2015 年 PSBH 中国区卓越项目奖申请书 Award for Outstanding PSBH Project 2015 Application Form 项目详细内容 Project Details: 项目名称 Project Title 项目负责人 Project Lead 经费 Funding 對 30 名澳門初中生進行吃有質量早餐的促進計劃 A Health Promotion Program on Having Quality Breakfast for 30 Middle School Students. 歐妙玲 Au Mio Leng MOP 463.4 年月日至年月日 项目成员 Project Team 主题 Theme 早餐推廣 Quality Breakfast Promotion Program 鄭可琦 Ho Kei Cheng 梁嘉敏 Ka Man Leong 何浩斐 Hou Fei Ho 项目起止日期 Project Period 起始 :2010 年 11 月 22 日 Start Year Month Day 完成 :2011 年 1 月 16 日 End Year Month Day 青春期是人生第二個生長高潮, 需要足夠的熱量及營養素供給發育 與活動所需 ( 李清亞 張琳, 2005) 回想中學早會時, 偶爾有同學因沒有吃早餐而不支倒地, 班中的同學不吃早餐情況普遍, 原因是沒有時間 減肥等 研究指出約一半澳門中學生沒有每天吃早餐的習慣, 比例較小學生高, 且 24.3% 中學生表示七天中最少有三天沒有進食早餐 ( 李大拔 何敏 薑美雲 王國強, 2009) 而時間不足 沒有食慾 認為沒有必要 问题描述 Problem Description 请描述问题起因及存在多久 问题形塑过程中的关键人员及人数 请以中英文填写 吃早餐是澳門初中生不吃早餐的主因 ( 劉國寧 吳赤蓬 林漢生 範存欣 王惠蘇, 2006) 不吃早餐會引起全天能量和營養素攝入不足, 並影響其生長發育 ( 徐斌 李永進 馬洪波 宋春梅, 2002; 張淵等, 2003; Chitra & Reddy, 2007); 一般而言, 從晚餐結束到第二天起床已間隔十個小時以上, 若再不吃早餐, 供給大腦及肌肉的葡萄糖不足, 令新陳代謝 減慢, 容易感到疲勞 注意力不集中 情緒低落, 影響學習及工作效率 (Gajre, Fernandez, Balakrishna & Vazir, 2008; Lien, 2007); 且容易在早上出現胃痛 乏力和暈眩等症狀和造成肥胖 ( 趙洪霞 王思雯, 2010; 劉國寧等, 2006; Croezen, Visscher, Ter Bogt, Veling & Haveman-Nies, 2009; Timlin, Pereira, Story & Neumark-Sztainer, 2008); 由此可見, 不進食有質量早餐對兒童青少年有很大影響 1
綜合分析文獻, 有質量早餐主要體現於早餐的熱量 營養 進食時間及頻率 熱量方面,13~16 歲的女性青少年每天約需 1900 仟卡至 2400 仟卡熱量 ( 台灣行政院衛生署, 2010), 而早餐提供的能量應佔全天總能量的 25%~30% ( 中國營養學會, 2010), 即 475~720 仟卡 ; 營養方面, 應按照食物金字塔的標準, 碳水化合物 纖維素 蛋白質的份量比例應為三比二比一 ( 香港衞生署, 2010a; 香港衞生署, 2010c); 進食時間及頻率方面, 應安排在每天早上上課前 (6:30-8:30) 進行為宜 ( 中國營養學會, 2010) Adolescence is the second peak of life development, more calories and nutrients are needed in order to supply for the development and activities ( 李清亞 張琳, 2005). In my memory, it was quite common that students didn t eat breakfast because of timeless and on diet, sporadically, some students collapsed caused by hypoglycaemia. According to a recent survey, nearly half of the high school students in Macau have no habit of eating breakfast which holds a higher proportion than primary school students ( 李大拔 何敏 薑美雲 王國強, 2009). The consequences of not eating a healthy breakfast don't just affect you during the morning hours; it is proven that they have an impact on work performance and ability to focus all day long (Gajre, Fernandez, Balakrishna & Vazir, 2008; Lien, 2007).Furthermore, studies generally demonstrate that eating breakfast has a positive effect on children's physical development ( 徐斌 李永進 馬洪波 宋春梅, 2002; 張淵等, 2003; Chi t r a & Reddy, 2007). Therefore, the promotion of enhance the motivation and consciousness of eating breakfast is extremely important. 中學是飲食習慣形成的重要階段 ( 熊光練, 2005), 而培養中學生吃早餐的習慣是護理人員作為健康教育者的責任 健康教育的理論眾多, 其 解决方法 Solution 请描述可行的解决方法和形塑过程 请以中英文填写 中計劃行為理論 (Ajzen, 1991; Armitage & Conner, 2001; Corcoran, 2007/2008) 指出個人的行為是基於 行為意圖 的控制, 而 行為意圖 是由 主觀規範 行為態度 知覺行為控制 三個因素共同決定, 主觀規範 是由個人在採取某一特定行為時所感受到的社會 壓力的認知, 行為態度 是個人實行某特定行為的正向或負向評價, 2
知覺行為控制 是個人預期在採取某一特定行為時自己所感受到可以控制的程度 是次健康教育計劃是圍繞此三個因素所設計 ( 詳見圖 1), 期望通過 8 週的健康教育系列活動, 使澳門某校初中生對吃早餐建立正確的態度, 培養參與學生吃有質量早餐的習慣 圖 1. 計劃行為理論 According to 熊光練 (2005), High school is the important stage in the formation of diet, nurse as health educator has to grasp this supreme period. The decided of this promotion is based on the theory of planned behavior which is about the link between beliefs and behavior (Ajzen, 1991; Armitage & Conner, 2001; Corcoran, 2007/2008). Regarding to Ajzen (1991), attitude toward behavior, subjective norms, and perceived behavioral control, together shape an individual's behavioral intentions and behaviors (Fig. 2). Furthermore, Behaviors Intention is the possibility of individual decided to 3
