conference in public health and preventive medicine 2010...

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Conference in Public Health and Preventive Medicine 2010「公共衛生及預防醫學」學術會議

Health Promoting Schools in Taiwan ：Present Status and Future

Perspectives台灣健康促進學校現況與展望Prof. Song-yuan Huang黃松元教授

Department of Health Promotion and Health Education

National Taiwan Normal University, Taipei, Taiwan

Hong Kong6th-8th November 2010

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大綱Ⅰ. Introduction 緒言

Ⅱ. Major Health Problems Among the Students in Taiwan 台灣學生主要健康問題Ⅲ. The Organizations Responsible for Implementing the School Health Programs 負責推動學校衛生計劃的機構

Ⅳ. Development of Health Promoting Schools in Taiwan (in Brief) 台灣健康促進學校發展概況

Ⅴ. Future Perspectives 未來展望Ⅵ. Concluding Statements 結語

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Ⅰ. Introduction 緒言

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Ⅰ. Introduction 緒言 Educational culture and changes in health indicators are the

two most important conditions and characteristics in relation to school health in Taiwan. The interaction of the effects of these two factors creates challenges and opportunities for school health innovations and leadership.

教育文化和健康指標的改變是關係到台灣學校衛生最重要的兩項狀況和特徵。這兩項因素的交互作用為學校衛生的創見和領導提供了挑戰和機會。

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Ⅰ. Introduction 緒言 Prior to 2001, implementation of school health in Taiwan was

essentially based on the model of the traditional school health program that consists of health services, health instruction, and the healthy school environment.

2001 年之前，台灣學校衛生之推動基本上是基於傳統

學校衛生計畫模式，包括健康服務、健康教學和健康環境。

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Ⅰ. Introduction 緒言 In 2003, Taiwan began to adopt the new model of chool health

– the “health promoting school” (HPS) – to implement a variety of school health programs for the sake of promoting the health of students, teachers, staff, parents, and community residents.

及至 2003 年，台灣開始採行學校衛生工作新模式─健

康促進學校 (HPS) ，推動各項學校衛生計畫，以促進學生、教職員、家長及社區居民的健康。

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Ⅰ. Introduction 緒言 In 2002, the School Health Act was promulgated which was a

highly important milestone in the development of school health in Taiwan.

值得一提的是，「學校衛生法」於 2002 年公布施行，

此為台灣學校衛生發展上的重要里程碑。

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Ⅱ. Major Health Problems Among the Students in Taiwan 台灣學生主要健康問題

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Ⅱ. Major Health Problems Among the Students in Taiwan

The students in Taiwan now are facing a variety of health problems which are harmful to their health. The major health problems are as follows:

台灣各級學校學生目前仍面臨著許多對其健康有害的問題，主要的問題如下：

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1. Smoking 吸菸 2. Betel nuts chewing behavior 嚼檳榔行為3. Physical inactivity身體活動不足4. Obesity 肥胖5. Myopia 近視 6. Dental caries 齲齒7. Suicide 自殺 8. Communicable diseases 傳染病 9. Sexual behavior and AIDS性行為與愛滋病

10. Unintentional injuries 事故傷害11. Stress 壓力 12. Drug abuse 藥物濫用


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Table 1.

The smoking prevalence rate among junior high and senior high school students in Taiwan.

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2004(%) 2006(%)

2005(%)

2007(%)

Junior high

Males 8.5 9.7

Females 4.2 4.7

Seniorhigh

Males 21.1 19.3

Females 8.5 9.1

Source: Taiwan Bureau of Health Promotion, Departmant of Health, Taiwan. 台灣衛生署國民健康局。

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The Taiwan Youth Health Survey (TYHS), completed by the BHP in 2006, found that the major health problems among junior high school students in Taiwan were obesity, physical inactivity, improper body image, violence, physical fighting, injuries, insomnia, suicide, low self-esteem, smoking, drinking, betel nuts chewing behavior, drug abuse, and sexual behavior

