本研究目的在探討衛生教育和改良式太極拳的介入對社區老人體適能、三高數值（膽固醇、飯後血糖及血壓）、健康促進生活型態及健康相關生活品質的成效。教學內容包含整合性的健康促進生活型態課程和改良式太極拳訓練，執行期間達四個月。
本研究為準實驗研究設計，以立意取樣的方式選取研究對象，將取樣所得樣本分為控制組32位、實驗組33位。以實際測量體適能和三高數值，以及填答結構式問卷來收集資料，問卷包括健康促進生活型態問卷和健康相關生活品質量表。
主要的研究結果如下：
1.教育計畫介入能顯著改善心肺適能、身體柔軟度及腰臀圍比。
2.教育計畫介入能顯著降低血壓。
3.教育計畫介入有助於增進整體健康促進生活型態，以及健康責任、運動、
營養及人際支持層面的執行。
4.教育計畫介入後，健康相關生活品質無顯著改變。
本研究結果可以做為發展社區老人健康促進計畫的參考。建議未來老人健康促進實務工作者可採取的措施，包括於開設健康方面的課程、培訓種子教師，以及推廣改良式太極拳，以達到促進老人健康的目標。

The purpose of this study was to explore the effectiveness of health education and modified Tai Chi Chuan programs on physical fitness, three high data (cholesterol, blood sugar and blood pressure), health promotion lifestyle and health-related quality of life among community-dwelling elders. Programs were implemented over a 4-month period.
A quasi-experimental design was employed in this study. Criteria for selecting subjects are based on purposive sampling. One group was assigned to be a controlled group (n=32) and the other was an experimental group (n=33).The subjects were measured by physical fitness, three-high data and structural questionnaires. Structured questionnaire included Health Promotion Lifestyle Profile (HPLP) and the Medical Outcome Study Short Form-36 (SF-36).
The major findings of the study were as the followings:
1. The cardio-pulmonary fitness, flexibility and waist / hip ratio (WHR) were significantly improved.
2. The blood pressure was significantly decreased.
3. The performance improved in overall health promotion lifestyle, health responsibility, exercise, nutrition and interpersonal support.
4. The health-related quality of life did not significantly change.
Based on the results, this present study suggests that in the future the health promotion programs for the elders be feasible and promising. The health promotion practitioners can develop a series of health education programs, seed teachers for health education teaching and extend modified Tai Chi Chuan exercise training in order to promote the elder’s health.

中文文獻
方進隆（1991）。老年的運動處方。健康教育，67，17-20。
王淑諒（2002）。坐月子期間產婦之健康促進生活方式及其影響因素之探討。未發表的碩士論文，臺北醫學大學：台北。
內政部（2005）。我國生命表：93年簡易生命表提要分析報告。取自http://www.moi.gov.tw/ stat/
內政部（2005）。內政國際指標：主要國家65歲以上人口占總人口比率。取自http://www.moi.gov.tw/stat/
內政部（2005）。中華民國九十一年臺閩地區老人狀況調查摘要分析。取自http: //www.moi.gov.tw/stat/index.asp
行政院衛生署（2005）。93年衛生統計動向：死因統計。取自http:// www.doh.gov. tw/statistic/data/衛生動向/93/93.htm