engage in performing the behavior, thus, two of the main factors affect the behaviors intention are Attitude and Subjective Norm. Attitude is the sense that the person s positive or negative evaluation about performing the behavior while Subjective Norm is the perception of social pressure to the preferment. Moreover, Attitude is estimated by Beliefs and Evaluations as Subjective Norm is evaluated by Normative Beliefs and Motivation to copy. The aims of this activity are to develop students habit of having quality breakfast and taking it before the first class at least 6 times per week during this 8-week health promotion program. Fig.2 Theory of planned behavior (Ajzen, 1991) 在知識方面, 兩次教育後評估表的全對率為 100%, 顯示學生能掌握健康教育講座的內容 三次廣播劇後的隨機抽問對象, 全對率為 100%, 顯示學生能吸收廣播劇的重點內容 在行為方面, 透過每週的持續評價, 分析需重點加強幹預的部分, 成效 / 影响力 Outcome/Impact 请提供方案实施前的基线数据和实施后的成果指标 请以中英文填写 作出具針對性的幹預, 經過 8 週的幹預後, 一週吃 6 至 7 天早餐的學生由幹預前佔 66. 6% 上升至幹預後之 90%, 其中在上課前進食的早餐由 65. 3% 上升至 90. 7%, 營養符合比例的早餐由 0% 上升至 82. 5%, 熱量適宜的早餐由 50% 上升至 81. 4% The total percentage of achieving the aim is 80% of above expectedly. The percentage of 30 students who had breakfast 6 to 7 days per week increased from 66.6% to 90%, and the percentage of breakfast taken before the first class rose from 65.3% to 90.7%. Total percentage of students who took quality breakfast rose from 0% to 82.5% (reached nutritional standard) and from 50% 4
to 81.4% (attained the standard of calorie). 規劃運行 8 週, 預算為 500 澳門元 實際為 8 週, 花費 463.4 澳門元 資金 主要運用在健康教育之教材製作及比賽獎品 ( 詳見表 1) 执行力 Excel l ence i n Execut i on 请提供评价标准 ( 如时间 预算 人力 干预族群的满意度 ), 及计划初始估计与成果的比较 例 : 规划运行 4 个月,800 人民币 实际为 4 个月, 花费 680 人民币 请以中英文填写 項目 數量 支出 影印 ( 各評估表 早餐咭 食物熱量表 ) 各 30 份 84.6 展版材料 1 份 25.4 光碟 3 張 11.0 獎品 ( 文具 ) 5 份 65.0 獎品 ( 食物 ) 30 份 49.0 比賽獎品 ( 文具 餐盒 包裝 ) 12 份 163.8 奬狀用色紙 2 包 35.4 文具 ( 畫紙 箱頭筆 綿繩 ) 各 1 份 29.2 合計 ( 澳門幣 ) 463.4 表 1 活動支出表 This is an eight-week health promotion activity, the budget of this activity is MOP500, yet, MOP463.4 had been used. The Funds are mainly used in health education teaching material and prize of the competition. 发展性 Sus t ai nabi l i t y 请描述如何持续项目成果, 及在其他区域的可复制性 例 : 若需在五个社区复制此方案, 需要的策略合作伙伴为乙方及丙方, 估计需要五千人民币, 可能从以下三个单位获取, 及资金取得的时间表 请以中英文填写 這個計劃有着很大的延展性, 由於是次計劃採用錄製廣播劇 展板 遊戲衛教及餐單設計比賽等形式進行, 而當中的元素和宣傳材料都是可複製的, 加上計劃所需要的人手並不多, 所以整個計劃的執行性及複製性很高, 可考慮把計劃推廣到不同地方 This plan has a great ductility, due to the method including radio play, exhibition board, educational games, breakfast menu design competition etc. All the elements and promotional material in this plan are reproducible and sustainability. Moreover, the number of the manpower needed in this plan is affordable. To sum up, the execution and replication in the whole project is very high, and can be considered to promote in different places. 5
項目過程中同時考慮到對象的年齡和心理特點, 在健康教育講座中把握對象的專注力, 以生動方式表達教育內容 ; 設計遊戲 廣播劇 展板 早餐餐單設計比賽等教育形式, 目的是增加對象的興趣及營造環境氛圍 ; 以小禮物及表揚方式奬勵表現良好的對象, 以鼓勵及激勵其他對象對計劃的積極性 每週派發一份早餐咭, 並於下週收回, 以持續評估方式來追蹤學生在健康教育後的吃早餐狀況, 作為行為改變的評價工具, 針對每次評價結果 创新力 Innovation 请描述方案执行中遇到的挑战 应对过程及方式 请提供任何项目执行的相关照片 影片 如前后的比较 干预对象 宣教范本等 请以中英文填写 來制定及調整教育內容重點 Since the participants of this Project are secondary school students as a distinct period in which adolescents prefer novelty, excitement and peers. In order to grasp the object of concentration in health education lecture, with vivid expression of education content; also, games, radio, exhibition boards and competition are adopted, the purpose of using multi-method in health education is to increase interest in the object and build the environment atmosphere; furthermore, giving small gifts and praise to the participants is as an encouragement. Distributing breakfast record card every week, and will be collected next week, this continuously assessments can provide effective ways to track and evaluate of behavior change, also, as the evidence for the arrangement of the health education. 6