目的：本研究運用6C行銷模式探討社區長者參加預防失智症課程意圖。透過可靠且有效的方式測量臺灣社區長者參加預防失智症課程之可能性。並發展適用於臺灣社區長者參加預防失智症課程可能性之預測模式。
方法：本研究共分三階段進行，第一階段採用深度訪談，以6C行銷模式為架構設計訪談大綱，訪談逐字稿以直接內容分析法進行分析；第二階段採用Q方法，Q分類排序所得之資料以主成份分析（Principle Components Analysis）及最大變異轉軸法（Varimax Rotation）進行因素抽取及類型區分；第三階段採用量性問卷調查，以深度訪談資料為基礎及參考相關文獻，建構量化測量工具及進行資料收集，再以結構方程模式（Structure Equation Modeling, SEM）進行預測模式驗證分析。
結果：第一階段研究邀請30位社區長者進行深度訪談，以逐字稿方式進行彙整，找出32個關鍵詞，再依據6C行銷模式進行歸類，結果如下：記憶衰退、腦部空白、表達障礙、家人照顧負擔及年紀增長等5個關鍵詞歸類「老化影響」；認識新朋友、朋友在一起互動、增進身心健康、增加身體活動量、增加知識、利用時間及保持獨立等7個關鍵詞歸納「消費者本身」；交通便利與否、上課學費多寡、上課次數多寡、上課時間長短及生病醫療費用等5個關鍵詞歸納「成本考量」；團體上課方式、線上上課方式、學習負荷及體力負荷等4個關鍵詞歸納「方便採用」；失智症相關資料、危險因子（跌倒、三高、憂鬱、社會互動）、朋友建議、媒體、老人機構人員介紹及醫護人員建議等6個關鍵詞歸納「溝通管道」；子女期待、朋友邀約、實際接觸、家人生病及造成別人困擾等5個關鍵詞歸納「人際影響」。第二階段研究共招募33位社區長者參與Q-分類排序，根據Q分類結果之分析共歸納出四種因素類型社區長者，各因子如下：因子 1：認同參加課程能認識新朋友並善用時間、因子2：擔心自己會因為失智而造成別人的負擔、因子 3：考量風險、成本及專家建議、因子 4：多種需求綜合考量。第三階段研究共收回282份有效問卷，根據SEM分析整體模式適配性良好，路徑分析顯示以老化影響的影響力最大，其次為消費者本身的想法，整體模式對於行為意圖解釋力為60.4%，表示當社區長者自覺老化，以及消費者本身的想法越認同預防失智症課程時，其採取參加預防失智症課程的意圖就越高。
結論：本研究同時結合6C行銷模式與被介入者（社區長者）的觀點來探討老人參與預防失智症課程意圖，並以Q方法成功的將社區長者區分為四種不同類型，也發展出適合於社區長者參與預防失智症課程可能性之測量工具，可提供未來在設計參與預防失智症課程行銷方案之應用，使方案內容更能符合社區長者的心理與實際需求，以促進社區長者對參與預防失智症課程的參與率。

Objective: This study investigated the intention of elderly individuals of the Taiwanese community to participate in dementia prevention program. The study used the 6C model of marketing. It adopted a reliable and effective method to measure the likelihood of the Taiwanese community elderly participating in dementia prevention program. In addition, a model that could predict their intention was developed.
Methods: This study was carried out in 3 stages. The 1st stage consisted of in-depth interviews, the outline of which was designed using the 6C model of marketing as the framework. The resultant interview transcript was explored by content analysis. The 2nd stage was completed using the Q-methodology. Factor extraction and categorization of the data obtained from Q-sorting was achieved via principal components analysis and varimax rotation. The 3rd stage, which consisted of a quantitative questionnaire survey, established a quantitative measurement tool for data collection based on the in-depth interview data and associated literature. Subsequently, structural equation modelling (SEM) was adopted to verify and analyze the prediction model.
