● 中文摘要：

　　本計畫為三年期的研究，目的為建構國中階段青少年藥物濫用預防教育指標及進行介入研究。第一年為需求評估調查，完成工作包括：（1）收集國內外青少年藥物濫用預防教材並進行文獻分析，（2）訪問衛生署、教育部、臺北市及桃園縣教育局、衛生局、少警隊、國中等藥物濫用預防推動人員與教師計10人，（3）調查臺北市及桃園縣國中學生（各1312、1475名）、家長（各1023、1083名）、教師（各258、260名），評估其藥物濫用認知、態度、預防教育效能及需求等。以SAS軟體進行統計分析，結果分述如下： 在青少年藥物濫用預防教育指標適切性評估方面，教師對各項指標評估傾向重要或非常重要。在「學生能力指標」上，教師認為學生拒絕成癮物質、壓力調適、自我肯定、問題解決、藥物濫用認知、批判性思考、溝通技能等指標，皆傾向非常重要。在「家長/社區指標」上，教師認為家長角色模範、辨識與問題處理、協助發展生活技能、督導子女行為、家長與子女的溝通等指標對預防青少年藥物濫用，皆傾向非常重要。在「健康促進學校指標」上，教師對健康服務、學校物質環境、學校藥物濫用預防政策、藥物教育教學與活動、學校社會環境、社區關係等指標，傾向重要。 在學生成癮物質使用情形方面，臺北市及桃園縣國中學生過去一個月使用入門藥包括飲酒（8.8%、8.8%）、吸菸（3.7%、5.6%）、嚼檳榔（0.8%、1.0%），臺北市及桃園縣國中學生23名（0.8%）曾使用非法藥物，包括使用強力膠等吸入劑（0.7%、0.2%）、K他命（0.2%、0.4%）、大麻（0.2%、0.1%）、搖頭丸（0.2%、0%）、安非他命（0.2%、0%）、海洛英、嗎啡（0.5%、0.1%）。使用非法藥物學生也多有飲酒（82.6%）與吸菸（52.2%）。 在學生成癮物質使用的危險因子方面，臺北市及桃園縣國中學生藥物使用的危險因子分佈，如曾去網咖或撞球店（25.2%、35.6%）、家庭狀況為中低/低收入戶（25.2%、35.7%）、父親吸菸（39.2%、50.0%）、好友吸菸（10.8%、19.0%）、鄰居吸菸（20.5%、29.4%）、容易取得菸品（35.2%、39.7%）。多變項結果顯示原住民生、學生成癮物質危險知覺較低、贊成使用成癮物質、生活技巧效能較低、好友使用成癮物質者、好友有偏差行為、父母及好友傾向贊成使用成癮物質者，學生較可能使用成癮物質。 在學生成癮藥物認知方面，學生平均答對率僅約一半，學生易高估成人與青少年使用成癮物質的情形，及不清楚相關法律規定。在預防效能方面，學生的倡議與批判性思考得分較低，多變項結果顯示學生成績較不好、吸菸者、成癮藥物認知較低、成癮物質危險知覺較低、成癮物質使用態度傾向贊成、藥物教育有效性較低者，其藥物濫用預防生活技巧效能也較低。 在藥物濫用預防教育經驗方面，九成學生表示在國中階段曾上過藥物濫用預防相關課程，八成曾透過網路與電視接觸反毒訊息，六成曾參加學校反毒宣導活動，然近三成學生表示同學朋友曾告知吸食毒品訊息，半數學生也曾從電視、網路、報紙接觸過吸食毒品訊息。學生表示需要生活技能（如壓力調適、溝通等）與成癮藥物法律規範、資源管道等課程，多變項結果顯示桃園縣學生、年級較低者、危險知覺較高、藥物教育有效性看法較高者，其藥物教育需求愈高。 比較學生、家長、教師資料，結果顯示家長填答親子關係得分比學生高，而家長填答其子女使用成癮物質的情形比學生自填情形低，顯示部份家長可能不知道其子女使用成癮物質情形，另近八成家長表示曾告訴其子女有關使用成癮物質危害，然僅有四成的子女表示其家長曾說過使用成癮物質危害。在藥物教育有效性方面，學生、家長、教師皆認為警察加強檢查社區不良場所的有效性最高，其他是學校辦理特定學生的尿液篩檢、學校訂定明確藥物濫用防制政策並落實、及教導生活技巧等。在預防效能方面，家長與教師對於學校結盟社區推動無毒家園及與家長參與等的效能得分較低。 訪談臺北市與桃園縣衛生局、教育局、國中等相關人員，結果顯示學校藥物濫用預防教育推動的困難，如：上課時間有限、健康教育課程被配給其他主科、高風險學生的家長與學校互動少、健康教育師資不足、縣市經費、人力資源有限等，建議瞭解各區域青少年藥物教育需求，評估危險/保護因子，發展當地適合的教材，參考九年一貫指標發展具體、明確指標，建議教材內容強調使用成癮物質身心傷害與法律規範等。 第二年計畫將依據第一年需求評估的結果，及臺北市與桃園縣教師評估青少年藥物濫用預防各項指標重要性的結果，邀請專家進行德懷術調查，以建構青少年藥物濫用預防教育指標，並依所建構的指標，發展藥物教育教材、學校工作手冊、家長與社區資源手冊，及進行藥物教育介入研究。此外，建議各縣市政府與學校應聘請充足健康教育專業師資，落實各年級藥物教育課程，提供學校教師藥物教育訓練與資源，增強家庭的親職功能，鼓勵學校結盟家長、社區、警政、媒體等單位，加強聲色場所查緝、反毒訊息的宣導、降低成癮物質可近性及營造無毒家園規範。

