Summary: | 碩士 === 國立臺灣大學 === 健康政策與管理研究所 === 101 === Objective: To investigate behavior patterns, onset of betel nut chewing, and the influential factors among students from 4th to 12th Grade.
Methods: Data was obtained from the second cohort of the Children and Adolescent Behaviors in Long-term Evolution project. The original sample numbers were 2,687 students on 4th Grade. Participants included 2,295 students who were followed from 4th to 12th Grade(2001-2009) and completely answered specific items for group-based trajectory model and logistic regression analysis. On the other hand, after excluding the missing values and already had chewed betel nuts on 4th Grade, 2,043 participants for survival analysis. 5 individual-level factors, 6 environmental-level factors, and other 2 behavior-level factors were studied the relation to the behavior patterns and onset of betel nut chewing.
Results: 1.The highest proportion of betel nut chewing among nine grades was on 12th Grade(3.46%), and the lowest proportion was on 6th Grade(0.29%). The highest incident rate of betel nut chewing was 0.02 on 11th and 12th Grade. Besides, the highest hazard rate of beginning betel nut chewing was 0.02 on 11th Grade. During nine years, the cumulative proportion of never chewing was 0.93. 2.There were 2 trajectory patterns of betel nut chewing, including "continuing not chewing"(93.90%) and "the chewing probability obviously increasing"(6.10%). 3.Male, living in Hsinchu County, having had experiences on smoking or drinking, and surrounding peers or friends chewing betel nuts, which caused the increasing chewing probability and earlier onset of betel nut chewing.
Conclusion: The proportion of betel nut chewing increased with time going by, and 11th Grade might be the critical time of onset among students from 4th to 12th Grade. Based on the findings we recommend that the betel nut prevention should start from the elementary-school stage, construct supportive environment without betel nuts, and consider male students with having had smoking or drinking experiences, poor course performance, or poor family support to educate. On political aspect, we should place importance on the cluster effect between smoking, drinking, and chewing betel nuts together when progressing betel nut prevention programs.
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