量性問卷，並以居民自填的方式收集調查資料。資料將藉由因素分析與Cronbach’s α係數來測量其信效度，以描述性統計呈現研究對象的背景變項，最後透過平均數差異檢定、迴歸分析及路徑分析來探討TPB構念（行為態度、主觀規範、自覺控制）、飲酒意圖與飲酒行為之間的相關因素。 研究結果：本研究共納入412位樣本進行分析。研究樣本中，領酒資格分組（僅符合一種資格、符合多種資格及不具資格者）分別有66.02%、32.28%及1.70%；符合資格時長分組（0~5年、6~10年、11~15年、16~20年）分別為23.06%、15.78%、17.96%與43.20%。TPB三項構念（態度、主觀規範、自覺控制）均與飲酒意圖呈現顯著關聯 (p=.000)，對飲酒態度越開放 (β=0.461)、主觀規範越強 (β=0.255)，飲酒意圖越高；自覺控制越強 (β=-0.454)，意圖越低。分析結果顯示飲酒意圖對各項飲酒行為具顯著影響，包含過去一個月飲酒行為 (aOR=1.68 ; 95%CI: 1.36-2.07)、過去一年至少每月喝酒 (aOR=1.79 ; 95%CI: 1.43-2.24) 及過去一個月內暴飲行為 (aOR=1.54 ; 95%CI: 1.23-1.92)。結構方程模型分析顯示，領酒資格與資格時長對TPB構念大多無顯著影響，僅在過去一個月飲酒量（標準酒精單位）模型中發現，符合多種領酒資格者對行為態度具顯著關聯，僅符合一種領酒資格者及符合多種領酒資格者與主觀規範具統計顯著。 結論：計劃行為理論 (TPB) 可有效解釋金門居民飲酒意圖與行為模式，建議可以從居民對飲酒之態度、主觀規範與自覺控制方面著手，制定相關健康行為衛生教育策略。

Background: Alcoholic beverage policies and accessibility are widely regarded as key factors influencing drinking behavior. Increased accessibility and availability of alcohol may lead to higher alcohol consumption, which in turn can elevate alcohol-related health issues (Myran et al., 2019). Kinmen County implements a unique alcohol provision welfare policy, granting registered residents long-term and greater access to alcohol compared to the rest of the country. However, the association between this policy on residents’ drinking behavior and intentions has not yet been explored. This study applies the Theory of Planned Behavior (TPB) to analyze the drinking intentions of Kinmen residents through its constructs and to examine the association between policy factors and drinking behavior. The aim is to contribute to the local health survey data and provide empirical evidence for developing relevant public health policies. Purpose: This study aims to understand the association between Kinmen County Government's alcohol distribution policy on registered residents' drinking intentions and behaviors, and to explore the association between this policy and TPB-related constructs, including attitude toward the behavior, subjective norms, and perceived behavioral control. Methods: This study designed a quantitative questionnaire based on the TPB framework and collected survey data through self-completed questionnaires from residents. The data was tested for reliability and validity using factor analysis and Cronbach's alpha coefficients. Background variables of research subjects were presented through descriptive statistics. Finally, mean difference tests, regression, and path analysis were used to explore the correlating factors between TPB constructs (attitude, subjective norms, perceived control), drinking intentions, and drinking behaviors. Results: A total of 412 samples were included in the analysis. Among the research samples, the three alcohol qualification groups (eligible for only one qualification, multiple qualifications, and not qualified) accounted for 66.02%, 32.28%, and 1.70%, respectively. The qualification duration groups (0-5 years, 6-10 years, 11-15 years, 16-20 years) accounted for 23.06%, 15.78%, 17.96%, and 43.20%, respectively. All three TPB constructs (attitude, subjective norms, perceived control) showed significant associations with drinking intentions (p=.000). More open attitudes toward drinking (β=0.461) and higher subjective norms (β=0.255) were associated with higher intentions; stronger perceived control (β=-0.454) was associated with lower intentions. Drinking intentions significantly influenced various drinking behaviors, including drinking in the past month (aOR=1.68; 95%CI: 1.36-2.07), drinking at least monthly in the past year (aOR=1.79; 95%CI: 1.43-2.24), and binge drinking (aOR=1.54; 95%CI: 1.23-1.92). The structural equation modeling analysis revealed that the eligibility for and duration of alcohol distribution permits generally had no significant impact on TPB constructs. However, within the model of alcohol consumption in the past month (per standard drink), individuals eligible for multiple types of permits showed a significant association with behavioral attitudes. Moreover, those eligible for only one type of permit and those eligible for multiple types showed statistically significant associations with subjective norms. Conclusion: The Theory of Planned Behavior (TPB) constructs effectively explain Kinmen residents' drinking intentions and behaviors. Focusing on residents' attitudes towards drinking, subjective norms, and perceived behavioral control is recommended when formulating related health education strategies.