研究背景: 移民與探訪親友是旅遊感染蟲媒傳染病之高危險族群，而我國之新
移民大多來自蟲媒傳染病流行地區，因此其返鄉是否採取預防行為成為感染疾
病與否的重要因子。
研究目的: 境外移入蟲媒傳染病為我國境外移入病例之主要疾病，本研究目的
為使用健康信念模式探討台灣的新移民在返回母國時採取蟲媒預防行為的影
響因子。
研究方法: 利用結構式問卷訪談在2011 年6 月至10 月期間，曾至台北或台南
移民服務中心且在過去五年曾經返回東南亞及大陸地區之新移民，將被納入本
研究中。
結果: 一共有316 位新移民完成問卷，回應率為87%。平均年齡為37.5 歲(標
準差9.9)。大部分(70%)的新移民皆未接受旅遊前的健康風險諮詢;超過4 成以
上的新移民未採取預防蚊蟲叮咬的措施。利用多變項羅吉斯迴歸分析顯示中文
程度、旅遊前風險諮詢、較低的疾病易感受性和較高的預防行為之自我效能可
有效地預測新移民在返鄉期間的預防蚊蟲叮咬行為(R2, 0.18; χ2,36.91; p <
0.05)。
結論: 健康信念模式可以有效地預測預防蚊蟲叮咬的行為。但是，有高比例的
新移民在返回母國時未採取適當的預防行為。瘧疾的風險教育應該針對返回瘧
疾流行地區之新移民。

Background: Immigrants and visiting friends and relatives (VFR) are the high-risk groups of infected with insect-borne infectious diseases, and the immigrants in Taiwan are mostly come from southeast Asia where are the insect-borne disease
endemic areas, so whether they take anti-vectorial preventive measures (AVPMs) become an important factor for infection.
Objective: The aim of this study was to investigate the predictors of anti-vectorial preventive measures (AVPMs) among Taiwan immigrants returning to their country of origin using the Health Belief Model (HBM).
Methods: Between June and October 2011, all permanent immigrants originating from southeast Asia or China, attended by either the Taipei or Tainan Immigrant
Service Center, Taiwan, and who reported a history of returning to their country of origin within the preceding 5 years were enrolled.
Results: Complete information was collected from 316 immigrants, with a response rate of 87% (316/364). The mean age of the subjects was 37.5 years (SD=9.9). The majority (70%) of participants did not receive travel information through a pre-travel consultation; more than 40% reported that they did not use measures to prevent insect bites. Multiple regression analyses revealed that variables including Chinese proficiency, travel consultation before travel, lower perceived susceptibility, and higher self-efficacy could significantly predict the use of AVPMs during the return to their country of origin.
Conclusion: The health belief model can effectively predicted the use of AVPMs. However, a high proportion of immigrants return to their home country fails to take
appropriate preventive behaviors. The education of risk should be targeted on the immigrants, whom returning to insect-borne diseases endemic regions.

英文文獻
Askling, H. H., Nilsson, J., Tegnell, A., Janzon, R., & Ekdahl, K. (2005). Malaria risk in travelers. Emerg Infect Dis, 11(Peterson, Barber, & Schleier), 436-441.
Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral change.
Psychological review, 84(De Beaudrap et al.), 191.
Batchelor, T., & Gherardin, T. (2007). Prevention of malaria in travellers. Australian family physician, 36(5), 316-320.
Bhatia, M. R., Fox-Rushby, J., & Mills, A. (2004). Cost-effectiveness of malaria control interventions when malaria mortality is low: insecticide-treated nets versus
in-house residual spraying in India. Social Science &Medicine, 59(Peterson, et al.), 525-539.
Bond, L., & Nolan, T. (2011). Making sense of perceptions of risk of diseases and vaccinations: a qualitative study combining models of health beliefs, decision-making and risk perception. BMC Public Health, 11(Karin Leder & Graham V. Brown), 943.
Bozhao, X., Xianqi, X., Webber, R., & Lines, J. (1998). Comparison of the effect of insecticide-treated bed nets and DDT residual spraying on the prevalence of malaria transmitted by Anopheles anthropophagus in China.Transactions of the Royal Society of Tropical Medicine and Hygiene, 92(De Beaudrap, et al.), 135-136.