行政院衛生署（2005）。民國93年國民醫療保健支出：提要分析。取自http:// www. doh.gov.tw/statistic/data/國民醫療保健支出/93/提要分析93.doc
江東亮、余玉眉（1994）。健康促進：國民健康的新方向。中華公共衛生雜誌，13（5），381-387。
朱碧梧、黃奕清（2003）。社區老人運動養生策略。護理雜誌，50（3），37-42。
余玉眉（1993）。老人健康促進與預防保健服務之策略與措施。社區發展季刊，64，66-70。
余幸宜、于漱、李蘭（2004）。老年人之健康促進。台灣醫學，8（4），582-588。
李怡娟（1998）。健康促進在護理專業中的應用。護理雜誌，47（1），5-12。
李先五（2002）。太極拳。臺北市：逸文。
李碧霞（1997）。衛生教育與健康相關生活品質之關係。衛生教育雜誌，17，13-22。
吳淑瓊、張明正（1997）。台灣老人的健康照護現況分析。台北：國立台灣大學公共衛生研究所暨衛生政治研究中心。
吳貴琍、武為瓊（2004）。太極拳對中老年人平衡能力的影響。運動生理暨體能學報，1，90-98。
林清山（2003）。心理與教育統計學。臺北市：東華。
林佩欣、曾旭民、鄭寶釵、黃美涓、鄧復旦（1999）。太極拳對老年人感覺運動功能的影響。中華民國物理治療雜誌，24（4），231-241。
林茂榮、王夷暐（2004）。社區老人跌倒的危險因子與預防。臺灣衛生教育雜誌，23（4），259-271。
林碧珠、林麗嬋、林金真（1997）。成人衛生教育與老人衛生教育。護理雜誌，44（2），81-86。
林豔君、陳月枝、陳滋茨（1997）。鄉村地區中老年人參與衛生教育活動之狀況及保健服務之需求。護理新象，8（2），36-49。
林貴福、盧淑雲（2000）。認識健康體能。師大書苑。
周郁文、陳敏麗（2002）。「健康促進模式」（HPM）於健康行為－「規律運動之應用」。長庚科技學刊，1，187-198。
高淑芬、蕭冰如、蔡秀敏、邱珮怡（2000）。老年人的健康促進生活型態與衛生教育。護理雜誌，47（1），13-18。
郭錦松、胡啟民、林琇瑩、陳涵栩、郭清輝、何橈通、周淩瀛（2001）。單次團體衛教對輔助第二型糖尿病控制之成效評價。彰化醫學，6（1），31-36。
郭清輝（2000）。肥胖症。臨床醫學，46（3），200-204。
郭鐘隆（2002）。國民健康局九十一年度研究計畫期末報告：民國八十八年台灣地區中老年身心社會生活狀況長期追蹤調查。
梁金麗（2001）。社區老人生活品質及其相關因素之探討。國立台北護理學院。未發表碩士論文
許佩蓉、江瑾瑜（2001）。健康促進與老年健康教育策略。榮總護理，18（3），254 -258。
許智欽、黃美涓（2003）。老年人之運動處方。台灣醫學，7（3），396-403。
陳美燕、王明誠、邱獻章、吳運東（1995）。桃園地區醫師實施健康促進行為之探討。中華公共衛生雜誌，14（1），41-49。
陳富莉、李蘭（2001）。臺灣地區不同年齡層民眾的健康行為聚集型態。公共衛生，28（1），37-47。
陳清惠、顏妙芬（2002）。太極拳運動對慢性疾病症候控制之成效。護理雜誌，49（5），22-27。
陳桂敏、劉慈慧（2004）。太極拳運動於老年族群之應用成效。長期照護雜誌，8（2），223 -235。
黃奕清（2000）。低能量消耗運動對老年身體適能的影響－以太極拳為例。高師大體育，1，19-24 。
黃壽宸（2002）。太極拳術的理論與實際。臺北市：逸文。
黃盈翔、盧豐華（2003）。老年人之用藥原則。台灣醫學，7（3），385-395。
黃璉華（1996）。社區老人用藥教育介入成效之探討。護理研究，4（2），104-114。
黃惠璣（2004）。銀髮族的運動。長期照護雜誌，8（3），311-320。
黃毓華、邱啟潤（1996）。健康促進生活型態量表信度效度之探討。高雄醫學科學雜誌，12（9），529-537。
黃毓華、邱啟潤（1997）。高雄地區大學生健康促進生活型態之預測因子。中華公共衛生雜誌，16（1），24-36。
曾旭民、盧瑞芬、蔡益堅（2003）。國人生活品質評量（Ⅱ）：SF-36台灣版的常模與效度檢測。台灣公共衛生雜誌，22（6），512-518。
張廖麗珠、葉素汝（2004）。論體育教師推廣中老年人休閒運動的策略與作為。中州學報，16，225-239。
張瓊丹、陳靜敏、鄭綺、林貴福（2005）。太極拳運動訓練對改善老年高血壓個案之健康狀況成效。運動生理暨體能學報，2，103-118。
劉秋松、林正介（2003）。老年人之健康促進與預防性服務。台灣醫學，7（3），375-384。
劉惠瑚、陳玉敏（2004）。慢性病老人自我照顧之生活經驗。慈濟護理雜誌，3（3），50-59。
賴惠玲、謝佩珊、謝美玲（2004）。團體有氧運動對中老年人生理心理指標的影響。慈濟護理雜誌，3（2），50-58。
鍾寶玲（2001）。老年糖尿病健康促進生活型態及相關因素之探討。未發表的碩士論文，高雄醫學大學：高雄。
藍青、賴金鑫、黃美涓（1999）。太極拳對中老年人心肺功能之促進及維持效果。中華民國復健醫學雜誌，27（2），63-69。

英文文獻
Alywahby, N. F. (1989). Principle of teaching for individual learning of older adults. Rehabilitation Nursing, 14(6), 330-333.
