健康識能課程與教學實踐探究：批判性識讀觀點

Investigation on the Practice of Health Literacy Curriculum and Instruction: The Critical Literacy Perspective

健康識能是健康促進的一環，是達成健康成果的中介因素。本研究採批判性識讀 觀點，探究研究者於任教的成人識讀教育研究課程與教學實踐經驗，以瞭解其特色和 學生學習成效，以及教學實施遇到的議題，作為後續健康識能教育實務和研究發展的 參考。研究對象共有11 人。課程中融入健康識能議題，於作業中要求學生進行健康 專題探究。研究檢視學生課堂學習過程的回饋、期中和期末作業，以及期末問卷回饋 等資料。結果發現，本研究的課程與教學呈現一個含括三項相互輔助元素的模式：以 批判性識讀為核心；兼顧理論與實務，並將微觀的議題放到鉅觀脈絡中檢視；以及運 用多樣化教學活動設計，以協助學生近用、理解與使用健康資訊。在學習成效上，學 生從內容、過程與前提的反思中，逐漸產生批判性健康識能。在前提反思時，能進入 個人的價值觀與生活態度層次。其次，學生不僅擴大了對於成人識讀教育內涵和相關 議題的理解，改變過去對識讀、健康和健康識能內涵的認識，並且體會到識讀的增能 意涵，學生的健康識能也因從事健康專題探究而得以提升。其三，學生健康識能學習 成效進一步顯現在其健康行為、態度與信念上改變，對他們的生活型態有所影響，並 且更能覺察影響健康的因素。最後，本研究並提出未來實務發展及研究上的建議。

Health literacy is a part of health promotion and also an element to achieve health outcome. This study uses the critical literacy perspective as the rationale to explore my teaching practices， including their characteristics and outcomes and the related issues of health literacy education in a graduate course--Study in Adult Literacy Education. Totally， there were 11 students in this research. Health literacy issues were included in the course， and students were asked to critically reflect upon their health issues in daily lives. Data collected and analyzed included students’ reflection during the course， their midterm and final homework reports， and questionnaires at the end of the semester. The results show that the model of curriculum and instruction contains three mutual supporting elements as follows: Firstly， it sets critical literacy as the core rationale. Secondly， it integrates theories and practices， and examines micro issues on macro contexts. Thirdly， it uses a variety of teaching activities to help students access， understand and use health information. In terms of learning outcomes， firstly， students develop their critical health literacy by reflecting upon contents， processes and premises of their learning. Secondly， students not only expand their understanding of the significance of adult literacy education and relevant issues， change their concepts about literacy， health and health literacy， but also embody the empowerment of literacy. Students’ health literacy is enhanced by the combination with personal reflection and action to do research on their own health issues. Thirdly， students change their health behaviors， attitudes and beliefs， and thus have impacts on their lifestyles， and also are more conscious of the affecting factors of their health. Finally， this study also addresses the issues of how to develop curriculum and instruction on health literacy education and advances research in the future.