Results: During the 1st stage of the study, 30 elderly people of the community were recruited for in-depth interviews. After compiling the interview transcripts, 32 keywords were identified and categorized according to the 6C model of marketing. More specifically, the 5 keywords of memory decline, blank mind, expression disorder, burden of family care, and age growth were categorized as “Aging effects”; the 7 keywords of knowing new friends, interacting with friends, improving physical and mental health, increasing physical activity, enhancing knowledge, utilizing time, and maintaining independence were categorized as “Consumers’ opinions”; the 5 keywords of traffic convenience, cost of the course, number of classes, length of the course, and medical expenses were categorized as “Cost consideration”; the 4 keywords of group class, online class, learning load, and physical load were categorized as “Convenience to participate”; the 6 keywords of dementia-related information, risk factors (fall, hypertension/hyperlipemia/hyperglycemia, depression, social interaction), recommendation by friends, media, referral by aged care staff, and recommendation by medical staff were categorized as “Communication channel”; and the 5 keywords of children’s expectation, invitation by friend, actual experience, family member’s illness, and disturbing others were categorized as “Interpersonal influence”. Alternatively, during the 2nd stage of the study, 33 community elderly people participated in Q-sorting. According to the results of Q-sorting, the participating elderly people were divided into 4 types, the factors of which were: Factor 1. Acknowledge that participation in the course can help make new friends and use time wisely; Factor 2. Worry about the fact that one may impose an extra burden onto others due to dementia; Factor 3. Consider risks, costs, and expert advice; and Factor 4. Comprehensively consider the needs from multiple perspectives. In the 3rd stage of the study, a total of 282 valid questionnaires were collected. SEM suggested that the adaptability of the overall model was superior. Path analysis showed that the most influencing factor was Aging effects, followed by Consumers’ opinions. In addition, the explanatory power of the overall model was 60.4%, which indicated that the more the community elderly felt that they were aging, or the more the consumers acknowledged the usefulness of dementia prevention program, the higher their intention to enroll in the program.
Conclusion: This study combined the 6C model of marketing with the opinions of the intervened (the community elderly) to explore elderly people’s intention to participate in dementia prevention courses. In addition, the study successfully divided the community elderly into 4 types using the Q-methodology, and on this basis developed a tool that could accurately measure the likelihood of the community elderly participating in dementia prevention program. The application of this tool in designing the marketing plan for dementia prevention program can make its content more tailored to the mental and the physical needs of the community elderly, thereby promoting their participation rates in the program.

中文部分
台灣失智症協會（2014）。世界衛生組織報告「失智症-公共衛生首要議題」摘要中譯版。2014年4月16日，取自：http://www.tada2002.org.tw/tada_event_detail.aspx?pk=190
