廖勇柏Yung-Po Liaw蔣志偉Chih-Wei Chiang公共衛生學系博士班2026-02-102030-12-0820252025-11-24https://handle.ncl.edu.tw/11296/435cm9https://scholars.csmu.edu.tw/handle/123456789/5347背景與問題：糖尿病防治是台灣一項嚴峻的公共衛生挑戰，連續多年高居台灣十大死因第五位，且 18歲以上國人糖尿病盛行率男性及女性分別為11.4％與8.9%，相當於男性約每 8人即有 1 人罹患糖尿病，女性約每 11人即有 1 人罹患糖尿病。糖尿病不僅盛行率高，還與高血壓、腎臟病、癌症、肥胖等複雜共病交織成健康風險網。臨床與民眾之間長期存在認知落差，主因之一是健康識能不足，影響疾病預防與控制效果。在此背景下，新聞媒體因其視覺影像與情境再現的優勢，成為銜接醫療專業與社會大眾的重要橋樑。研究目的與方法：本研究採用質性研究為主、量性研究為輔的整合性研究架構。質性部分結合內容分析與敘事探究，其目的不在於統計新聞效果或進行量化分析，而是希望透過敘事性與建構性的方式，於電視台擔任資深醫藥記者期間，實際撰寫與製作之多則以上糖尿病專題新聞逐字稿，轉譯為一套有系統的健康溝通文本，並反映新聞在醫療知識擴散與健康行為啟動上的潛力，醫藥專題新聞多數為研究者就讀博士班期間所製作。研究方法包括對新聞文本進行系統化主題歸納（如併發症、飲食、運動等六大主題），並進行「健康訊息轉譯」，將專業術語轉化為符合健康識能原則的傳播內容。同時，研究也分析新聞如何透過議題設定與訊息選擇，塑造公眾認知的框架，形塑民眾對疾病與健康行為的理解。量性部分則利用台灣人體生物資料庫（TWB）資料進行兩項分析：（1）探討規律運動與糖尿病前期進展之關聯；（2）評估 rs1111875 基因型在不同性別中對第二型糖尿病風險的影響，以檢驗新聞內容與實證醫學之間的一致性與互補性。研究結果：1. 主題呈現與核心內容：新聞報導廣泛聚焦於糖尿病若控制不佳可能導致的心血管疾病、腎臟病變（洗腎）、足部病變（截肢）、視網膜病變（失明）等嚴重併發症。管理建議則強調生活型態的調整，具體涵蓋飲食管理（如多攝取原型食物、低 GI 食物、控制熱量、改變進食順序、地中海飲食） 與運動管理（如規律運動、增肌減脂的重要性）。2. 專家觀點： 內分泌新陳代謝科、心臟內科、腎臟科、營養師等不同專科專家，對「三高」控制、體重管理與早期篩檢等觀點高度一致。差異點則呈現於專業取向，例如內分泌新陳代謝科醫師強調糖化血色素目標值與新型藥物應用，而腎臟科醫師則專注於腎功能維持與飲食禁忌。3. 個案傳達效果：報導透過呈現不同年齡與病程階段的真實病人案例，有效地將抽象的疾病概念具體化，不僅提升了公眾的警覺性與共鳴，也提供了正面的行為示範（如成功減重、改變飲食習慣）或負面的警示作用，進而有效傳達健康行為的重要性。4. 新聞框架： 新聞報導主要採用了「問題-解決方案框架」、「風險-後果框架」、「專家權威框架」及「趨勢與數據框架」。這些框架的結合使報導內容具備高權威性、警示性、實用性與數據支持，推論有助於提升民眾對健康資訊的接受度，並啟動行為改變意願。5. 實證佐證：實證分析顯示「規律運動」在男女皆能顯著降低糖尿病風險，而短期開始運動或停止運動則無明顯保護效果，顯示運動須具長期性與持續性。另 rs1111875 基因型在女性中具有顯著遺傳效應（TT 與 CT 基因型皆顯著提高風險），但在男性中影響較弱，呈現性別特異性的遺傳風險。結論與建議：本研究顯示，醫藥專題新聞在提升糖尿病相關健康識能與促進行為改變上具有關鍵影響力。新聞媒介不僅是資訊傳遞的管道，更是驅動民眾採取健康行動的重要社會機制。結合 TWB 實證資料後，本研究進一步強調規律運動、性別差異與遺傳風險在糖尿病預防中的重要性，並指出健康新聞可作為推動精準健康與公共衛生介入的關鍵環節。未來建議媒體應強化科學性與平衡報導、深化敘事與專家結合、擴大報導議題廣度並積極防範錯誤健康資訊，納入更多實證觀點，以期最大化健康傳播的潛力。公共衛生機構應支持媒體健康傳播倡議，並建立合作平台以提供準確指引，共同應對糖尿病帶來的公共衛生挑戰。Background: Diabetes prevention and control constitute a persistent and serious public health challenge in Taiwan. The disease has consistently ranked fifth among the top ten causes of death for consecutive years, with a prevalence rate of 11.4% among adult males aged 18 and above, indicating that approximately one in eight individuals is affected. Beyond its high prevalence, diabetes is intertwined with multiple comorbidities, including hypertension, kidney disease, cancer, and obesity, forming a complex network of health risks. A considerable gap remains between clinical expertise and public understanding, largely attributable to insufficient health literacy, which undermines both prevention and disease management. Within this context, the news media, with its visual and narrative advantages, plays a crucial role in bridging medical knowledge and public comprehension.Objectives and Methods: This study employed an integrated qualitative–quantitative design, with qualitative inquiry as the core approach and quantitative analysis as complementary support. The qualitative component combined content analysis and narrative inquiry to examine how medical news reports—specifically over one hundred diabetes-focused television features produced during the author’s tenure as a senior medical journalist—translate complex medical information into accessible public knowledge and facilitate behavior change. These reports, many of which were developed during the researcher’s doctoral training, served as empirical data to examine how journalistic narratives transformed medical information into accessible public knowledge and motivated health behavior change. The methodology involved thematic coding of news texts across six major domains, including complications, diet, exercise, medication, lifestyle, and prevention, and applied the concept of “health message translation” to reformulate medical terminology into content that aligns with health literacy principles. In addition, the study explored how agenda-setting and framing strategies within these news reports shaped public perceptions of diabetes and its management.The quantitative component utilized Taiwan Biobank data to conduct two empirical analyses: (1) examining the association between regular