摘要
目的：本研究應用跨理論模式，針對處於「準備期」階段的坐式生活者，介入身體活動行為策略，探討能否成就「行動期」指數，包括主動改變健康行為與積極參與規律身體活動。方法：招募34名無規律運動習慣坐式生活者，採隨機分成實驗組與控制組，每組17人。實驗組進行每週3次，連續8週介入運動課程、營養衛教及關懷等行為改變策略，後16週以身體活動量驗證介入行為改變策略的保留效果；控制組則維持日常身體活動。實驗總期程為6個月，以台灣活動量調查長版問卷（IPAQ）為身體活動量評估工具，實驗組與控制組每2個月各評估一次。所得資料以混合設計二因子變異數分析法，依工作、交通、家事、體育休閒、步行、中等費力活動、費力活動及總身體活動量等8種分項內容，比較不同組別及實驗期間（前測、中測和後測）身體活動量的差異，顯著水準訂為α=.05。結果：依據IPAQ評估結果，發現組別與實驗期間有顯著交互作用 (p <.05)，再經單純主要效果檢驗，顯示實驗組後測優於控制組的類別分別為體育休閒、中等費力、費力活動及總身體活動量；從前、中及後3個測驗中平均數觀察總身體活動量結果，實驗組從1082.38 METs、2369.62 METs增至2732.58 METs，而控制組則為724.07 METs、1017.64 METs至1361.75 METs；實驗組驗證行為改變的效果為後16週優於前8週。結論：經八週介入運動課程、營養衛教及關懷策略等，確實主動改變健康行為與積極參與規律身體活動，進而提升日常生活中不同強度的身體活動量。

Abstract
Purpose: This study was to apply transtheoretical model to intervene physical activity behavior strategies in sedentary people at preparation phase, and investigate whether indicators of action phase would be induced, including actively changing health behaviors and positively participating in regular physical activities. Methods: This study examined 34 sedentary people with no regular physical activity habits, split into experimental group and control group, each with 17 people. The experimental group underwent 3 sessions per week for 8 consecutive weeks of interventions such as exercise classes, nutritional health education and care, and the last 16 weeks were used to verify the retention of the interventions by physical activity; the control group maintained daily physical activity. The total duration of the experiment was 6 months, and the IPAQ was used as the physical activity assessment tool for experimental group and control group every 2 months. The obtained data would be analyzed by repeated measure ANOVA, and the differences between different groups and physical activity levels during the experimental period (pre-test, mid-test, and post-test) were compared by eight categories: work, transport, housework, physical recreation, walking, moderate-intensity activities, vigorous-intensity activities, and total physical activity, with a significance level was set to α=.05. Result: According to the results of the IPAQ evaluation, it was found that there was a significant interaction between the group and the experimental period (p <.05). The main effects alone showed that the experimental group outperformed the control group in the categories of
physical recreation, moderate-intensity activities, vigorous-intensity activities, and total physical activity in the posttest; pre-test, mid-test, and post-test observation showed an increase in physical activity from 1082.38 METs, 2369.62 METs to 2732.58 METs for the experimental group and 724.07 METs, 1017.64 METs to 1361.75 METs for the control group. The effect of behavioral change in the experimental group was better in the last 16 weeks than in the first 8 weeks. Conclusion: After 8 weeks of interventional exercise courses, nutrition, health educations and care, the initiative to change healthy behaviors and actively participate in regular physical activities is confirmed, thereby increase the amount of physical activity of different intensities in daily life.

參考文獻
教育部體育署（2018）。107年運動現況調查報告。臺北市：教育部體育署。
教育部體育署（2019）。108年運動現況調查報告。臺北市：教育部體育署。
教育部體育署（2020）。109年運動現況調查報告。臺北市：教育部體育署。
黃森芳、陳杰（2018）。身體活動、心肺適能與靜態心跳數做為預測死亡風險
的重要指數。台灣家醫誌，29，12-22。
衛生福利部國民健康署（2018a）。全民身體活動指引。臺北市：衛生福利部國民健
康署。
衛生福利部國民健康署（2018b）。臺灣肥胖防治策略。臺北市：衛生福利部國民健
康署。
衛生福利部國民健康署（2019）。2019年國民健康署年報。臺北市：衛生福利部國民健
康署。
臺大醫院（2020）。何謂「健康體適能」? 臺北市：臺大醫院健康電子報
自取https://epaper.ntuh.gov.tw/health/202004/history_1.html
賴鼎富、廖邕、薛名淳、林倩宇（2018）Walk Score®之相關文獻回顧：身體活動、步行行為及慢性疾病風險。台灣家醫誌，37，375-393。
Abula, K., Gröpel, P., Chen, K., & Beckmann, J. (2018). Does knowledge of physical activity recommendations increase physical activity among Chinese college students? Empirical investigations based on the transtheoretical model. Journal of Sport and Health Science, 7(1), 77-82. https://doi.org/10.1016/j.jshs.2016.10.010.
Alves, A. J., Viana, J. L., Cavalcante, S. L., Oliveira, N. L., Duarte, J. A., Mota, J., Oliveira, J., Ribeiro, F. (2016). Physical activity in primary and secondary prevention of cardiovascular disease: Overview updated. World Journal of Cardiology, 8(10), 575-583.
American College of Sports Medicine, & Bushman, B. (2017). ACSM's Complete Guide to Fitness & Health, 2E. Human Kinetics.
Castro, A. R., Oliveira, N. L., Ribeiro, F., & Oliveira, J. (2017). Impact of educational interventions on primary prevention of cardiovascular disease: A systematic review with a focus on physical activity. European Journal of General Practice, 23(1), 59-68.