由國民健康局於 2006 年完成的「台灣青少年健康調查」發現國中生主要的健康問題包括肥胖、身體活動不足、不恰當的身體意象、暴力、打架、傷害、失眠、自殺、低自尊、吸菸、飲酒、嚼檳榔、藥物濫用及性行為。

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Ⅲ. The Organizations Responsible for Implementing the School Health Programs 負責推動學校衛生計劃的機構

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Ⅲ. The Organizations Responsible for Implementing the School Health Programs

1. Ministry of Education 教育部 (1) School Health Committee 學校衛生委員會 (2) Department of Physical Education →Division of School Health

體育司學校衛生科2. Department of Health, Executive Yuan 行政院衛生署 (1) Health Education Implementation Committee 衛生教育推動委員會 (2) Bureau of Health Promotion 國民健康局 a. Health Education Center 衛生教育中心 b. Division of Child and Adolescent Health 兒童及青少年保健組

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3. Ministry of Interior → Bureau of Children 內政部兒童局4. National Taiwan Normal University →Department of Health Promotion and Health Education 國立臺灣師範大學健康促進與衛生教育學系5. National Taipei University of Education →Graduate Institute of Life Education and Health Promotion 國立台北教育大學生命教育與健康促進研究所 6. Local governments, including departments of health,

education, environmental protection, and social welfare. 地方政府，包括衛生、教育、環境保護及社會福利等局、處

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7. NGOs 非政府組織 (1) National School Health Association, Republic of China（ 1961 ）中華民國學校衛生學會


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(2) School Nurses Association of the

Republic of China （ 1996 ）


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(3) Taiwan Health Promotion and Education Association （ 1980 ）


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（ 4 ） Taiwan Public Health Association （ 1972 ）

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8. Schools 各級學校 (1) School Health Committee 學校衛生委員會 (2) Office of Student Affairs 學生事務處 →Health Care Section 衛生保健組 →Health Center / Service 健康中心


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Ⅳ. Development of Health Promoting Schools in Taiwan (in Brief) 台灣健康促進學校發展概況

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2002 1.Promulgation of the School Health Act with 29 articles. 「學校衛生法」開始施行 2.The Ministry of Education （ MOE ） and Department of Health （ DOH ） form a collaborative team. 教育部與衛生署組成合作小組

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Ⅳ. Development of Health Promoting Schools in Taiwan ( in brief)

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2003 1.The DOH publishes the “Guidelines for Health Promoting Schools” . 衛生署編印「健康促進學校工作指引」 2.The International Workshop on Health Promoting Schools in Taiwan is held jointly by the MOE and DOH in Taipei, Taiwan. 教育部與衛生署於台北市聯合召開台灣健康促進學校工作坊

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2004 1.The National School Health (Ⅰ) Association of the Republic of China conducts the Health Promoting School Supervision Program under contract with the DOH. 中華民國學校衛生學會接受衛生署之委託執行健康促進學校督導計畫

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2004 2.A pilot study for health promoting ( ) Ⅱ school in 50 primary, junior high, and high schools is conducted cooperatively by the MOE and DOH. 教育部與衛生署合作推動五十所國小、國中及高中健康促進學校實驗計畫

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2005 1.The Health Promoting School Supporting Network is established jointly by the MOE and DOH. The structure of the Network depicted in Fig.1 教育部與衛生署聯合建構健康促進學校支持網絡，其組織如圖 1 所示

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International cooperation

Mon

itorin

g an

d

Asse

ssm

ent S

yste

mSupervisory and Supporting Network Project

Teaching Resource Development Center

Education and Training Center

Health Communication

and Media Center

Health Promoting

School Network Platform

Health promoting

school

Policy

plan

Fig.1 Health promoting school supporting network in Taiwan

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The Health Promoting School Supporting Network consists of three major domains: the Policy Plan, the Monitoring and Assessment System, and International Cooperation. Through the operation of the Teaching Resource Development Center, the Education and Training Center, the Health Communication and Media Center, the Health Promoting School Network Platform,

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and the Supervisory and Supporting Network Project, a variety of school health programs have been carried out for the majority of primary, junior high, and high schools in Taiwan. The Network is implemented for three years from 2005 to 2007.

