背景與目的：近兩年，隨著COVID-19疫情的爆發，民眾待在室內的時間漸漸變長，室外空氣污染對民眾的威脅或許暫時性的減緩，不過相對的，民眾卻在不知不覺的情況下，不斷暴露到各種各樣的室內空氣污染物(包括：CO2、O3、NO2、PM2.5或PM10等)，根據美國環境保護署的數據，在某些情況下，室內空氣污染物的濃度可能是室外的2到5倍。在目前室內空氣污染未受足夠重視與周延監管的情況下，民眾更應該要具備「取得」、「瞭解」、「評估」和「應用」室內空氣品質(Indoor air quality，IAQ)和健康狀況不良之間相關性資訊取得，以增加自己的室內空氣污染健康識能以及室內環境管理的能力。為了調查目前我國成年民眾的室內空氣污染健康識能，以作為未來擬定介入策略的背景資訊，本研究旨在發展一份適合我國的室內空氣污染健康識能的評估工具，並利用此份經信效度驗證之工具來探討我國一般成年民眾室內空氣污染健康識能的程度以及影響因素。
方法：本研究採用橫斷式研究設計，以歐盟健康識能量表(Health Literacy Europe)發展架構為基礎，依據資訊「取得」、「瞭解」、「評估」、與「應用」等四個構面，加上健康照護、疾病預防、健康促進等疾病三段預防構面，從個人層次到群體(法規)層次，發展一份涵蓋38個題項的本土室內空氣污染健康識能量表。本研究針對此工具進行內容效度、表面效度、與建構效度驗證，以及內部一致性信度與再測信度之驗證。本研究的樣本是20歲以上的成年民眾，按居住分為四個地理區域(北、中、南、東)，並考量各地人口之年齡與性別配置後採配額取樣，並以滾雪球取樣法針對受訪樣本進行網路線上訪問，訪視資料蒐集期間自民國110年9月18日開始，至11月24日止。本研究以次數分配與百分比來描述樣本之特徵，計算平均數與標準差來描述室內空氣污染健康識能四個構面之平均分數，也採用一般線性迴歸模式之廣義估計方程式法來檢定四個構面的平均分數是否達統計上之顯著差異。另外也透過多元線性迴歸分析，探討影響民眾室內全構面以及構面別空氣污染健康識能分數的顯著影響因子。
結果: 本問卷所測量的4與12個構面在驗證性因素分析中的五項建構效度指標皆有不錯的結果(RMSE=0.07、0.07；SRMR=0.06、0.06；CFI=0.84、0.90；NFI=0.80、0.83；TLI=0.83、0.90)；而專家效度分析結果為：內容關聯性、重要性以及明確性之CVI值分別為0.98、0.97與0.93；另外，在收斂效度中，發現不同教育程度或不同年齡者的識能平均分數是有顯著差異的；而在區辨效度中則發現民眾看電視時長短與其室內空氣污染識能呈低度相關；並且整體問卷也具有良好的內部一致性(Cronbach’s α= 0.952)與再測信度(ICC=0.937)。在描述性統計中，共647份問卷納入分析，在經過資料加權後，全構面室內空氣污染健康識能的平均分數與標準差為2.51(±0.57)，而特定構面分數則是呈現，最高分與最低分分別為「瞭解」(2.63±0.67)與「評估」構面(2.41±0.59)；而透過多元線性迴歸分析，在控制其他變項後，找出了影響民眾室內空氣污染健康識能之總構面平均分數之變項與其識能之間的相關性， 我們發現65歲以上的人與那些平均每天待在室內的時間較少者都有顯著較高的整體室內空氣污染健康識能分數。我們還發現，在工作中無法獲取室內空氣污染資訊、目前吸菸或曾經吸菸但已戒菸、不願將收入用於購買有利於室內空氣污染改善的物品、在室內環境中會接觸二手菸者，以及不熟悉會影響室內空氣品質東西的人，皆有顯著較低的整體室內空氣污染健康識能分數。
結論：本研究所發展的量表是全世界第一個且具有不錯信效度之室內空氣污染健康識能評估工具，可以做為日後提升室內空氣污染健康識能介入措施有效性評估之用；並於結果發現我國民眾在「評估」構面的識能分數最低，未來應針對提升評估有關室內空氣污染與健康資訊能力研擬提升計畫；另外透過全國性樣本之調查，發現其中有8個變項皆會顯著影響民眾整體室內空氣污染健康識能，這些結果可以做為我國成年民眾室內空氣污染健康識能不足風險特徵辨識之參考訊息。

SUMMARY
The purpose of this project was to develop an indoor air pollution health literacy instrument and to find out the public awareness of various air pollutants that may cause health risks. In this cross-sectional study, the instrument (questionnaire), including 38 items based on the theoretical model of the previously developed Ambient Air Pollution Health Literacy Assessment Scale and the EU Health Literacy Scale, was developed through expert meetings, cognitive interviews, expert review, and the final revision. While internal consistency reliability and test-retest reliability were assessed for the instrument, confirmatory factor analysis, convergent and discriminant validity, and expert validity were used to indicate the validity of the instrument. We used quota-sampling to collect 647 adult participants aged 20 years or older around Taiwan and to conduct web-interviews between September 18 to November 24, 2021. These 647 subjects were weighted by gender, age, and region of living in the analysis. The results showed the highest and lowest indoor air pollution health literacy score noted for “understand” and “appraise” domain, respectively; and there was significant difference in the mean scores among the 4 domains. The analysis of multiple linear regression model indicated 8 factors significantly associated with indoor air pollution health literacy including: age, job employment, smoking history, amount of income spent to purchase goods that can improve indoor air pollution, exposure to second-hand smoke in the indoor environment, perception of situations that can affect indoor air quality, having access to indoor air pollution information at work, and daily number of hours spent in an indoor environment.

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