Disease Prevention and Health Promotion (2018). Physical Activity Guidelines for Americans, 2nd edition. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Duijvestijn, M., Berg, S. W., & Wendel-Vos, G. C. (2020). Adhering to the 2017 dutch physical activity guidelines: A trend over time 2001–2018. International Journal of Environmental Research and Public Health, 17(3), 681. https://doi.org/10.3390/ijerph17030681
Ekelund, U., Steene-Johannessen, J., Brown, W. J., Fagerland, M. W., Owen, N., Powell, K. E., Bauman A., Lee, I. M., Lancet Physical Activity Series 2 Executive Committee & Lancet Sedentary Behaviour Working Group. (2016). Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet, 388(10051), 1302-1310. https://doi.org/10.1016/S0140-6736(16)30370-1
Elezim, A., Elezi, G., Gontarev, S., & Georgiev, G. (2019). Application of the Transtheoretical Model (TTM) to exercise behaviour among Macedonian college students. Journal of Human Sport and Exercise. 15(3) http://hdl.handle.net/20.500.12188/12050
Freitas, P. P., Menezes, M. C., Santos, L. C., Pimenta, A. M., Ferreira, A. V. M., & Lopes, A. C. S. (2020). The transtheoretical model is an effective weight management intervention: a randomized controlled trial. BMC Public Health, 20(652),1-12.
Gleeson, M., Bishop, N. C., Stensel, D. J., Lindley, M. R., Mastana, S. S., & Nimmo, M. A. (2011). The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nature Reviews Immunology, 11(9), 607-615.
Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., Ekelund, U., & Lancet Physical Activity Series Working Group. (2012). Global physical activity levels: surveillance progress, pitfalls, and prospects. The lancet, 380(9838), 247-257.
Haskell, W. L., Lee, I. M., Pate, R. R., Powell, K. E., Blair, S. N., Franklin, B. A., Macera C. A., Heath G. W., Thompson P. D.,& Bauman, A. (2007). Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation, 116(9), 1081-1093.
Liu, K. T., Kueh, Y. C., Arifin, W. N., Kim, Y., & Kuan, G. (2018). Application of transtheoretical model on behavioral changes, and amount of physical activity amoingamong university’s students. Frontiers in Psychology, 9(2402), 1-8. https://doi.org/10.3389/fpsyg.2018.02402
Lynn, J., Urda, J., & Winters, C. S. (2015). Slippery Rock University: A Case Study of Success in Exercise is Medicine® On Campus. ACSM's Health & Fitness Journal, 19(4), 34-36.
Mainous, A. G., Tanner, R. J., Anton, S. D., Jo, A., & Luetke, M. C. (2016). Physical activity and abnormal blood glucose among healthy weight adults. American Journal of Preventive Medicine, 53(1), 42-47. https://doi.org/10.1016/j.amepre.2016.11.027
Nes, B. M., Gutvik, C. R., Lavie, C. J., Nauman, J., & Wisløff, U. (2017). Personalized activity intelligence (PAI) for prevention of cardiovascular disease and promotion of physical activity. The American Journal of Medicine, 130(1), 328-336.
Pedersen, B. K., & Saltin, B. (2015). Exercise as medicine–evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian journal of medicine & science in sports, 25, 1-72.
Planchard, J. H., Corrion, K., Lehmann, L., & d'Arripe-Longueville, F. (2018). Worksite physical activity barriers and facilitators: A qualitative study based on the Transtheoretical model of change. Frontiers in public health, 6, 326.
Pollock, M. L. (1973). The quantification of endurance training programs. Exercise and Sports Science Reviews, 1(1), 155-188. doi.org/10.1249/00003677-197300010-00010
Prochaska, J. O., & Marcus, B. H. (1994). The transtheoretical model: Applications to exercise. Advances in Exercise Adherence, 161–180.
Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1993). In search of how people change: Applications to addictive behaviors. Addictions Nursing Network, 5(1), 2-16.
Romain, A. J., Bortolon, C., Gourlan, M., Carayol, M., Decker, E., Lareyre, O., Ninot G., Boiche J., & Bernard, P. (2018). Matched or nonmatched interventions based on the transtheoretical model to promote physical activity: A meta-analysis of randomized controlled trials. Journal of Sport and Health Science, 7(1), 50-57. https://doi.org/10.1016/j.jshs.2016.10.007
Saeidi, A., Mirzaei, A., Mahaki, B., Jalali, A., & Jalilian, M. (2018). Physical activity stage of change and its related factors in secondary school students of Sarableh city: A perspective from Iran. Open Access Macedonian Journal of Medical Sciences, 6(8), 1517-1521.
Thompson, W. R., FACSM (2021). Worldwide survey of fitness trends for 2021. ACSM's Health & Fitness Journal, 25(1), 10-19. https://doi.org/10.1249/FIT.0000000000000631
Wen, C. P., Wai, J. P. M., Tsai, M. K., Yang, Y. C., Cheng, T. Y. D., Lee, M. C., Chan, H. T., Tsao, C. K., & Wu, X. (2011). Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study. The lancet, 378(9798), 1244-1253.
Wilson, O. W. A., Bhuiyan, N., Papalia, Z., & Bopp, M. (2018). The implementation and outcomes of Exercise is Medicine on Campus. Translational Journal of the American College of Sports Medicine, 3(20), 158-168. https://doi.org/10.1249/TJX.0000000000000071
Winters, C., & Sallis, R. E. (2015). Five steps to launching Exercise is Medicine® in your campus. ACSM's Health & Fitness Journal, 19(4), 28-33.
World Health Organization (2010). Global recommendations on physical activity for health.
file:///C:/Users/user/Downloads/9789241599979_eng%20(2).pdf
World Health Organization (2018). Global action plan on physical activity 2018–2030: more active people for a healthier world. https://www.who.int/publications/i/item/9789241514187