Developing a Model for Preventing Falls in the Elderly with the Participation of the Community in the Area of Responsibility of Ban Lamduan Subdistrict Health Promoting Hospital, Lamduan Subdistrict, Krasang District, Buriram Province

Abstract

This participatory action research aimed to develop a model for preventing falls among the elderly through community participation in the area of responsibility of Ban Lamduan Subdistrict Health Promoting Hospital, Lamduan Subdistrict, Krasang District, Buriram Province. The study was conducted from December 2024 to September 2025 and consisted of two phases. The model development phase applied the PAOR process based on the concept of Kemmis and McTaggart in the first phase and the resulting model was implemented in the second phase through two iterative cycles. Participants included 35 community stakeholders selected by purposive sampling and 60 elderly individuals residing in the study area. Quantitative data were collected using a demographic questionnaire, the Thai Fall Risk Assessment Tool (Thai-FRAT), a self-care behavior questionnaire, and the Activities of Daily Living (ADL) assessment. Qualitative data were obtained through observation and focus group discussions. The research instruments were validated for content validity by three experts, yielding an overall Content Validity Index (CVI) of 0.85. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed via content analysis.  

               In Phase 1, 28.33% of the elderly were identified as being at risk of falls, with key risk factors including unsafe home environments, impaired balance, high-risk medication use, visual impairment, and prior fall history. The first iteration of Phase 2 resulted in the development of a five-component fall prevention model which included health promotion integration with elderly schools, standardized screening and assessment, home safety modification, exercise promotion with Thai traditional medicine services, and strengthening of the community emergency medical system. In the second iteration, post-intervention knowledge and self-care behavior scores were significantly higher than pre-intervention scores (p-value < 0.001). Therefore, it can be concluded that model can be applied at the subdistrict and local administrative levels for sustainable fall prevention.