Chang, M. C., Teng, H. J., Chen, C. F., Chen, Y. C., & Jeng, C. R. (2008). The resting sites and blood-meal sources of Anopheles minimus in Taiwan. Malaria Journal, 7, 105-105.
Clark, G., Rigau-Perez, J., Vorndam, V., & Hayes, J. (2002). Imported dengue—United States, 1999 and 2000. Morbidity and Mortality Weekly Report, 51(13), 281-283.
Cronbach, L. J. (1951). Coefficient alpha and the internal structure of tests. Psychometrika, 16(Peterson, et al.), 297-334.
D'alessandro, U., Olaleye, B., McGuire, W., Thomson, M., Langerock, P., Bennett, S., & Greenwood, B. (1995). A comparison of the efficacy of insecticide-treated and
untreated bed nets in preventing malaria in Gambian children. Transactions of the Royal Society of Tropical Medicine and Hygiene, 89(6), 596-598.
D'Ortenzio, E., Sissoko, D., Dehecq, J., Renault, P., & Filleul, L. (2010a). Malaria imported into Reunion Island: is there a risk of re-emergence of the disease? Transactions of the Royal Society of Tropical Medicine and Hygiene, 104(4), 251-254.
D'Ortenzio, E., Sissoko, D., Dehecq, J. S., Renault, P., & Filleul, L. (2010b). Malaria imported into Reunion Island: is there a risk of re-emergence of the disease? Trans R Soc Trop Med Hyg, 104(4), 251-254. doi: S0035-9203(09)00349-6 [pii]10.1016/j.trstmh.2009.10.008
dos Santos, C. C., Anvar, A., Keystone, J. S., & Kain, K. C. (1999). Survey of use of malaria prevention measures by Canadians visiting India. Canadian Medical 50 Association Journal, 160(De Beaudrap, et al.), 195-200.
Fever, D., Virus, W. N., & Fever, Y. Mosquito-borne Illnesses in Travelers: A Review of Risk and Prevention.
Freedman, D. O. (2008). Malaria prevention in short-term travelers. New England Journal of Medicine, 359(6), 603-612.
Freedman, D. O., Weld, L. H., Kozarsky, P. E., Fisk, T., Robins, R., von Sonnenburg, F., . . . Cetron, M. S. (2006). Spectrum of disease and relation to place of exposure among ill returned travelers. New England Journal of Medicine,
354(De Beaudrap, et al.), 119-130.
Gibbons, R. V., & Vaughn, D. W. (2002). Dengue: an escalating problem. BMJ, 324(7353), 1563.
Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, research, and practice: Jossey-Bass.Gubler, D., & Trent, D. (1993). Emergence of epidemic dengue/dengue hemorrhagic
fever as a public health problem in the Americas. Infectious Agents and Disease, 2(6), 383.
Gubler, D. J. (1989). Aedes aegypti and Aedes aegypti-borne disease control in the 1990s: top down or bottom up. The American journal of tropical medicine and hygiene, 40(6), 571.
Guthmann, J. P., Hall, A., Jaffar, S., Palacios, A., Lines, J., & Llanos-Cuentas, A. (2001).
Environmental risk factors for clinical malaria: a case-control study in the Grau region of Peru. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95(6), 577-583. Guzman, M. G., Alvarez, M., Rodriguez, R., Rosario, D., Vazquez, S., Valdes, L., . . .
Kouri, G. (1999). Fatal dengue hemorrhagic fever in Cuba, 1997. International Journal of Infectious Diseases, 3(Peterson, et al.), 130-135.
Henchal, E. A., & Putnak, J. R. (1990). The dengue viruses. Clinical Microbiology Reviews, 3(4), 376.
Hira, P., Behbehani, K., & Al-Kandari, S. (1985). Imported malaria in Kuwait. Transactions of the Royal Society of Tropical Medicine and Hygiene, 79(Peterson, et al.), 291-296.
Hochbaum, G. M. (1956). Why people seek diagnostic x-rays. Public Health Reports, 71(4), 377.
