Developing a Management Model for Frailty in Older Adults via a Community - Driven Sub - district Health Board in Cham Phak Phaeo Sub-district, Saraburi Province

Abstract

Thailand has become a fully aged society, and frailty has emerged as a critical public health issue that requires systematic management. This participatory action research aimed to 1) explore the context and situation of frailty among older adults following the Integrated Care for Older People (ICOPE) framework, 2) develop the "Cham Phak Phaeo Model", and 3) evaluate the appropriateness and effectiveness of the developed model. This research employed a Participatory Action Research (PAR) approach consisting of three phases: contextual study, model development through the PAR cycle (planning–action–observation–reflection), and evaluation. Data were collected using ICOPE screening tools, questionnaires, and focus group discussions between October 2024 and September 2025 in Cham Phak Phaeo Subdistrict, Kaeng Khoi District, Saraburi Province. Screening of 439 older adults revealed that 312 (71.1%) were at risk of frailty, and 66 individuals were identified as frail and in need of care. The developed management model consisted of six key strategies: service support system development, service integration, team capacity building, data management, participation enhancement, and value promotion. Evaluation by 103 network partners indicated a high level of appropriateness in all aspects ( = 3.91 – 4.10). Regarding effectiveness after 6 months of implementation, 54 older adults (81.8%) demonstrated statistically significant health improvements in all aspects (p-value < 0.01). The developed model effectively delayed frailty progression and strengthened the sub-district health board mechanism. It is recommended for integration into local development plans for sustainability.