目的：身體活動量不足是高齡者健康的危險因子，但步行行為被認為是最適合高齡者身體活動的方式，而環境是影響一個個人是否從事步行行為的重要因素，因此本研究旨在瞭解臺灣65歲以上高齡者之認知環境因素與休閒娛樂步行及交通步行之關聯性。方法：本研究以電話訪談方式調查臺灣高齡人口之認知環境因素及從事休閒娛樂步行、交通步行的時間，共取得1,028份有效樣本，並以邏輯斯迴歸進行分析。結果：一、高齡者每週休閒娛樂步行未達150分鐘比例為45.8%；高齡者每週交通步行未達150分鐘比例為78.6%。二、教育程度越低、擁有全職工作的高齡者較難達成每週150分鐘的休閒娛樂步行；居住在南、東部及外島地區、擁有私人運輸工具者較難達成每週150分鐘的交通步行。三、高齡者認知到住家附近商店及休閒設施的易達性越高，有充足的人行道設置、社會環境、周遭景觀及充足的目的地時越會從事休閒娛樂步行 (商店易達性：OR= 1.48；95% CI=1.06-2.05、休閒設施的易達性：OR= 1.56；95% CI=1.15-2.11、人行道設置：OR= 1.47；95% CI=1.13-1.90、社會環境：OR=1.34；95%CI=1.01-1.79、周遭景觀者：OR= 1.31；95% CI=1.01-1.69、目的地的多寡：OR=1.46；95%CI=1.06-2.02)。四、高齡者認知具有足夠的人行道及充足目的地的較容易從事交通步行 (人行道的設置：OR=1.83；95%CI=1.28-2.63、目的地的多寡：OR=2.10；95%CI=1.33-3.30)。結論：未來針對臺灣高齡者提出有關提升休閒娛樂步行或交通步行時間的方案時，可先針對居住於南、東部及外島地區、教育程度較低、擁有全職工作的高齡者進行相關介入，以便進一步改善其步行時間不足之問題；另外建議各縣市政府及相關單位設計行為改變策略及方案時，可使用觀察學習及認識住家附近景點等方式提升高齡者的認知，並將改善人行道設置的完備性及提升大眾交通工具易達性作為重點改善項目。

Aims: Physical inactivity is a risk factor for the health of the elderly. Walking behavior has been considered as a recommended type for elderly to engage in physical activity. According to ecological model, the perceptions of environment are important factors affecting whether an individual is engaged in walking behavior. Therefore, the purpose of this study is to understand the relationship of the perceived environmental factors with leisure and transport-related walking behavior among Taiwanese elderly. Methods: A telephone-based cross-sectional survey of Taiwanese elderly was conducted in November 2016. Data related to personal factors, perceived environmental factors, and time spent in transportation-related and leisure walking were obtained from 1,028 elders. The data were analyzed by performing adjusted binary logistic regression. Results: After adjusting for potential confounders, the access to shops (AS), presence of sidewalks (PS), access to recreational facilities (AR), seeing people being active (SA), aesthetics (AE) and the presence of a destination (PD) were positively associated with 150 minutes of walking for leisure (AS: odds ratio [OR] = 1.48; 95% confidence interval [CI]: 1.06-2.05; PS: OR = 1.47; 95%CI: 1.13-1.90; AR: OR = 1.56; 95%CI: 1.15-2.11; SA: OR = 1.34; 95%CI: 1.01-1.79; AE: OR = 1.31; 95%CI: 1.01-1.69; PD: OR = 1.46; 95%CI: 1.06-2.02). Two perceived environmental factors, namely the presence of sidewalks (PS) and the PD were found to be positively associated with 150 minutes of walking for transportation (PS: OR = 1.83; 95% CI: 1.28-2.63; PD: OR = 2.10; 95%CI: 1.33-3.30). Different personal and perceived environmental factors were also associated with walking for leisure and transportation, respectively. Conclusions: These findings suggest that policy makers and physical activity intervention designers should develop both common and different environmental strategies in order to improve and increase awareness of the neighborhood environment to promote leisure and transportation walking behaviors among older adults.

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