Ibrahim, N. K. R., Al-Bar, A., Kordey, M., & Al-Fakeeh, A. (2009). Knowledge, attitudes, and practices relating to Dengue fever among females in Jeddah high schools.
(1876-0341). Retrieved from
http://www.sciencedirect.com/science/article/pii/S1876034109000057.
Jansen, C. C., & Beebe, N. W. (2010). The dengue vector Aedes aegypti: what comes next. Microbes and Infection, 12(4), 272-279. doi: 10.1016/j.micinf.2009.12.011
Janz, N. K. (1984). <The Health Belief Model_A Decade Later.pdf>.
Katsuragawa, T. H., Gil, L. H. S., Tada, M. S., e Silva, A. A., Costa, J. D. A. N., da Silva Araujo, M., . . . da Silva, L. H. P. (2010). The dynamics of transmission and spatial distribution of malaria in riverside areas of Porto Velho, Rondonia, in the Amazon region of Brazil. PLoS One, 5(De Beaudrap, et al.), e9245.
Kay, B. H., Nam, V. S., Tien, T. V., Yen, N. T., Phong, T. V., Diep, V. T. B., . . . Aaskov, J. G. (2002). Control of Aedes vectors of dengue in three provinces of Vietnam by
use of Mesocyclops (Copepoda) and community-based methods validated by 51 entomologic, clinical, and serological surveillance. The American journal of tropical medicine and hygiene, 66(Karin Leder & Graham V. Brown), 40.
Keating, J., Locatelli, A., Gebremichael, A., Ghebremeskel, T., Mufunda, J., Mihreteab,
S., & Berhane, D. (2011). Evaluating indoor residual spray for reducing malaria infection prevalence in Eritrea: results from a community randomized control trial. Acta Tropica.
Kirscht, J. P. (1988). The health belief model and predictions of health actions. Health behavior: Emerging research perspectives, 27-41.
Koenraadt, C. J. M., Tuiten, W., Sithiprasasna, R., Kijchalao, U., Jones, J. W., & Scott, T. W. (2006). Dengue knowledge and practices and their impact on Aedes aegypti
populations in Kamphaeng Phet, Thailand. The American journal of tropical medicine and hygiene, 74(4), 692.
Kolaczinski, K., Kolaczinski, J., Kilian, A., & Meek, S. (2007). Extension of indoor residual spraying for malaria control into high transmission settings in Africa.
Transactions of the Royal Society of Tropical Medicine and Hygiene, 101(9), 852-853.
Kroeger, A., Gonzalez, M., & Ordonez-Gonzalez, J. (1999). Insecticide-treated materials for malaria control in Latin America: to use or not to use? Transactions of the Royal Society of Tropical Medicine and Hygiene, 93(6), 565-570.
Mas Lago, P. (1979). Dengue fever in Cuba in 1977: some laboratory aspects.
Matthews, G., Dobson, H., Nkot, P., Wiles, T., & Birchmore, M. (2009). Preliminary examination of integrated vector management in a tropical rainforest area of Cameroon. Transactions of the Royal Society of Tropical Medicine and Hygiene, 103(11), 1098-1104.
Montgomery, C. M., Munguambe, K., & Pool, R. (2010). Group-based citizenship in the acceptance of indoor residual spraying (IRS) for malaria control in Mozambique. Social Science & Medicine, 70(10), 1648-1655. doi:10.1016/j.socscimed.2010.01.020
O'Leary, A. (2001). Social-cognitive theory mediators of behavior change in the National Institute of Mental Health Multisite HIV Prevention Trial. Health psychology, 20(5), 369.
Organization, W. H. (2004). Global strategic framework for integrated vector management: WHO Geneva.
Organization., W. H. (1996). Prevention and control of dengue/dengue haemorrhagic fever in South-East Asia region : report of a WHO regional consultation, New Delhi, 10-13 October 1995. New Delhi: WHO Regional Office for South-East
Asia.
Pavli, A., & Maltezou, H. C. (2010). Malaria and travellers visiting friends and relatives.
Travel Medicine and Infectious Disease, 8(Peterson, et al.), 161-168. doi: 10.1016/j.tmaid.2010.01.003
Phillips-Howard, P., Radalowicz, A., Mitchell, J., & Bradley, D. (1990). Risk of malaria in British residents returning from malarious areas. British Medical Journal,
300(6723), 499-503.