● English Abstract:

     The present study was a 3-year effort to make an impact on youth drug abuse prevention education. The objectives included the following: needs assessment; development of education indicators through Delphi surveys; development of education materials; and, evaluation of youth drug education intervention. In the first year, 10 personnel from the Department of Health, Ministry of Education, Taipei and Taoyuan county officials were interviewed in an effort to understand the implementation of youth drug abuse prevention programs at the school and county levels. In addition, groups of 1,312 and 1,475 middle-school students, 1,023 and 1,083 parents, and 258 and 260 teachers from Taipei and Taoyuan counties were randomly selected to collect the data on drug-related knowledge, attitudes, perceived competence, and the need for youth drug abuse prevention education. The results showed that teaches attached a high level of importance to proposed youth drug abuse prevention education indicators such as student life skills (i.e., refusal skill, stress management, and critical thinking), drug-free schools (i.e., school policy, curriculum, and environment), and parent/community collaboration. In addition, the prevalence of alcohol, cigarette and betel nut use among middle-school students in Taipei County was 8.8, 3.7 and 0.8%, respectively, while the prevalence of alcohol, cigarette and betel nut use among middle-school students in Taoyuan County was 8.8, 5.6 and 1.0%. Moreover, 23 students (0.8%) reported ever having used illicit drugs: inhalants, ketamine, marijuana, amphetamine, heroin, and morphine. Students who reported illicit drug use also reported alcohol and cigarette use. In addition, the prevalence of drug use risk factors was higher in Taoyuan County than in Taipei County. For example, drug use risk factors among the students included spending time in Internet cafés (Taipei: 25.2%, Taoyuan: 35.6%), belonging to a low-income family (25.2%, 35.7%), paternal smoking (39.2%, 50.0%), peer group smoking (10.8%, 19.0%), neighborhood smoking (20.5%, 29.4%), and cigarette availability (10.8%, 19.0%). Multivariate analysis results indicated that students who were aborigines, who had a low perception of the risk of drug use and a high approval attitude of drug use, were more likely to use illicit drugs. Most students had a mid-level knowledge of drugs. Students tended to over-estimate the prevalence of drug use among adolescents and adults. The awareness level of the penalties of illicit drug use was low among middle school students. Student advocacy of drug-free campaigns and critical thinking was low. Multivariate analysis results indicated that students were less likely to develop life skills if they had the following indicators: poor academic performance, self-assessment as a smoker, a low level of knowledge concerning drugs, a lower perception of the risks of drug use, lower drug use approval, and, a lower perception of drug education effectiveness. About 90% of the students reported that they were taught drug prevention curricula in middle school. In addition, 80% of the students reported they had received anti-drug messages from television and the Internet, while 30% of the students reported friends ever speaking of how to use illicit drugs. Students had a high level of need for training on life skills (i.e., stress management and communication), drug use penalties, and drug use prevention resources. Multivariate analysis results indicated that students in Taoyuan County, having a higher perception of the risks of drug use and a higher level of drug education effectiveness, were more likely to have a higher level of drug use prevention education needs. The present study also evaluated discrepancies in the reports from parents, adolescents and teachers. The results showed that there were considerable discrepancies in how parents, adolescents and teachers report family communication, use of illicit drugs by youth, and perception of drug education effectiveness. Approximately 80% of parents reported that they had ever talked about the health hazards of illicit drug use, while only 40% of adolescents reported that their parents had ever talked about the health hazards. Parents perceived a greater level of family communication than adolescents, and adolescents reported a greater level of illicit drug use. Adolescents, parents and teachers all reported highly beneficial prevention strategies that included investigating certain locations in communities, implementing urine tests in schools, and teaching life-skills curricula. However, parents and teachers both reported that participation in school-community collaboration was low. Qulitative research results indicated that the barriers to implementing school drug education included a lack of time, low parent-school connection, a lack of health education teachers, and a lack of financial resources, etc. Officials’ and teachers’ recommendations included an investigation of risk and protective factors among different communities, an assessment of youth drug use prevention needs, and the development of youth drug use prevention education indicators and education materials. The second-year study will conduct Delphi surveys to construct the indicators for youth drug abuse prevention education. The indicators will be used to develop educational materials, drug-free school pamphlets, and parent/community resource materials to assist teachers, schools, parents, and communities in conducting youth drug abuse prevention programs. In addition, in order to construct a drug-free social norm, county officials and schools should hire an adequate number of health educators, should strengthen drug education, should encourage parent/community collaboration, should conduct anti-drug campaigns, and should reduce the availability of illicit drugs.

● 文章連結：https://goo.gl/kL3hfJ

● 資料來源：政府研究資訊系統