國家圖書館典藏電子全文

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逻桂
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3 Abstract Healthy children are the greatest treasure of a society. An individual s behavior and attitude towards health mostly has been established since one s childhood. The fifth and sixth grade students fall right into this crucial time period. Taking balanced diet is a must for children to grow up healthily, and drinking sugar-sweetened beverages would cause deficiencies. The family lifestyle now is quite abundant in Taiwan, and students are easily having access to sugar-sweetened beverages. Therefore, it is worthwhile to understand the elementary school students sugar-sweetened beverages intake behavior and what the key factors are. The purposes of this research are to realize the fifth and sixth grade students sugar-sweetened beverages drinking behavior and its key factors. The questionnaire method was adopted for this research and the intended subjects are the fifth and sixth grade students in Taichung City. The research tool is a copy of self fill-in questionnaire by multiple-stage sampling to get 497 students to participate. So far there are 458 valid questionnaires returned. The result shows that beverages students often take are sports drinks, juices, lactic drinks and milk tea. The students knowledge regarding sugar-sweetened beverages is quite well and positive, and they also can understand that parents and teachers do not wish them to take sugar-sweetened beverages. The students with better knowledge of sugar-sweetened beverages have more positive attitude. The ones with better attitude have higher self-efficacy of refusing sugar-sweetened beverages as well as having lesser chance to take sugar-sweetened beverages. The variables of sugar-sweetened beverages intake behavior according to the II

4 influence from great to small are: self-efficacy of refusing sugar-sweetened beverages, having no sugar-sweetened beverages at home, and gender. The researcher recommended: (1) Educational institutions can improve students' attitudes towards sugar-sweetened beverages through education, hence reducing the consumption; (2) Teachers should enhance students refusing skill in all kinds of environment such as gatherings, dining out etc, in order to raise the students self-efficacy of refusing sugar-sweetened beverages; (3) Parents can prepare healthy drinks at home. Water should be placed at an easily accessible location for children, hence reducing the consumption of sugar-sweetened beverages. Keywords: elementary school students, sugar-sweetened beverage, health behavior III

5 IV

6 ...I... II... V... VII... VII V

7 VI

8 PRECEDE-PROCEED model VII

9 15-20% 1999 Dennison, Rockwell & Baker, 1997; Ludwig, Peterson & Gortmaker, 2001 Ohio AAP, SNAC, 2002 CDC, 2003 Splett & Story, 1991 Ward, Cunnane, Robinson, Heorr, Strandmark & Mavis, 1993 Bouchard, 1

10 Despres and Tremblay % 30% 5-25% % % % % % c.c c.c c.c. 71.1% % 14 13%

11 1995 (2000c.c.) % % 30% 2001 Kloeblen & Batish, 1999 ; Abood, Black, & Feral, 2003 Backman, Haddad, & Lee,

12 Mullen, Hersey and Iverson 1987 (Health belief model) (Fishbein/Ajzen s theory of reasoned action) PRECEDE Model PRECEDE (Health belief model) PRECEDE (Predisposing factors) (Enabling factors) (Reinforcing factors) 4

13 Green and Kreuter 1999 PRECEDE

15 7

16 93 4 8

18 ppm 500ppm DHA 8. 50% 10

21 % 1716c.c % 53.7% % % 13

22 % % % % 14 13% / % 2000a 30.5% 16.7% 14.2% %

23 a 2000b % % 37.1% % % 63.6% 15

24 16 100% % C C %

25 17 C C C LDL HDL

26 ph ph 2.4 ; ph ph mg/l 3 15 ph g/100ml g/100ml 11.5 g/100ml 7.5 g/100ml 4.2 g/100ml 8.5 g/100ml 5.7 g/100ml g/100ml 18

27 2 2 c.c. c.c. 100% % % % % %

28 Mullen et al PRECEDE Model PRECEDE PRECEDE PRECEDE PRECEDE Model PRECEDE 1970s PRECEDE Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation Green, Kreuter, Deeds, & Patridge, 1980 PRECEDE Model 1 Green & Kreuter, 1999 (1) Predisposing factors 20

29 ( ) (2) Enabling factors (3) Reinforcing factors PRECEDE PROCEED 1 PRECEDE-PROCEED model Green & Kreuter,

30 PRECEDE Model Predisposing factors 1. (1) Perry et al Foley, Vaden, Newell, and Dayton Cusatis and Shannon

31 2001 (2) (3) Eppright, Fox, Fryer, Lamki and Vivian Olvera-Ezzell, Power & Cousins 1990 Garn, Cole and Bailey

32 Ward

33 Axelson, Federline and Bringberg 1985 Meta analysis Axelson, Federline and Bringberg 1985 Meta analysis 2001Doyle, Feldman and Keller

34 26 6. Bandura 1977 Bandura (coping behavior) Bandura,

35 27 Slater % Parcel, Edmundson and Perry % Enabling factors 1. (NASBE) SNAC,

36 a 30% Story Neumark-Sztainer & French, % 37.1%

37 % 91% Taras & Gage, Gorn and Goldberg Reinforcing factors 29

38 Bandura Burkey, Beilin & Dunbar, 2001 Lau, Quardrel & Hartman, 1990 Mavor, Borah-Giddens and Falciglia Neumark-Sztainer, Story, Perry and Casey