台灣失智症協會（2021）。臺灣失智症人口推估。2021年4月，取自：http://www.tada2002.org.tw/About/IsntDementia
內政部戶政司全球資訊網（2018）。中華民國2018至2065年人口推估簡報。2018年12月，取自：https://www.ris.gov.tw/app/portal/673
呂莉婷（2017）。探討社區高齡者參與「樂智課程」之主觀需求：應用深度訪談形成 Q 陳述句的歷程研究。健康生活與成功老化學刊，9（1），23-35。
Gallo, J. J., Bogner, H. R., Fulmer, T., Paveza, G. J. （2015）。老人健康評估。（何瓊芳、呂莉婷、張倩華、曾淑芬、李百麟、洪麗玲…陳翠芳等合譯）。臺北市：華騰（原出版於2007）。
Cress, C. J.（2013）。老人照顧管理（何瓊芳、吳亮慧、吳瓊滿、呂莉婷、張佳琪、曾淑芬…陳美戎等合譯）。臺北市：華騰（原出版於2012）。
余淑吟、林品章（2010）。高齡者認知需求與廣告信任度對於廣告效果之關係。商業設計學報 ，14，69-82。
邱皓政（2011）。當PLS遇上SEM：議題與對話。αβγ量化研究學刊，3（1），20-53。
邱皓政（2012）。量化研究與統計分析：SPSS（PASW）資料分析範例解析（5版）。臺北市：五南。
邱銘章（2007）。輕度失智症患者健康促進方案成效研究。行政院衛生署委託科技研究計劃。臺北市：社團法人台灣失智症協會。
邱銘章，湯麗玉（2018）。失智症照護指南。臺北市：原水。
林淑錦、白明奇（2006）。失智症病患主要照顧者的壓力－以家庭生態觀點論之。長期照護雜誌，10（4），412-425。
徐台閣，李光武（2013）。如何決定調查研究適當的問卷樣本數。臺灣運動教育學報，8（1），89-96。
翁林仲、劉建良、楊君宜（2021）。失智症整合照護手冊：以人為本的失智症專業融合照護。臺北市：雙葉。
陳清惠、高淑真、胡夢鯨（2019）。樂齡健康促進課程規劃之研究—以預防失智症教學策略為例。長庚科技學刊，30，61-76。
陳淑敏、張澄清、吳志富（2018）。臺北市高齡學習者健康促進、人際互動及生活滿意之研究。教育科學研究期刊，63（2），127-161。
陳錫晚，陳瑛治（2019）。認知運動操對失智症預防之應用。長期照護雜誌，23（1），61-74
黃芳銘（2009）。結構方程模式：理論與應用（5版）。臺北市：五南。
黃惠玲、劉錦螢、徐亞瑛（2006）。以家庭為基礎之社區失智症照顧模式簡介。長期照護雜誌，10（4），333-342。
黃富順、林麗惠、梁芷瑄、林曉齡（2008）。我國屆齡退休及高齡者參與學習需求意向調查研究報告。教育部委託專案報告。新竹市：玄奘大學教育人力資源與發展學系。
鄧世雄（2011）。失智症整合照護。臺北市：華騰。
楊淵韓、李明濱、劉景寬（2009）。極早期阿茲海默是失智症之篩檢。台灣醫界，52（9），8-10。
楊淵韓（2018）。失智症事件簿：失智症AD-8量表在檢測什麼。臺北市：大塊文化。
傅中玲、陳正生、歐陽文貞、林克能、李光廷、宋惠娟…譚蓉瑩（2019）。失智症照護。臺北市：華杏。
趙建剛，劉文健，奚明德，曾秀蘭及馬瀰嘉（2009）。失智症之生活型態危險因子。北市醫學雜誌，6（5），341-353。
羅文輝（1986）。Q方法的理論與應用。新聞學研究，37，45-72。
英文部分
Aartsen, M. J., Martin, M., Zimprich, D., & Longitudinal Aging Study Amsterdam. (2004). Gender differences in level and change in cognitive functioning. Results from the Longitudinal Aging Study Amsterdam. Gerontology, 50(1), 35-38. https://doi: 10.1159/000074387
Anderson, J. C., & Gerbing, D. (1988). Structural equation modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103(3), 411-423. http://dx.doi.org/10.1037/0033-2909.103.3.411
Anderson, T. W., & Rubin, H. (1956). Statistical inference in factor analysis. In J. Neyman (Ed.), Proceedings of the third Berkeley symposium for mathematical statistics and probability (Vol. 5, pp. 111-150). Berkeley: University of California Press.
Bachman, D. L., Wolf, P. A., & Lin, R. (1992). Prevalence of dementia and probable senile dementia of the Alzheimer type in the Framingham study. Neurology, 42, 115-119.
Bartholomew, L. K. K., Parcel, G. S. S., Kok, G., Gottlieb, N. H. H. (2006). Planning Health Promotion Programs: An Intervention Mapping Approach. 1st ed. San Francisco: Jossey-Bass.
Boparai, J. K., Singh, S., Kathuria, P. (2018). How to Design and Validate A Questionnaire: A Guide. Current Clinical Pharmacology, 13(4), 210-215. https://doi: 10.2174/1574884713666180807151328.
Brown, S.R. (1980). Political subjectivity: Applications of Q methodology in political science. New Haven, CT: Yale University Press. (Chap 2)
Chen, S. F., Huang, S. F., Lu, L. T., Wang, M. C., Liao, J. Y., Guo, J. L. (2016). Patterns of perspectives on fall-prevention beliefs by community-dwelling older adults: a Q method investigation. BMC Geriatrics, 16: 132. https://DOI 10.1186/s12877-016-0307-1.
Chou, L.F., Fu, J.L., Wang, S.J. (2000). The economic costs of dementia in Taiwan. National Chengchi University Journal, 82: 1-25.