Phuanukoonnon, S., Brough, M., & Bryan, J. H. (2006). Folk knowledge about dengue
mosquitoes and contributions of health belief model in dengue control promotion in Northeast Thailand. Acta Tropica, 99(Karin Leder & Graham V. 52 Brown), 6-14.
Research, S. P. f., Diseases, T. i. T., Diseases, W. H. O. D. o. C. o. N. T., Epidemic, W. H. O., & Alert, P. (2009). Dengue: guidelines for diagnosis, treatment, prevention
and control: World Health Organization.
Robinson, P., Jenney, A. W., Tachado, M., Yung, A., Manitta, J., Taylor, K., & Biggs, B. A. (2001). Imported malaria treated in Melbourne, Australia: epidemiology and clinical features in 246 patients. Journal of travel medicine, 8(De Beaudrap, et al.), 76-081.
Ron H Behrens, Bernadette Carroll, Urban Hellgren, Leo G Visser, Heli Siikamäki, Lasse S Vestergaard, . . . Hatz, C. (2010). The incidence of malaria in travellers to South-East Asia: is local malaria transmission a useful risk indicator. Malaria Journal, 9(Karin Leder & Graham V. Brown), 266.
Rosenstock, I. M. (1974). Historical origins of the health belief model. Health education monographs, 2(4), 328-335.
Ryan, E. T., Wilson, M. E., & Kain, K. C. (2002). Illness after international travel. New England Journal of Medicine, 347(7), 505-516.
San Martin, J. L., Brathwaite, O., Zambrano, B., Solorzano, J. O., Bouckenooghe, A., Dayan, G. H., & Guzman, M. G. (2010). The epidemiology of dengue in the Americas over the last three decades: a worrisome reality. The American
journal of tropical medicine and hygiene, 82(Karin Leder & Graham V. Brown), 128.
Shahrabani, S., Benzion, U., & Yom Din, G. (2009). Factors affecting nurses??decision to get the flu vaccine. The European Journal of Health Economics, 10(De Beaudrap, et al.), 227-231.
Steffen, R., & Behrens, R. (1992). Travellers' malaria. Parasitology Today, 8(De Beaudrap, et al.), 61-66.
Steffen, R., Rickenbach, M., Wilhelm, U., Helminger, A., & Schar, M. (1987). Health problems after travel to developing countries. Journal of Infectious Diseases, 156(Karin Leder & Graham V. Brown), 84.
Strecher, V. J., & Rosenstock, I. M. (1997). The health belief model. Cambridge handbook of psychology, health and medicine, 113–117.
Uba, L. (1992). Cultural barriers to health care for southeast Asian refugees. Public Health Reports, 107(5),544.
WHO. (2003). The World health report 2003: shaping the future.
WHO. (2004a). Dengue, from http://www.who.int/tdr/diseases/dengue
WHO. (2004.). Global Strategic Framework for Integrated Vector Management., from
http://www.sciencedirect.com.ezproxy.lib.ncku.edu.tw:2048/science?_ob=Redi
rectURL&_method=externObjLink&_locator=url&_issn=00359203&_origin=arti
cle&_zone=art_page&_plusSign=%2B&_targetURL=http%253A%252F%252Fwh
qlibdoc.who.int%252Fhq%252F2004%252FWHO_CDS_CPE_PVC_2004_10.pdf
WHO. (2006). Reported Cases of DF/DHF in Selected Countries in SEA Region (1985 -
2005). WHO Regional Office for South-East Asia, New Delhi.
WHO. (2009a). Epidemiology, burden of disease and transmission. In Dengue:
Guidelines for diagnosis, treatment, prevention and control
WHO. (2009 ). World previous term malaria next term report.
WHO. (2010a). Malaria - About Malaria – Disease. Retrieved September, 2011,
from http://www.cdc.gov/malaria/about/disease.html53
WHO. (2010b). Malaria Profile South-East Asia Region,1971-2009., from
http://www.searo.who.int/LinkFiles/Malaria_Malaria_profile_SEAR_70-08.pdf
WHO. (2010c). Malaria: Disease burden in SEA region., from
http://www.searo.who.int/en/Section10/Section21/Section340_4018.htm
WHO. ( 2004b). First Meeting of the Regional Technical Advisory Group on Malaria,
Manesar, Haryana, India. .