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健康促進學校支持網絡包括三大領域：政策規劃、監控與評估系統，以及國際合作。透過教學資源發展中心、教育與訓練中心、健康傳播與媒體中心、健康促進學校網絡平台，以及督導與支持網絡計畫的運作，已經為大多數台灣的中小學推動許多學校衛生計畫。此項網絡自2005 年至 2007 年運作，為期三年。

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2.The MOE publishes the 4th edition of the School Health Guidelines based on the health promoting school concept and its six domains.

教育部根據健康促進學校的概念及其六大範疇出版第四版學校衛生工作指引3.318 primary, junior high, and high schools

become the health promoting schools. 318 所中小學成為健康促進學校

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2006 1.516 primary, junior high, and high schools become the health promoting schools. 516 所中小學成為健康促進學校 2.The First Asia-Pacific International Conference on Health Promoting Schools is held in Taipei, Taiwan. 第一屆亞太地區健康促進學校國際會議在台灣台北召開

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2007 1.773 primary, junior high, and high schools become the health promoting schools. 773 所中小學成為健康促進學校

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2008 1.The name of the Health Promoting (Ⅰ) School Supporting Network is changed to The Taiwan Health Promoting School’s Promotion Center under the joint administration of the MOE and DOH. The Center focuses on three domains: guidance, marketing and networking. The structure of the Center is depicted in Fig.2.

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2008 「健康促進學校支持網絡」易名為「台灣健康促進

學校推動中心」，著重輔導、行銷及網絡三個領域，其組織如圖 2 所示

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台灣健康促進學校推動中心運作機制架構圖

指標監測與回饋組

媒體傳播與行銷組健康促進學校推動中心

民間團體、企業、家長會組織教育訓練組

教材匯集研發組

網路建置與維護組政府政策完成指標監測促使成效顯彰

媒體地方行銷提供回饋機制規劃人力經費支持教材提供網路學習研發數位教材

教育訓練提供課程教材需求課程教材提供教育訓練夥伴關係資源協力

強化輔導成效提供地方行銷媒體傳播促成輔導深化

輔導支持網絡運作組37 圖 2. 台灣健康促進學校推動中心之運作機制。資料來源：教育部。

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2.All the 3871 primary, junior high, and high schools become the health promoting schools. 所有 3871 所中小學都成為健康促進學校

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2008

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1.An international conference entitled ”2009 Taiwan Health Promoting Schools” is held in Taipei, Taiwan 「 2009 年台灣健康促進學校」國際會議在台灣台北召開

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2009

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2.A group of 19 delegates from Macau visit Taiwan with the goal of learning about the present status of health promoting schools 澳門十九人代表團訪問台灣以了解健康促進學校實施現況

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2009

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1.The Taiwan Health-promoting School’s Promotion Center continues to operate. 台灣健康促進學校推動中心繼續運作 2.The Student Health Literacy Improvement Project is launched 學生健康素養改進計畫正式展開

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Ⅴ. Future Perspectives 未來展望

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Although school health in Taiwan has improved quite a lot in the past six decades, there are still many challenges that the school health personnel face and should strive to overcome. The following are recommendations for the sustainable development of school health in Taiwan in the twenty-first century.

雖然過去六十年，台灣的學校衛生已經有長足的進步，但是學校衛生人員仍然面臨許多有待克服的挑戰。此處提出一些建議，做為二十一世紀台灣學校衛生永續發展的參考。

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Ⅴ. Future Perspectives

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1. School Health Policy and Administration(Ⅰ) 學校衛生政策與行政 • Enhance the School Health Act that was promulgated

on February 6, 2002 with 29 articles 強化學校衛生法 • Develop and promulgate the Health Promotion Act 訂頒健康促進法 • Develop the professional certification system for health

promoters and health educators 為健康促進及健康教育人員發展專業認證制度

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1. School Health Policy and Administration(Ⅱ) • Upgrade the performance of the Division of School Health

in the MOE to administer and coordinate school health programs 提升教育部學校衛生科的功能

• Ensure an adequate budget for the field of school health in order to help promote the health of students, teachers, and staff 編列適當的學校衛生經費以促進學生及教職員的健康

