目的：為解決都市化帶給人類的挑戰，世界衛生組織於1986年開始倡導「健康城市計畫」，目前世界各國已有數千個城鎮加入「健康城市」之行列。台南市健康城市計畫則是台灣首個健康城市示範計畫，本研究目的即是以健康組示範計畫為例，去評估台南市健康城市計畫的執行成效。希望透過比較，找出影響計畫執行成果的因素，藉此協助其他縣市日後研擬適當的計畫內容及執行政策。

方法：本研究分為三個階段，首先採靜態資料收集的方式，先進行示範計畫之內容分析；接著收集健康城市相關指標資料，進行計畫之結果分析；最後，透過質性研究中的深度訪談法，以瞭解影響示範計畫執行成果的相關因素。

結果：結果顯示，健康組七個示範計畫在執行情形上可分為：活躍、普通、及不活躍三類。相較於不活躍組的示範計畫，活躍組的示範計畫制訂了較多的相關政策，獲得較高程度的政治允諾，且擁有較好的跨部門合作與社區參與，以及有創新的作法及策略。此外，承辦單位的特質、與媒體的關係、及其遇到困難時的因應態度，也都會影響執行成果。在指標結果中，雖然各個示範計畫的指標值普遍都有進步，但活躍組的改善幅度較多。整體而言，台南市健康城市計畫對該業務的執行過程與結果造成了不同程度的影響。

討論：運用渥太華憲章的五大行動綱領可有效結合社區資源、誘發社區行動與跨部門合作。健康城市是腳踏實地的運動，絕非是一個口號。與媒體建立起良好的關係很重要，因其能協助整個計畫的行銷與傳播。訂定健康城市指標可協助城市自我評價。健康城市指標的訂定不僅要透過縣市內部各門商討，最好也可以透過各縣市的經驗分享及交流。建議研議一套適合於台灣各縣市的健康城市指標，以方便未來各縣市的評價作業。

Introduction：For solving the challenges of urbanization, World Health Organization (WHO) has initiated ”Healthy Cities Project” since 1986. There have been thousands of cities joined this project around the world. Tainan Healthy City is the first demonstrated project in Taiwan. The purpose of the study was to evaluate the effects of Tainan Healthy City Project, using the health programs as an example. For helping other cities to plan suitable healthy city projects, this study also aimed to explore factors associated with the outcome of the programs.

Methods：There are three parts in this study. Firstly, we analyzed the content of the health programs by collecting static data. Secondly, we analyzed the outcome of the programs by collecting relative healthy city indicators. Finally, in-depth interviews were implemented to understand factors affected the outcome of the programs.

Results：Result showed that among 7 demonstrated programs, there were three kinds of situations in operation: active, fair, and inactive. Comparing with inactive programs, active groups have established more relative policies, achieved higher degree of political commitment, had better intersectoral collaboration and community participation, and had more innovative strategies. Additionally, the qualities of the administration, the relationship with media, and the attitude when meeting difficulties were also associated the outcome of the programs. As to the results of healthy city indicators, nearly all programs had positive results; however, the active programs had wider range improvements. In conclusion, the implementation of Tainan Healthy City project induced public affairs to have different degree of progress.

Discussions：The principles of Ottawa Charter for Health Promotion is effective to enlarge community resources, strength community action and increase inter-sectoral collaboration. Establishing a healthy city is a hard work and never a slogan. It is important to build up a good relationship with the media for they can disseminate and communicate with the public. Setting up healthy city indicators is very helpful for self-evaluation. The establishment of healthy city indicators is not only by inter-department discussions within the city, but also by learning from other cities’ experiences. In order to help other cities in Taiwan, it is suggested to setup a set of suitable indicators for the whole island in the future.

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