Coogan, J. & Herrington, N. (2011). Q methodology: an overview. Research in Secondary Teacher Education, 1(2), 24-28.
Craig Lefebvre, R. (2011). An integrative model for social marketing. Journal of Social Marketing, 1, 54-72.
Cummings, J. L. (2004). Alzheimer’s Disease. The New England Journal of Medicine, 351, 56-67. http:// DOI: 10.1056/NEJMra040223
Davis, J. J., Fournakis, N., Ellison, J. (2021). Ketogenic Diet for the Treatment and Prevention of Dementia: A Review. Journal of Geriatric Psychiatry Neurology, 34(1), 3-10. https://doi: 10.1177/0891988720901785.
De Vellis, R. F. (2003). Scale development: Theory and applications (2nd Ed.). Newbury Park, CA: Sage.
Donati, A., Pocnet, C., Rossier, J., Von Gunten, A. (2010). Personality and dementia: a new perspective. Europe PMC, 6(244), 759-761
Engel, J. F., Blackwell, R. D., and Miniard, P. W. (1995). Consumer Behavior 8th Ed., New York, NY: Dryden Press.
Eshkoor, S. A., Hamid, T. A., Mun, C. Y., Ng, C. K. (2015). Mild cognitive impairment and its management in older people. Clinical Intervention in Aging, 10: 687-93. http://doi: 10.2147/CIA.S73922.
Evans, D. A., Funkenstein, H. H., & Albert, M. S. (1989). Prevalence of Alzheimer’s disease in a community population of older persons: Higher than previously reported. Journal of the American Medical Association, 262, 2551-2556.
Exel, V. and Graff, D. G. (2005). Q methodology: A sneak preview. Retrieved from http://qmethod.org/articles/vanExel.pdf
Filipczyk, K., Smolarczyk-Kosowska, J., Kunert, Ł., Filipczyk, P., Dębski, P., Piegza, M., Pudlo, R. (2021). Physical, Cognitive and Social Rehabilitation in Relation to Sleep Quality and Cognitive Functions in the Elderly. International Journal of Environmental Research Public Health, 18(10):5148. http://doi: 10.3390/ijerph18105148.
Gale, B. T. (1994). Managing Customer Value. New York, NY: Free Press.
Glanz, K., Rimer, B. K. (2008). Health Behavior and Health Education. 4th Ed., John Wiley & Sons, Inc.
Graneheim, U. H. & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures, and measures to achieve trustworthiness. Nurse Education Today, 24(2), 105-112. http://dx.doi.org/10.1016/j.nedt.2003.10.001
Hair, J. F, Anderson, R. E., Tatham, R. L., & Black, W. C. (1998). Multivariate Data Analysis 5th Ed., Upper Saddle River, N.J.: Prentice Hall.
HELPGUIDE.ORG. (2015). Alzheimer’s and Dementia Prevention. http://www.helpguide.org/articles/alzheimers-dementia/alzheimers-and-dementia-prevention.htm. Accessed: 24 November 2015.
Herlitz, A., Airaksinen, E., & Nordstrom, E. (1999). Sex differences in episodic memory: the impact of verbal and visuospatial ability. Neuropsychology, 13(4), 590-597.
Hofman, A., Rocca, W. A., Brayne, C., Breteler, M. M. B., Clarke, M., Cooper, B., Copeland, J. R. M., Dartigues, J. F., …Amaducci, L. (1991). The prevalence of dementia in Europe: a collaborative study of 1950-1990 findings. International Journal of Epidemiology, 20, 736-748.
Homma, A., & Nina, R. (1988). Research on Alzheimer’s disease in Japan. Alzheimer Disease and Associated Disorder, 2, 366-374.
Hoyle, R. H. (1995). The structural equation modeling approach: Basic concepts and fundamental issues. In R. H. Hoyle (Ed.), Structural Equation Modeling: Concepts, issues, and applications. (pp.1-15). Thousand Oaks, CA: Sage.
Huang, L. H., Lin, Y. C. (2002). The health status and needs of community elderly living alone. The Journal of Nursing Research, 10, 227-236.