• Designate professionally trained teachers or supervisors to Implement school health programs

指定訓練有素的教師或督導人員，負責推動學校衛生計畫

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2. School Health Services 學校健康服務 • Improve health examinations for students 改進學生健康檢查 • Upgrade the quality of health services for disabled

students 提升為身心障礙學生所提供的健康服務的品質 • Reinforce the functions of the school health

center/service 強化健康中心的功能 • Recognize the importance and expanded role of the

school nurse in promoting student health 認同學校護士在促進學生健康上的重要性及擴大的角色46


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3. School Health Instruction 學校健康教學 • Reinforce the health education curriculum for grades

1–10 and increase time allotment for teaching it

強化一至十年級健康教育課程及增加授課時數 • Expand the number of health education professional

preparation programs offered at institutions of higher learning 擴充提供健康教育專業培育計畫之大學校數

• Enhance in-service training programs for health teachers 強化健康教育教師在職研習

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4. Healthful School Environment (Ⅰ) 學校健康環境 • Improve the healthful school environment, including

the physical and social aspects 改善學校物質及社會環境 • Reinforce safety education and first-aid training for the

teachers and students 加強教師及學生安全教育與急救訓練

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4. Healthful School Environment (Ⅱ) 學校健康環境 • Continue to implement smoking education and drug

education programs for the sake of establishing a smoke-free and drug-free school environment 持續推動吸菸教育及藥物教育計畫，以建立無菸及無毒校園

• Strengthen the implementation of the “Grand Project for Building a Friendly Campus” 加強推動「友善校園總體營造計畫」

• Improve interpersonal relationships on and off campus 改善校內外人際關係49


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5. School Health Survey and Research(Ⅰ) 學校衛生調查與研究 • Conduct more research projects focused on

intervention and information dissemination in order to demonstrate the effectiveness of the health education curriculum in improving the health knowledge, attitudes, practices, and skills of students 進行更多在介入與資訊散播方面的研究以展示健康教育課程在改進學生健康知識、態度、習慣和技能上的成效。

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5.School Health Survey and Research(Ⅱ) 學校衛生調查與研究 • Periodically plan and implement a nationwide school

health study that is similar to the School Health Policies and Programs Study (SHPPS) and the School

Health Profiles conducted in the United States in order to examine the accountability and effectiveness of school health programs 定期規劃及執行全國性學校衛生調查，有如在美國所進行之「學校衛生政策與計畫調查」及「學校衛生剖析」，以檢視學校衛生計畫的可行性及成效

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6. Communication and Collaboration with Domestic and International Professional Organizations (Ⅰ) 與國內及國際專業性組織之溝通與合作 • Involve more private and professional organizations in

the effort of improving child and adolescent health 納入更多的私人及專業性組織共同努力增進兒童及青少年的健康

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6. Communication and Collaboration with Domestic and International Professional Organizations (Ⅱ) 與國內及國際專業性組織之溝通與合作 • Improve the exchange of information and participation

in school health programs between Taiwan and other countries and international organizations such as the International Union for Health Promotion and Education (IUHPE) 改進台灣與其他國家以及國際性組織 ( 如國際健康促進暨教育聯盟 )在學校衛生計畫方面的資訊交流與參與

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Ⅵ. Concluding Statements 結語

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The twenty-first century is still the era of health promotion. To promote the health of children and adolescents in Taiwan, school health professionals need to do much more regarding the enforcement of laws and regulations, improving professional training, and developing organization/community empowerment. Resource mobilization, fund raising, evaluation of the effectiveness of school health programs, the promotion of lifestyle changes, and an increase in international collaboration are also very important.


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二十一世紀仍然是健康促進的年代。為了促進台灣兒童及青少年的健康，學校衛生人員必須在強化法令規章、改進專業訓練，以及發展組織 / 社區賦權方面多所著力。資源流通、募款、學校衛生計畫成效評價、生活方式改變的促進，以及國際合作的增進亦一樣非常重要


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