Development of Operations to Support an Aging Society through the Mechanism of District Health Board in Palian District, Trang Province

Abstract

This research and development aimed to conduct a situational analysis, develop an operational model, evaluate its effectiveness, and propose policy recommendations for preparing for an aging society through the mechanism of the District Health Board (DHB). The study was carried out in four stages: (1) Situational analysis: Problems and needs were identified through input from 20 participants, including DHB members and pre-aging individuals; (2) Development of the operational model: An operational model tailored to support an aging society via the DHB mechanism was designed, validated by experts, and assessed for its suitability, feasibility, and potential benefits; (3) Model evaluation: The model's effectiveness was  examined using a quasi-experimental one-group pretest-posttest design with 270 pre-aging individuals. Data were analyzed using descriptive statistics, the Wilcoxon signed ranks test, and a one-sample t-test; and (4) Policy recommendations: Insights from seven experts were collected through in-depth interviews and analyzed via content analysis. The findings were as follows:

1. Key operational challenges included a lack of vision, fragmented processes, and unclear, discontinuous systems. Identified needs encompassed shared vision development, increased participation, enhanced budget allocation, improved public services, better access to information, and health care support for the elderly.

2. The "PALIAN – MPI 4 PLUS Model" was developed and customized for Palian District, Trang Province.

3. Implementation of the model resulted in: (a) 100% screening of the pre-aging population for diabetes, hypertension, and depression; (b) significant improvements in health literacy and quality of life scores (p-value < 0.001); and (c) an average operational success rate exceeding 3.50, rated as "good" with statistical significance (p-value < 0.001).

4. Policy recommendations emphasized health promotion, creating supportive social and environmental contexts, enhancing policy awareness, leveraging technology, establishing an individual level database system, and developing national policies to sustain these efforts.

This study underscores the importance of integrated, comprehensive approaches to preparing for an aging society, with a focus on health promotion, community participation, and policy alignment.