American College of Sports Medicine. (2000). ACSM’s guidelines for exercise teasing and prescription (6th ed.). Philadelphia: Lippincott Williams &Wilkins.
Berg, R. L., & Cassells, J. S. (1990). The second fifty years: Promoting health and preventing disability. Washington, DC: National Academy Press.
Black, J. S. & Kapoor, W. (1990). Health promotion and disease prevention in older people: Our current state of ignorance. American Geriatrics Society, 38(2), 168 -172.
Brawley, L. R., Rejeski, W. J., & King, A. C. (2003). Promoting physical activity for older adults: The challenges for changing behavior. American Journal of Preventive Medicine, 25, 172-183.
Bright, L. (2005). Strategies to improve the patient safety outcome indicator: Preventing or reducing falls. Home Healthcare Nurse, 23(1), 29-37.
Center for Disease Control and Prevention (n. d.). Healthy aging: Healthy aging for older adults. Retrieved 12/01/ 2005 from http://www.cdc.
gov/aging/
Center for Disease Control and Prevention (n. d.). Healthy People 2010- Summary of objectives: Educational and community-based programs. Retrieved April 12, 2004 from http://www.cdc.gov/nchs/ otheract/ hpdata2010/2010fa28.htm.
Curry, L. C., Hogstel, M. O., Davis, G. C., & Frable, P. J. (2002). Population-based osteoporosis education for older women. Public Health Nursing, 19(6), 460-469.
Davidhizar, R., Eshleman, J., & Moody, M. (2002). Health promotion for aging adults. Geriatric Nursing, 23(1), 28-34.
Deurenberg, B. P., Weststrate, J. A., & Seidell, J. C. (1991). Body mass index as a measure of body fatness: Age-and sex-specific prediction formulas. British Journal of Nutrition, 65, 105-114.
Eaton, C. B., Lapane, K. L., Garber, C. E., Gans, K. M., Lasater, T. M., & Carleton, R. A. (1999). Effects of a community-based intervention on physical activity: The Pawtucket heart health program. American Jounal of Public Health, 89(11), 1741-1744.
Hancock, L., Sanson-Fisher, W., Redman, S., Burton, R., Burton, L., Butler, J., Girgis, A., Gibberd, R., Hensley, M., McClintock, A., Reid, A., Schofield, M., Tripodi, T., & Walsh, R. (1997). Community action for health promotion: A review of methods and outcomes 1990-1995. American Journal of Preventive Medicine, 13(4), 229-238.
Harris, D. M., & Guten, S. (1979). Health protective behavior: An exploratory study. Journal of Health and Social Behavior, 20(1), 17-29.
Hogan, M. (2005). Physical and cognitive activity and exercise for older adults: A review. International Journal of Aging & Human Development, 60(2), 95-126.
Hong, Y., Li, J. X., & Robinson, P. D. (2000). Balance control, flexibility, and cardio- respiratory fitness among older Tai Chi practitioners. British Journal of Sports Medicine, 34(1), 29-34.
Huang, L. H., Chen, S. W., Yu, Y. P., Chen, P. R., & Lin, Y. C. (2002). The effectiveness of health promotion education programs for community elderly. Journal of Nursing Research, 10(4), 261-270.
