本研究是以國民健康局所委製一套『媽咪拒菸寶典』為教學內容，探討「拒吸二手菸介入計畫」對孕婦及嬰幼兒母親在拒吸二手菸認知、改變階段、改變過程、決策權衡、自我效能及行為意向的影響成效。
本研究採準實驗性研究設計，以台南縣市、屏東市孕婦或嬰幼兒母親共100人為對象，實驗組提供一次90分鐘的衛生教育介入課程、二次學習單及二次電話訪談，對照組則不接受任何實驗處理。
實驗介入前，兩組同時接受前測；實驗組並在一次衛生教育介入課程後，馬上進行包括課程評價的立即後測；一個月後，兩組再同時實施後測。所取得的資料以次數分配、平均數、標準差、百分比、包卡爾對稱性考驗、配對t檢定、共變數分析等方法進行分析。
本研究的主要發現為：
一、介入計畫確實能使實驗組研究對象在「拒吸二手菸改變階段」移往維持期方向的階段優於對照組，且達顯著性差異。
二、介入計畫確實能使實驗組「拒吸二手菸的認知」、「拒吸二手菸改變過程」、「拒吸二手菸決策權衡」、「拒吸二手菸自我效能」、「拒吸二手菸行為意向」的立即後測得分優於前測，且達顯著性差異。
三、計畫介入後，在控制前測成績下，實驗組「拒吸二手菸的認知」、「拒吸二手菸改變過程」、「拒吸二手菸決策權衡」、「拒吸二手菸自我效能」、「拒吸二手菸行為意向」後測得分優於對照組，且達顯著性差異。亦即介入計畫對孕婦及嬰幼兒母親拒吸二手菸具有良好成效。
四、實驗組受試者對拒吸二手菸介入課程之教學媒體、課程內容等多持正向肯定的評價與回饋。
本研究的貢獻可提供拒吸二手菸介入計畫的參考建議，未來研究者可在本研究的基礎下，進一步以吸菸家庭為對象，更嚴謹的縱貫性研究來進行介入，以探討其適用範圍與成效。
關鍵詞：二手菸、改變階段、改變過程、決策權衡、自我效能、行為意向

The main purpose of this study is to implement “Rejection of Secondhand Smoke Program” to pregnant women and mothers with young children and investigate the effects of “The Handbook of Mommy’s Rejection of Secondhand Smoke” made by the Bureau of Health Promotion as a teaching material on the subjects’ improvement of cognition, stages of change, process of change, decisional balance, self-efficacy, and behavioral intention.
A quasi-experimental design was employed in this study. Participants were 100 pregnant women or mothers with young children in Tainan City, Tainan County, and Pintong City. The experimental group was provided a 90-minute health education course, two worksheets, and two follow-up interviews; the control group did not receive any treatment. Pretest questionnaires were administered to all the participants at first. Immediate posttest questionnaires concerning course evaluation were assessed by experimental group after a health education course. One month later, both groups were assessed with the posttest questionnaires again.
All the data of the two groups were analyzed using SPSS11.0 version software for Windows. Frequency, mean, standard deviation, percentage, paired t-test, Bowker’s test of symmetry, and one-way ANCOVA. The main findings in this study were as follow:
1.There was a significant impact of forwarding the stages of rejecting secondhand smoke on the experimental group.
2.In the experimental group, there was a significant increase in the scores of subjects’ cognition, stages of change, process of change, decisional balance, self-efficacy, and behavioral balance on the immediate posttest.
3.There was a significant increase in the scores of subjects’ cognition, stages of change, process of change, decisional balance, self-efficacy, and behavioral balance on the postponed posttest. The results show that “Rejection of Secondhand Smoke Program” had a good effect on pregnant women or mothers with young children.
4.Most subjects receiving a health education course were interested in the teaching materials and satisfied with the curriculum.
The results of this study have definite implications for further researches. Based on this study, researchers might explore the longitudinal effects of “Rejection of Secondhand Smoke Program” and focus on a kind of family with someone smoking so as to revise the program and investigate the effectiveness.

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