臺灣博碩士論文加值系統

背景：青少年性健康在世界各地皆為重要之公共健康問題。根據臺灣國家衛生研究院之數據指出，在有性經驗的青少年中，22％在14歲以前即發生初次性行為，其中32.6％在最後一次進行性行為時未使用保險套。過去文獻指出，由家長提供之安全性行為相關之家庭性教育能有效協助青少年在面對性行為時，做出明智的決定。然而，目前尚未釐清哪些可能影響因素分別促使母親和父親進行安全性行為相關之家庭性教育。

目的：欲以計劃行為理論為基礎，透過量性問卷調查，檢視臺灣國小高年級學童家長進行家庭性教育之意圖、相關因素，以做為未來衛生教育或政策宣傳之依據。

方法：研究工具係以計劃行為理論為基礎設計之量性問卷，本研究於2018年1月15日至2018年3月29日進行網路收案，係藉由傳遞網路問卷連結之方式，分享於可觸及國小高年級學童家長各大網路平台，一共蒐集587份有效樣本。運用多變項羅吉斯迴歸，探討臺灣國小高年級學童家長進行家庭性教育之意圖及相關因素。

結果：具以下特質之學童母親顯示擁有進行家庭性教育之較高行為意圖：對於進行家庭性教育造成之正向結果，抱持相對正向之態度者 (AOR=4.42)、對於負向結果，態度相對正向者 (AOR=2.26)、當面對有利於進行家庭性教育之情境時，擁有高度自覺行為控制者 (AOR=2.25)。此外，當學童父親具備下列特質顯示擁有較高行為意圖：面對進行家庭性教育之負向結果，態度相對中立者 (AOR=10.22)、主觀規範為高度支持 (AOR=10.38)。

結論：此研究發現，影響母親與父親進行家庭性教育意圖之計劃行為理論相關因素不同，因此，未來健康相關衛教欲於臺灣推廣家庭性教育，可依據研究發現，為母親與父親分別設計適性教育內容，為母親強調進行家庭性教育之正向預期結果，並為父親創造支持性環境。

Background: Adolescent sexual health has continued to be a public health issue around the world. In Taiwan, among sexually experienced adolescents, 22% of them had sexual debut before the age of 14, and 32.6% did not use condoms during their last sexual intercourse. Safe sex education, when provided by parents, has been found effective in helping teenagers make wise decisions. However, it remains unclear what factors might motivate mothers and fathers, respectively, to engage in parent-child communication about sexual behaviors (PCCSB).

Objectives: Based on the Theory of Planned Behavior (TPB), this study intended to examine the factors associated with the intention to engage in PCCSB among 5th–6th-graders’ parents in Taiwan.

Methods: Anonymous online survey data (N=587), including background characteristics, TPB variables, and PCCSB intention, were collected through social networking sites frequented by 5th–6th-graders’ parents in Taiwan, from January to April 2018. Multivariate logistic regression was performed, separately by parents’ gender, to examine the factors associated with higher PCCSB intention among parents.

Results: The multivariate model showed that 5th–6th-graders’ mothers in Taiwan who had the following characteristics had higher PCCSB intention: relatively neutral (AOR=2.53) and positive (AOR=4.42) ATB toward positive outcomes, relatively positive (AOR=2.26) ATB toward negative outcomes, relatively high (AOR=2.25) PBC under facilitating conditions. By contrast, fathers with the following characteristics had higher PCCSB intention: relatively neutral (AOR=10.22) ATB toward negative outcomes, relatively supportive SN (AOR=10.38).

Conclusions: Gender differences were noted in this study. Mothers with positive attitudes toward positive outcomes of PCCSB had the highest PCCSB intention, whereas supportive SN was strongly linked to fathers’ intention. Accordingly, tailored education efforts to promote PCCSB in Taiwan could emphasize positive outcome expectations for mothers and create supportive environments for fathers to optimize program effectiveness.

Chapter 1 Introduction 1
1.1 Adolescent sexual health problems 1
1.1.1 Adolescent sexual health problems around the world 1
1.1.2 Adolescent sexual health surveillances and issues in Taiwan 1
1.2 Importance and effects of parent-child communication about sexual behaviors (PCCSB) 2
1.3 Current status and obstacles of PCCSB in Taiwan 3
1.4 Background characteristics associated with PCCSB 4
1.4.1 Gender of parents and children 4
1.4.2 Age, educational level, living status, and religion 4
1.4.3 Parents’ satisfaction with their relationships with their children 5
1.4.4 Past PCCSB experiences 5
1.5 Theory of Planned Behavior (TPB) 6
1.5.1 Attitude toward the behavior (ATB) 7
1.5.2 Subjective norm (SN) 7
1.5.3 Perceived behavioral control (PBC) 8
1.6 The current study 8
Chapter 2 Methods 10
2.1 Research framework 10
2.2 Participants 10
2.3 Measures 11
2.3.1 Outcome variable 12
2.3.2 TPB variables 12
2.3.3 Background characteristics 14
2.4 Procedure 15
Chapter 3 Results 17
3.1 Characteristics of sampled parents in this study 17
3.2 Bivariate Associations Between TPB Constructs and both PCCSB Intention and gender of the parents 17
3.2.1 Bivariate Associations Between TPB Constructs and PCCSB Intention 17
3.2.2 Bivariate Associations Between TPB Constructs and gender of the parents 18
3.3 Bivariate Associations Between TPB Constructs and both PCCSB Intention, by gender of the parents 19
3.4 Multivariate logistic regression for factors associated with PCCSB intention, by parents’ gender 20
3.5 Multivariate logistic regression models for individual TPB items associated with higher PCCSB intention, by gender of the parents 21
Chapter 4 Discussion 23
4.1 Low frequency of condom use in premarital sex related to higher PCCSB intention among mothers 23
4.2 Child’s gender characteristic associated with higher PCCSB intention among mothers 24
4.3 ATB about positive outcomes related to PCCSB intention varied with parents’ gender 24
4.4 ATB about negative outcomes differentially linked to PCCSB intention among the parents 25
4.5 Supportive SN associated with higher PCCSB intention only among fathers 26
4.6 High PBC related to higher PCCSB intention among mothers 27
4.7 High PBC about offspring sexuality linked to higher PCCSB intention among mothers 28
4.8 Limitations and future directions 29
Chapter 5 Conclusions 30
References 31

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