台灣中學生健康減重網路學習素材發展與評估之研究

Abstract

為配合資訊時代的需求，如何將資訊網路科技融入衛生教育領域中，實為當前醫學界刻不容緩之要務。本研究旨在應用行為理論之計劃性學習、認知理論之情境問題導向學習(Situated Problem-based Learning)與建構論、並融入跨越行為模式(Transtheoretical Model)、激發學習動機的教學性策略等於網路學習(e-learning)，研擬設計與發展一套適合青少年的健康減重衛教課程網站。本文將健康減重定義為：以正確的飲食、身體活動觀念，配合行為改變，以減少過重的體重。本課程在媒體表現方面定位於能呈現網路超媒體特性的「線上課程」，在學習對象與實施場域方面定位為「線上課程為主，面對面為輔」。 在設計理念上，本研究根據文獻分析認為結合網路之青少年健康減重衛教課程設計，應有下列效益，分別為：(1)具匿名性的特質，可避免許多因面對面接觸所帶來的尷尬場面；(2)具有立即互動性，學習不再受時空影響，可隨時在線上與專業人員互動、諮詢；(3)具經濟效益，學生經由線上學習即可獲得專業的減重諮詢與知識；(4)可呈現動態的多媒體教材內容，可促進學習；(5)可提供使用者自主的網路學習環境；(6)可營造網路社群及合作學習。 在衛教教材的設計模式上，本研究之敎材發展乃根據Passerini及Granger的「混合型設計模式」(Hybrid model)，修正後使其適用於本研究教材之設計與發展，並融合各式學習理論，醫師、營養師與衛教師專業意見，專業醫學文獻內容分析，瞭解網路課程需要性與應包含的學習項目、適合的學習活動後而設計。本研究融入實際學校生活情境，將中學生健康減重課程規劃為十單元：分別是「校史館」－簡述設站源由及理念、作者及研究團隊之簡介，以加深學員對本站資訊正確性之認同，並提供減重營相關資料等；「保健組」－瞭解身體質量指數、每人每日所需熱量、肥胖症的害處、減重的迷思及如何健康減重等；「餐廳」－瞭解六大類食物、飲食份量表及標示等；「福利社」－瞭解各式零食之熱量及標示等；「運動場」－瞭解如何身體活動減重、身體活動的好處及身體活動熱量計算等；「BBS留言版」－供學生們留言、建立社群等；「佈告欄」－供學生寫日記自我評鑑、回答問卷、公佈事項及實施問題導向學習等；「網路資源」－讓學生也可遨遊於網路世界中，從各種的資料庫、網站中，獲取、建構其知識基模；「我的日記本」－讓專業人員回饋學生所問的問題及其填寫的問卷，促進彼此之間的互動，期能幫助學習；「與我們聯絡」－讓學生可直接與專業人員電子郵件聯絡，並宣告此網站之版權。 在研發歷程中，本研究同時考慮青少年青春期生長發育之因素，並且重視學生在整個學習過程對自身行為改變的檢閱與反思，期能建立學生們正確的飲食與身體活動觀念，養成終生具體可行的健康減重行為。 本研究依此流程發展出的青少年健康減重衛教網路學習系統，歷經專家、焦點團體評鑑以及青少年使用者測試等多次形成性評估與修正之後發現，本研究所研發的青少年健康減重衛教網路學習素材，在教學設計上能達到健康減重的目標，在人機介面設計上達到一定的使用性原則，並可引發青少年的學習動機與採用意願。 本研究之成果希望能作為未來發展衛生教育網路學習素材之參考，不僅透過網路科技輔助青少年的衛生教育教學，也藉由網路無遠弗屆的特性提供青少年自學素材，來提昇國內青少年之健康。末來希望更進一步推廣至各年齡層及各個不同的衛教議題。

In order to keep up with the coming information era, it is an urgent task for medical society to integrate information technology into health education. The purpose of this study is to apply transtheoretical model, situated problem-based learning (SPBL) strategy, the ARCS motivation model and e-learning environment to design and develop on-line healthy weight reduction curriculum and website for adolescent. According to the literature analysis, the definition of Healthy Weight Reduction was provided and the curriculum was designed accordingly. The curriculum proposed is a hybrid of on-line and face-to-face styles. This study mapped out ten units in the Web site to introduce healthy weight reduction program to high school students. These units include: (1) School history building, (2)Health care center, (3)Restaurant, (4)Welfare society, (5)The sports ground, (6)Bulletin Board System (BBS) for postings, (7)The bulletin board, (8) Internet Resources, (9) My diary, and (10) Contacting with us. When designing the curriculum, the factors were considered as following: (1) anonymity help to reduce the embarrassment of face-to-face situations, (2) high interactivity to enhance the interaction between learners and medical staff, (3) effectiveness and efficiency due to the professional opinions from medial experts directly, (4) multimedia presentation to demonstrate multi-modality information, (5) learner-center design to promote active learning, and (6) online community to help cooperative learning. During the development stage of the curriculum and the website, factors influencing learning, such as the characteristics of puberty, was also considered. This curriculum also encourages students to reflect on their eating behaviors and body activities throughout the whole learning period. In other words, the online learning curriculum developed in this study not only provides students updated information on healthy weight reduction, but also help them cultivate lifelong weight-control attitudes and behaviors. After evaluated by the experts, focus group and adolescent users, it is found that the curriculum achieved its set goals. In addition, the design of the computer-human interface met the usability design guidelines, and helped motivate students’ learning. By assisting adolescents to construct correct concept of diet, and to conduct healthy weight reduction behavior with the Internet technology, it is concluded that the curriculum developed in this study could become an on-line curriculum model for future health education.