exercise and the risk of progressing from prediabetes to diabetes, and (2) investigating the sex-specific effects of the rs1111875 genetic variant on type 2 diabetes susceptibility. These analyses served to compare media-presented health messages with biomedical evidence and to explore gene–behavior interactions relevant to diabetes risk.Results:1.Thematic Focus: News coverage predominantly emphasized severe complications associated with poorly controlled diabetes, such as cardiovascular disease, nephropathy requiring dialysis, diabetic foot leading to amputation, and retinopathy causing blindness. The reports consistently highlighted lifestyle modification, particularly dietary management (for example, whole-food intake, low-glycemic diets, calorie control, meal sequence adjustment, and the Mediterranean diet) and exercise (regular physical activity, muscle maintenance, and fat reduction).2.Expert Perspectives: Interviews with specialists in endocrinology, cardiology, nephrology, and dietetics revealed consensus on the importance of controlling the “three highs” (blood glucose, blood pressure, and blood lipids), maintaining a healthy body weight, and conducting early screening. Professional emphases varied by specialty. Endocrinologists focused on HbA1c targets and novel pharmacotherapies, while nephrologists stressed renal protection and dietary restrictions.3.Patient Narratives: Real-life patient stories across various age groups and disease stages effectively translated abstract medical concepts into relatable experiences. These narratives enhanced emotional resonance and provided both positive behavioral models, such as successful weight loss and dietary adherence, and cautionary lessons, reinforcing the importance of preventive health behaviors.4.Framing Strategies: The reports primarily employed four journalistic frames: the problem–solution frame, the risk–consequence frame, the expert–authority frame, and the trend–data frame. The combination of these frames enhanced the authority, urgency, and credibility of the news content, increasing audience receptivity and intention toward behavior change.5.Scientific Support Evidence: Quantitative analyses corroborated media-reported prevention recommendations. Regular exercise was significantly associated with reduced diabetes risk in both women and men, whereas initiating or discontinuing exercise did not yield notable protective effects, suggesting that sustained and consistent physical activity is essential. Furthermore, the rs1111875 genetic variant exhibited significant sex-specific effects, with CT and TT genotypes strongly associated with increased diabetes risk in women but not in men.Conclusions: The findings demonstrate that medical news features play a pivotal role in enhancing public health literacy and promoting behavioral change related to diabetes prevention and management. News media function not merely as conduits of information but as active social mechanisms that catalyze health engagement. By integrating Taiwan Biobank evidence, this study further highlights the importance of sustained physical activity, sex-specific genetic factors, and gene–behavior interactions in diabetes prevention, thereby aligning journalistic content with biomedical insights. Future media practices should strengthen scientific accuracy and balanced reporting, deepen the integration of expert perspectives and human narratives, broaden thematic coverage, incorporate evidence-based perspectives and proactively address misinformation to maximize the potential of health communication. Public health authorities are encouraged to collaborate with media professionals to develop evidence-based communication frameworks that effectively address the growing public health burden of diabetes and strengthen population-level health literacy.基因運動媒體框架公衛傳播健康識能醫藥新聞健康行為健康傳播糖尿病台灣人體生物資料庫ExerciseMedia FramingPublic Health CommunicationHealth LiteracyMedical News ReportingHealth BehaviorHealth CommunicationDiabetesGenetic RiskTaiwan Biobankthesis