Janssen, I., Heymsfield, S. B., Allison, D. B., Kotler, D. P., & Ross, R. (2002). Body mass index and waist circumference independently contribute to the prediction of non-abdominal, abdominal subcutaneous, and visceral fat. American Society for Clinical Nutrition, 75, 683-688.
Kim, C. G., June, K. J., & Song, R. (2003). Effects of a health promotion program on cardiovascular risk factors, health behaviors, and life satisfaction in institutionalized elderly women. International Journal Nursing Studies, 40(4), 375-381.
King, A. C., Rejeski, W. J., & Buchner, D. M. (1998). Physical activity interventions targeting older adults: A critical review and recommendations. American Journal of Preventive Medicine, 15(4), 316-332.
Kutner, N. G., Barnhart, H., Wolf, S. L., McNeely, E., & Xu, T. (1997). Self-report benefits of Tai Chi practice by older adults. Journal of Gerontology : Psychological Sciences, 52(5), 247-250.
Laforge, R. G., Rossi, J. S., Prochaska, J. O., Velicer, W. F., Levesque, D. A., & McHorney, C. A. (1999). Stage of regular exercise and health-
related quality of life. Preventive Medicine, 28, 349-360.
Lahmann, P., Lissner, L., Gullberg., & Berglund, G. (2000). Socio-
demographic factors associated with long-term weight gain, current body fatness and central adiposity in Swedish women. International Journal of Obesity, 24, 685-694.
Lai, J. S., Wong, M. K., Lan, C., Chong, C. K., & Lien, I. N. (1993). Cardiorespiratory responses of Tai Chi Chuan practitioners and sedentary subjects during cycle ergometry. Journal Formosa Medicine Association, 92(10), 894-899.
Lai, J. S., Lan, C., Wong, M. K., & Teng, S. H. (1995). Two-year trends in cardiorespiratory function among older Tai Chi Chuan practitioners and sedentary subjects. Journal of American Geriatrics Society, 43, 1222-1227.
Lam, P. (2006). Tai Chi Productions: History of Tai Chi. Retrived 2006 from http://www.taichiproductions.com/articles/display.php?articleid =48
Lan, C., Lai, J. S., Wong, M. K., & Yu, M. L. (1996). Cardiorespiratory function, flexibility, and body composition among geriatric Tai Chi Chuan practitioners. Archives of Physical Medicine and Rehabilitation, 77(6), 612-616.
Lan, C., Lai, J. S., Chen, S. Y., & Wong, M. K. (1998). 12-month Tai Chi training in the elderly: Its effect on health fitness. Medicine and Science in Sports and Exercise, 30(3), 345-351.　
Lin, Y. C., Wong, M. K., Chou, S. W., Tang, F. T., & Wong, P. Y. (2000). The effects of Tai Chi Chuan on postural stability in the elderly: Preliminary report. Chang Gung Medicine Journal, 23(4), 197-204.
Maban, J. & Clark, J. M. (1995). Health promotion: A concept analysis. Journal of Advanced Nursing, 22, 1158-1165.
Melillo, K. D., Williamson, E., Futrell, M., & Chamberlain, C. (1997). A self- assessment tool to measure older adults’ perceptions regarding physical fitness and exercise activity. Journal of Advanced Nursing, 25, 1220-1226.
Merzel, C., & D’Afflitti, J. (2003). Recosidering community-based health promotion: Promise, performance, and potential. American Journal of Public Health. 93(4), 557-574.
Miller, A. M. & Iris, M. (2002). Health promotion attitudes and strategies in older adults. Health Education & Behavior, 29(2), 249-267.
Ourania, M., Yvoni, H., Christos, K., & Ionannis, T. (2003). Effects of a physical activity program: The study of selected physical abilities among elderly women. Journal of Gerontological Nursing, 29(7), 50-55.
Padula, C. A. (1997). Development of the health-promotion activities of older adults measure. Public Health Nursing, 14(2), 123-128.
Palank, C. L. (1991). Determinants of health-promotive behavior: A review of current research. Nursing Clinics North American, 26(4), 815-832.
Pascucci, M. A. (1992). Measuring incentives to health promotion in older adults: Understanding neglected health promotion in older adults. Journal of Gerontological Nursing, 18(3), 16-23.