39 %

40 32

41 Green and Kreuter 1999 PRECEDE 2 33

42 Predisposing factors Enabling factors Reinforcing factors 2 34

43 , ,764 31,

44 %

46 (Likert)

47 (Likert)

48 1 3 (Likert) (Likert)

49 Content Validity 1 0 item difficulty item discrimination 2001 P (PH PL) 2 D PH PL PH PL 41

50 25% 25% discriminatory power DP critical ration CR t t 2000 DP X H X L ( X CR 2 ( S N H H H X L ) + ( S ) 2 L N L ) X H X L 2 S H 2 S L N H 25 N L 25 Cronbach α 8 8 Cronbach α

51 r=.71 α

52 3 3 44

53 Statistical Package for Social Science ( SPSS for Window)

54 SPSS10.0 t t-test t One-way ANOVA F p<.05 Scheffe method Pearson Correlation Coefficients 46

55 Multiple regression 47

56 % % % % % % % % 11.4% % % % % % % % % % % % % % % 55.1% 27.8% 17.2% BMI % 80 48

57 % 10% 10% BMI R=.596 p<.001 (65.3%) 26.8% 7.9% 9 (%)

58 9 (%) % % % % % % 40.7% 39.4% %

59 % (%)

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61 SD= % 98.0% 98.0% 91.9% 85% 35.2% % 12 53

62 11 (%) (%) (%)

63 12 (%) (%) =6 =15 =11.45 = SD= SD= % 4.28 SD= % 55

64 3.15 SD= SD= ( ) % *

65 13 ( ) % 9. * * =16 =50 =38.45 =6.05 =1 =2 =3 =4 =5 * SD=7.20 M=3.54 SD=1.15 M=3.53 SD=1.20 M=2.39 SD=2.39 M=2.77 SD=

66 14 ( ) % =14 =50 =31.79 =7.20 =1 =2 =3 =4 =5 58

67 1 2 3 Friedman test 15 p< χ 2= df=2 N=457 P< χ 2= df=2 N=455 P< χ 2= df=2 N=457 P< χ 2= df=2 N=457 P< χ 2= df=2 N=458 P< χ 2= df=2 N=458 P< χ 2= df=2 N=458 P<

68 χ 2= df=2 N=458 P< χ 2= df=2 N=458 P< χ 2= df=2 N=457 P< SD= ( ) %

69 16 ( ) % =13 =54 =30.69 =7.88 =1 =2 =3 =4 =5 61

70 2.2% ( ) %

71 ( ) % % SD= M=2.93 SD=

72 18 ( ) % =4 =20 =13.68 =3.82 =1 =2 =3 =4 =5 64

73 t (Independent samples t-test) (One-way ANOVA) 19 F=3.424 p<.01 F=3.048 p< N t F Scheffe 65

74 19 N t F 63 / Scheffe 3.424** 5 > / * 6 15 * p<.05 ** p< t=3.876 p.05 66

75 Foley et al. (1983) t=7.620 p F=9.492 p N t F / / Scheffe 3.876* > 7.620** >

76 20 N t F Scheffe 9.492*** > > > * p<.05 ** p<.01 *** p< t=4.599 p<.05 F=2.987 p< F=4.513 p<

77 21 N t F Scheffe * > / * > 5 / ** > * p<.05 ** p<

78 22 t=4.609 p< t= p.001 Cullen and Zakeri F=4.809 p

79 22 N t F / / Scheffe 4.609* > *** > ** > * p<.05 ** p<.01 *** p<

80 23 F=3.611 p N t F / / Scheffe 3.611** > >

81 23 N t F Scheffe ** p<.01 73

82 24 r=.124 p< Glanz 1985 r r

83 ** *** *** -.311*** ***.255*** -.183*** ** p<.01 *** p<

84 PRECEDE (Predisposing factors) (Enabling factors) (Reinforcing factors) 25 F (20,382) =4.425 p<.05 R.434 R % β=-.268 p<.001 Slater 1989 Parcel et al

85 β=.161 p<.05 Cullen and Zaker 2004 β=.108 p<.05 β=-.268 p<.001 β=.161 p<.05 β=.108 p<.05 p<.05 77

86 25 B β t *** (Predisposing factors) * E E E E E *** (Enabling factors) ** 1.288E (Reinforcing factors) R=.434 R =.188 R =.146 (F (20,382) =4.425 p=.000) * p<.05 ** p<.01 *** p<

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90 82

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92 SPSS (4) (2) (NAHSIT) (1) (1)

93 85 38(5) (4) (3) (2)

94 GO GO GO (1) Papalia, D. E., Olds, S. W., and Feldman, R. D (88) /service/sts4-92.htm?FILEID=104128&open

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<4D6963726F736F667420576F7264202D20AEE7B6E9BFA4B0EAA4A4BEC7A5CDB6BCA5CEA774BF7DB6BCAEC6AEF8B64FA6E6ACB0A4A7ACE3A873>

<4D6963726F736F667420576F7264202D20AEE7B6E9BFA4B0EAA4A4BEC7A5CDB6BCA5CEA774BF7DB6BCAEC6AEF8B64FA6E6ACB0A4A7ACE3A873> 中國文化大學生活應用科學研究所碩士論文桃園縣國中學生飲用含糖飲料消費行為之研究指導教授 : 林慧生博士研究生 : 李恩鈺中華民國 97 年 12 月中國文化大學生活應用科學研究所 Gradute Institute of Applied Science of Living