Jorm, A. F., Korten, A. E., & Henderson, A. S. (1987). The prevalence of dementia: A quantitative of the literature. Acta Psychiatrica Scandinavica, 76, 465-479.
Katzman, R., Hill, L. R., Yu, E. S. H., Wang, Z. Y., Booth, A., Salmon, D. P., Liu, W. T., Qu, G. Y., Zhang, M. (1994). Predictors of Mortality in Clinically Diagnosed Dementia in a Population Survey of Shanghai, China. JAMA Neurology, 51(12): 1220-1225. http:// doi:10.1001/archneur.1994.00540240064017.
Katzman, R. (1993). Education and the prevalence of dementia and Alzheimer’s disease. Neurology, 43, 13-20.
Kerlinger, F. (1986). Foundations of behavioral research. New York: Holt, Rinehart & Winston.
Khalsa, D. S. (2015). Stress, Meditation, and Alzheimer's Disease Prevention: Where The Evidence Stands. Journal of Alzheimer’s Disease, 48(1). 1-12. http:// doi: 10.3233/JAD-142766.
Kline, R. B. (2005). Principles and Practice of Structural Equation Modeling 2nd ed., New York: Guilford Press.
Kokmen, E., Beard, C. M., & Offord, K. P. (1989). Prevalence of medically diagnosed dementia in a defined United States population: Rochester, Minnesota, January 1, 1975. Neurology, 39, 773-776.
Kotler, P. & Levy, S.J. (1969). Broadening the Concept of Marketing. Journal of Marketing, 33, 10-15.
Kotler, P. (1982). Marketing for nonprofit organization 2nd ed., NJ: Prentice-Hall.
Kramer, J. H., Yaffe, K., Lengenfelder, J., & Delis, D. C. (2003). Age and gender interactions on verbal memory performance. Journal of International Neuropsychological Society, 9(1), 97-102.
Lee, L. K., Shahar, S., Chin, A. V., Mohd Yusoff, N. A., Rajab, N., & Azia, S. A. (2012). Prevalence of gender disparities and predictors affecting the occurrence of mild cognitive impairment (MCI). Archives of Gerontology and Geriatrics, 54(1), 185-191. https://doi: 10.1016/j.archger.2011.03.015.
Lee, H. S., Park, S. W., Park, Y. J., (2016). Effects of Physical Activity Programs on the Improvement of Dementia Symptom: A Meta-Analysis. BioMed Research International.
Livingston, G., Sommerlad, A., Orgeta, V. et al. (2017). Dementia prevention, intervention, and care. The Lancet Commissions, 390, 2673-2734.
Lou, Q., Liu, S., Huo, Y. R., Liu, M., Liu, S., Ji, Y. (2015). Comprehensive analysis of patient and caregiver predictors for caregiver burden, anxiety and depression in Alzheimer's disease. Journal of Clinical Nursing, 24(17-18), 2668-2678.
Ito, Y. & Urakami, K., (2012). Evaluation of dementia-prevention classes for community-dwelling older adults with mild cognitive impairment. Psychogeriatrics, 12, 3-10.
Maitland, S. B., Herlitz, A., Nyberg, L., Backman, L., & Nilsson, L. G. (2001). Selective sex differences in declarative memory. Memory & Cognition, 32(7), 1160-1169.
Matthews, B. R. (2010). Lifelong Learning in Neurology. Continuun, 16(2), 15-30.
Manly, J. J., Bell-McGinty, S., Tang, M. Z., Schupf, N., Stern, Y., & Mayeux, R. (2005). Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community. Archives Neurology, 62(11), 1739-1746.
McKeown, B. & Thomas, D. (1988). Q methodology. Newbury Park, Calif.: Sage Publications.
Maxwell, S. E., Kelley, K., & Rausch, J. R. (2008). Sample size planning for statistical power and accuracy in parameter estimation. Annual Review of Psychology, 59, 537-563.
Narazaki, K., Matsuo, E., Honda, T., Nofuji, Y., Yonemote, K., & Kumagai, S. (2014). Physical Fitness Measures as Potential Markers of Low Cognitive Function in Japanese Community-Dwelling Older Adults without Apparent Cognitive Problems. Journal of Sports Science and Medicine, 13, 590-596.