Pullen, C., Walker, S. N., & Fiandt, K. (2001). Determinants of health- promoting lifestyle behaviors in rural older women. Family Community Health. 24(2), 49-72.
Schaller, K. J. (1996). Tai Chi Chih: An exercise option for older adults. Journal of Gerontological Nursing, 22(10), 12-17.
Schoenfelder, D. P. & Van Why, K. (1997). A fall prevention educational program for community dwelling seniors. Public Health Nursing, 14(6), 383-390.
Sohng, K., Sohng, S., & Yeom, H. (2002). Health-promoting behaviors of elderly Korean immigirants in the United States. Public Health Nursing, 19(4), 294-300.
Susser, M. (1996). Editoral: New directions for community intervention studies. American Journal of Public Health, 86(12), 1696-1697.
Stokols, D. (1996). Translating social ecological theory into guidelines for community health promotion. American Journal of Health Promotion, 10(4), 282-295.
Tse, S., & Bailey, D. M. (1991). Tai Chi and postural control in the well elderly. The American Journal of Occupational Therapy, 15, 295-300.
Redland, A. R., & Stuifergen, A. K. (1993). Strategies for maintenance of health- promoting behaviors. Nursing Clinics of North American, 28(2), 427-442.
Resnick, B. (2000). Health promotion practices of the older adult. Public Health Nursing, 17(3), 160-168.
Resnick, B. (2003). Health promotion practices of the older adult: Testing an individualized approach. Journal of Clinical Nursing, 12, 46-55.
U.S. Department of Health and Human Services (n. d.). Dietary Guidelines for Americans 2005 : Chapter 4 phyical activity. Retrieved March 31, 2005 from http://www.health.gov/dietaryguidelines/dga2005/ document/html/chapter4.htm
U.S. Department of Health and Human Services (n. d.). Healthy People 2010: Under- standing and Improving Health. Retrieved May 1, 2006, from http: //www.healthypeople.gov/Document/html/uih/uih_2.htm #goals3
Walcott-McQuigg, J. A., & Prohaska, T. R. (2001). Factors influencing participation of African American elders in exercise behavior. Public Health Nursing, 18(3), 194-203.
Walker, S. N., Schrist, K. R., & Pender, N. J. (1987). The health promoting lifestyle profile: Development and psychometric characteristics. Nursing Research, 36(2), 76-80.
Wallace, S. P., & Levin, J. R. (2000). Patterns of health promotion programs for older adults in local health departments. American Journal of Health Promotion, 15(2), 130-133.
Wang, H. H. (2001). A comparison of two models of health-promoting lifestyle in rural elderly Taiwanese women. Public Health Nursing, 18(3), 204-211.
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36): Conceptual framework and item selection. Medical Care, 30(6), 473-83.
Ware, J. E., Kosinski, M., & Gandek, B. (2005). SF-36 Health Survey: Manual & Interpretation Guide. Lincoln, RI: Quality Metric Incorporated.
Ware, J. E., & Kosinski, M. (2005). SF-36 Physical & Mental Health Summary Scales: A Manual for Users of version 1, Second Edition. Lincoln, RI: Quality Metric Incorporated.
WHO expert consultation. (2004). Appropriate body mass index for Asian populations and its implications for policy and intervention strategies. The Lancet, 363, 157-163.
Wing, R. R., & Hill, J. O. (2001). Successful weight loss maintenance. Annual Reviews Nutritation, 21, 323-341.
Wilhide-Tanner, E. K. (1991). Health promotion: Assessment of a health-promotive lifestyle. Nursing Clinics North American, 26(4), 845-854.
Wong, A. M., Lin, Y. C., Chou, S. W., Tang, F. T., & Wong, O. Y. (2001). Coordination exercise and postural stability in elderly people effect of Tai Chi Chuan. Arch Physical Medicine Rehabilitation, 82, 608-612.
Young, D., Appel, L. J., Jee, S. H., & Miller, E. R. (1999). The effects of aerobic exercise and Tai Chi on blood pressure in older people: Results of a randomized trial. Journal of the American Geriatrics Society , 47, 277–284.