The Model for Promoting Health of the Elderly Communities Based on the King’s Working Principles of Subdistrict Health Promoting Hospitals under the Primary Care Service Plan Network, Chiang Mai Province

Abstract

This study aimed to: 1) examine the context of older adults and health promotion networks in Subdistrict Health Promoting Hospitals (SHPHs); 2) analyze the factors and extent to which SHPH personnel applied the King’s working principles in promoting community-based elderly health; and 3) develop and evaluate a new health promotion model for older adults based on these principles. A mixed-methods approach was employed in three purposively selected communities in Chiang Mai Province, representing urban, peri-urban, and rural areas. The study involved five groups of participants: 350 older adults, 31 network partners, 30 household members, 23 SHPH personnel, and 30 village health volunteers. Data were collected using questionnaires, in-depth interviews, semi-structured interviews, and focus group discussions. Quantitative data were analyzed with descriptive statistics, while qualitative data were analyzed through content analysis.

The findings revealed that older adults experienced quality of life issues across physical, mental, social, economic, and environmental dimensions. Their primary needs included family caregiving, access to public spaces for recreation and exercise, and continuous care from SHPH personnel. Application of the King’s working principles was found at high to very high levels across all three communities. The developed model of elderly health promotion was structured around the “Five-Step Development Ladder,” which included: 1) foundational stage, 2) situation assessment and planning, 3) development stage, 4) expansion and sharing, and 5) achieving sustainable success. Expert and stakeholder evaluations across seven dimensions rated the model as highly appropriate.

In conclusion, the developed elderly health promotion model aligns with local contexts and elderly needs, using the King’s working principles as the important foundation through a Five-Step Development ladder process, enabling SHPH personnel and network partners to operate systematically, participatively, and sustainably.