研究背景
隨著全球氣候變化和都市化進程加快，登革熱作為一種社區性傳染病，在全球已爆發超過百次大規模的傳染。面對登革熱疫情，社區居民的認知、態度和行為在登革熱防治中扮演著至關重要的角色。因此透過創新策略提升居民的登革熱認知、態度和行為將成為控制登革熱傳播的關鍵策略。
研究目的
以設計思考針對居民的需求發展多元登革熱防治策略，並探討其在提升社區居民對於登革熱防治的認知、態度及行為改變的成效。
研究方法
採質量混合前實驗性研究設計，以立意取樣挑選介入台南某社區，共招募24位居民，運用設計思考發展多元登革熱防治策略作為介入措施，觀察社區居民對於登革熱防治的認知、態度及行為改變。本研究以結構式量表於介入前後對居民進行施測，並透過焦點團體訪談收集質性反饋。量性資料分析使用 SPSS 27 版軟體進行，透過成對t檢定、相關性檢定以及線性回歸檢視社區居民在設計思考策略介入前後，認知、態度及行為構面分數的變化，評估策略介入的短期效果，並用獨立樣本t檢定、單因子變異數分析分析社會人口學變項及過去防疫經驗對認知、態度及行為的影響；而質性訪談資料將由研究者分類並提煉主題進行分析，透過質量結果互相驗證以豐富研究結果的深度與廣度。
研究結果
本研究依據設計思考流程發展多元登革熱防治策略，以六種設計思考工具深入了解社區居民的需求與挑戰，定義出社區居民的心態(Mindset)後研發出創新衛教教案如「猜題大考驗」、「花花草草能防蚊」、「大地遊戲」和「誘殺桶DIY」，不斷迭代改進，驗證了設計思考策略在提升社區居民防治登革熱的認知、態度及行為方面的成效。從量性結果顯示，設計思考策略能顯著提升居民的防治認知(t=-4.656, p < 0.01)，但對態度及行為改變無顯著影響。相關性分析發現，認知與態度在前測時呈顯著負相關(r=-0.407, p =0.048)，但態度與行為之間的相關性在前後測中皆不顯著。此外，認知改變與行為改變呈顯著正相關(r=0.488, p=0.016)，而行為改變與態度改變無顯著相關，透過線性迴歸分析發現認知改變能促使行為改變。在社會人口學影響方面，前測中發現戶內噴藥經驗(F=8.077,p<0.01)對認知及戶內孳生源檢查經驗(F=4.369,p<0.05)對態度為干擾因子，經設計思考策略介入後戶內孳生源檢查經驗不再對態度構面產生顯著影響，然而戶內噴藥經驗對居民認知的影響仍具顯著(F = 5.496，p = 0.012)。
透過焦點團體訪談的分析，歸納出三大主題，分別為「改變的浪潮：認知為基，態度轉變，行動激發、「改變的漣漪：個人行動擴散至社區層面」和「投入海底的磚頭：創新設計驅動認知態度行為的多層次連動」，呈現社區居民在設計思考策略介入後，認知、態度與行為三個構面的顯著轉變。在認知方面，受試者透過活動學習了防蚊方法、病媒蚊種類及登革熱預防措施等新知識，並修正了過去對防疫行動的誤解，加深了對防疫行為的理解。態度上，受試者對政府的防疫措施接受度提升，從過去的懷疑轉變為主動配合，特別是對噴藥等防疫措施的支持度增加。行為上，受試者開始更頻繁地檢查和清理家中及社區的積水，積極參與防蚊防疫行動，並與家人、鄰居分享防疫知識，共同維護社區環境。此外，這些構面之間呈現相互影響的關係。認知的提升不僅帶動了態度的轉變，也促使行為的改變。例如，社區居民在學習到正確的防疫知識後，不僅更理解政府的防疫措施，態度上也從懷疑轉變為積極配合。行為上，受試者不僅更頻繁地檢查和清理家中及社區的積水，還積極分享所學防疫知識，促進社區合作，共同防治蚊媒孳生。整體而言，設計思考策略透過其創新設計與高度互動性，不僅提升居民的學習興趣與參與度，還深化了知識的記憶和應用，成功促進了居民的防疫行為改變，並增強了社區內的連結與協作，展現了其在公共衛生推廣中的應用潛力。
研究結論
本研究證實，設計思考策略能有效提升社區居民對登革熱的防治認知，並促進他們的態度轉變和行為改變。這表明設計思考策略在公共衛生領域中具有廣泛的應用潛力，尤其在社區傳染病防治工作中。建議未來應進行長期追蹤，以檢驗行為改變的持久性，並探索其在其他健康議題中的應用。

With the escalating impact of climate change and urbanization, dengue fever has become a prevalent community-transmitted disease worldwide. This study employed a mixed-method pre-experimental design to develop and evaluate innovative dengue prevention strategies using design thinking. A total of 24 community residents from Tainan participated, with interventions including activities such as "Quiz Challenge," "Plants and Herbs for Mosquito Prevention," "Outdoor Adventure Games," and "DIY Mosquito Traps". Quantitative analysis showed significant improvement in residents’ knowledge (t = -4.656, p < 0.01), though changes in attitudes and behaviors were not statistically significant. Correlation and regression analyses indicated that knowledge change positively influenced behavior change (r = 0.488, p = 0.016). Qualitative findings revealed three themes: "Waves of Change: Knowledge as the Foundation, Attitude Transformation, and Action Stimulation," "Ripples of Change: Individual Actions Expanding to the Community Level," and "The Brick Dropped into the Sea: Innovative Design Driving Multilayered Interactions of Knowledge, Attitude, and Behavior". Participants corrected misconceptions, supported government measures, and actively shared prevention knowledge, fostering community collaboration. The study highlights the potential of design thinking strategies in enhancing public health efforts, with recommendations for future research to explore their long-term impact and application to other health challenges.

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