Ohara, T., Doi, Y., Ninomiya, T., Hirakawa, Y., Hata, J., Iwaki, T., Kanba, S., Kiyohara, Y. (2011). Glucose tolerance status and risk of dementia in the community: the Hisayama study. Neurology, 77, 1126-1134.
Parsons, T. D., Larson, P., Kratz, K., Thiebaux, M., Bluestein, B., Buckwalter, J. G., & Rizzo, A. A. (2004). Sex differences in mental rotation and spatial rotation in a virtual environment. Neuropsychologic, 42(4), 555-562.
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health Education Monographs, 2, 328-335.
Rubin, R. (2018). Exploring the Relationship Between Depression and Dementia. JAMA, 320(10). 961-962. http://doi: 10.1001/jama.2018.11154.
Schinger, M. J. (1969). Cue on q-technique. Journal of Advertising Research, 9(3), 53-60.
Seelaar, H., Rohrer, J. D., Pijnenburg, Y. A., Fox, N. C., Swieten, J. C. (2011) Clinical, genetic and pathological heterogeneity of frontotemporal dementia: a review. Journal of Neurology, Neurosurgery & Psychiatry, 82(5):476–486.
Simons, J. (2013). An introduction to Q methodology. Nurse Researcher, 20(3), 28-32. http://dx.doi.org/10.7748/nr2013.01.20.3.28.c9494
Sims-Robinson, C., Kim, B., Rosko, A., Feldman, E. L. (2010). How does diabetes accelerate Alzheimer disease pathology? Nature Review Neuroscience, 6, 551-559.
Smith, R. E., & Swinyard, W. R. (1982). Information Response Models: An Integrated Approach. Journal of Marketing, 46(1), 81-93.
Spearman, C. (1904). The proof and measurement of association between two things. American Journal of Psychology, 15, 72-101.
Steelman, T. A., & Maguire, L. A. (1999). Understanding participant perspectives: Q-methodology in national forest management. Journal of Policy Analysis and Management, 18(3), 361-388.
Stephenson, W. (1935). Technique of factor analysis. Nature, 136, 297. (Reprinted in Brown, Political subjectivity, pp. 9-10.)
Sun, Y., Lee, H. J., Yang, S. C., Chen, T. F., Lin, K. N., Lin, C. C., … Chiu, M. J., (2014). A nationwide survey of mild cognitive impairment and dementia, including very mild dementia, in Taiwan. PLoS One. 9(6): e100303. https://doi: 10.1371/journal.pone.0100303.
Van Dijk, P. T. M., Dippel, D. W. J., Habbema, D. F. (1991). Survival of Patients with Dementia. Journal of American Geriatrics Society. https://doi.org/10.1111/j.1532-5415.1991.tb03602.x
Wennberg, A. M. V., Wu, M. N., Rosenberg, P. B., Spira, A. P. (2017). Sleep Disturbance, Cognitive Decline, and Dementia: A Review. Seminars in Neurology, 37(4). 395-406. http://doi: 10.1055/s-0037-1604351.
WHO Press Release. (2012). Dementia cases set to triple by 2050 but still largely ignored. Neuroscience, 17, 296-7.
World Health Organization. (2015). Dementia. http://www.who.int/mediacentre/factsheets/fs362/en/#. Accessed: 24 November 2015.
Woodruff, R. B. (1997). Consumer value: The next source for competitive advantage. Journal of the Academy of Marketing Science, 25(2), 139-153. https://doi: 10.1007/ BF02894350.
Zeithaml, V. A. (1988). Consumer Perceptions of Price, Quality, and Value: A Means-End Model and Synthesis of Evidence. Journal of Marketing, 52(3), 2-22. https://doi: 10.2307/ 1251446.
Yonker, J. E., Eriksson, E., Nilsson, L. G., & Herlitz, A. (2003). Sex differences in episodic memory: minimal influence of estradiol. Brain and Cognition, 52(2), 231-238.
Yu, H., Wang, X., He, R., Liang, R., Zhou, L. (2015). Measuring the Caregiver Burden of Caring for Community-Residing People with Alzheimer’s Disease. PLoS ONE, 10(7), e0132168. doi:10.1371/ journal.pone.0132168.