WHO. ( 2009b). World malaria report 2009.
WHO. ( 2010d). Regional office for SEA. Malaria: Disease burden in SEA region., from
http://www.searo.who.int/en/Section10/Section21/Section340_4018.htm
World Health Organization. (2011). World malaria report 2011. Geneva: World Health
Organization.
Yohannes, K., Dulhunty, J. M., Kourleoutov, C., Manuopangai, V. T., Polyn, M. K., Parks,
W. J., . . . Bryan, J. H. (2000). Malaria control in central Malaita, Solomon
Islands:: 1. The use of insecticide-impregnated bed nets. Acta Tropica, 75(De
Beaudrap, et al.), 173-183.
中文文獻
王穎筠, & 蔡慈儀. (2011). 出國旅客登革熱之防護知識及態度與其行為之相關因素探討. [Knowledge, Attitudes and Practices with Regard to Dengue Fever
among Travelers in Taiwan]. 臺灣公共衛生雜誌, 30(De Beaudrap, et al.),
191-200.
行政院衛生署 (Ed.). (1993). 台灣撲瘧紀實.
李美珠. (2003). 高血壓患者服藥遵從行為相關因子之研究. 慈濟大學醫學研究所碩士論文, 113.
周欽賢、王正雄 (Ed.). (2002). 醫學昆蟲與病媒防制 (第一版 ed.).
范瑋益. (2007). 運用情境互動媒體於防制藥物濫用知識學習與健康信念之研究. 臺北醫學大學醫學資訊研究所學位論文.
馬作鏹, 吳宜玲, 邱鈺婷, 邵國寧, & 黃素雲. (2006). 應用健康信念模式探討台
灣地區影響老年人利用健保成人預防保健服務之相關因素研究. 醫務管理
期刊, 7(4), 349-369.
許瑜真, 蔡坤儒, 施金水, & 陳穎慧. (2010). 越籍配偶對傳染病防治認知與預防接種現況之調查分析. 疫情報導, 26(6), 87-94.
陳威諭. (2009). 高雄市社區環境及民眾對登革熱認知, 態度, 行為與過去疫情之相關研究. 高雄醫學大學公共衛生學研究所學位論文(2009 年).
陳菁惠. (2007). 高雄縣某國中學生登革熱防治知識, 態度, 預防行為及相關因素之研究. 臺灣師範大學衛生教育學系在職進修碩士班學位論文(2007 年).
曾明玉, 林慧真, 馬瑞芳, & 劉士豪. (2009). 境外移入先天性德國麻疹症候群病例事件報告. 疫情報導, 25(Peterson, et al.), 140-152.
曾慧娟. (2007). 應用健康信念模式探討影響台中市南屯區老年人利用衛生所社
區健康篩檢服務相關因素.
廖琪玉, & 陳漢瑛. (2007). 流感疫苗接種的健康信念與行為意向之研究-以北部某醫學中心醫護人員為例. 健康促進暨衛生教育雜誌(27), 1-21.
鄧華真 , 陳., 張梅君. (2005). 台灣地區矮小瘧蚊棲息場所及吸血源的研究. 行政院衛生署疾病管制局九十五年度科技研究發展計畫, 計畫編號：DOH94-DC-2015 及 DOH95-DC-2012.
簡慧儀, & 李雪梅. (2008). 桃園國際機場發燒篩檢站成效概況分析. 疫情報導, 24(Karin Leder & Graham V. Brown), 38-50.
羅淑芬, 鄭麗娟, 張慈惠, & 彭台珠. (Florent Mouba et al.). 燒傷病患對彈性衣穿著之知識, 健康信念, 遵從行為及其相關因素之探討. 慈濟醫學雜誌,
14(Peterson, et al.), 163-172.
觀光局. (2012). 觀光統計圖表, from
http://admin.taiwan.net.tw/public/public.aspx?no=315