Network Collaboration Integration in Proactive Health Management for Older Adults: A Case Study of Chaophraya Municipality and the Community Health Network, Sapphaya Subdistrict, Chainat Province

Abstract

As Thailand transitions into an aged society, localized health management for older adults has become a strategic priority for Local Administrative Organizations (LAOs) and public health agencies. This study aimed to 1) examine the proactive health management model for older adults in Sapphaya Subdistrict, Chainat Province; 2) analyze the collaborative roles of Chaophraya Municipality, Ban Wat Kamphaeng Health Promoting Hospital, and Village Health Volunteers (VHVs); and 3) propose integrated development guidelines for an elderly health management system. A sequential explanatory mixed-methods design was employed. Quantitative data were collected from 120 older adults using a validated questionnaire (IOC = 0.67–1.00; Cronbach's Alpha = 0.85), while qualitative data were obtained from 20 key informants through in-depth interviews and focus group discussions. The findings revealed that 94.2% of participants had at least one chronic disease, with hypertension (75.0%), cardiovascular disease (73.3%), and diabetes (53.3%) being the most prevalent. Proactive health management operated through a three-tier network linking households, villages, and the subdistrict. Access to proactive health services was rated high (Mean = 3.87, SD = 1.28), with collaboration among the municipality, health promoting hospital, and VHVs receiving the highest rating (Mean = 4.57, SD = 0.86). Older adults also reported a high overall quality of life (Mean = 4.06, SD = 0.97), particularly in social relationships (Mean = 4.20, SD = 0.71), while physical health and environmental domains scored relatively lower. Spearman's rank correlation indicated a positive relationship between community health network performance and quality of life (rho = 0.201, p = .029), especially systematic collaboration among the three organizations (rho = 0.371, p < .001). Key challenges included limited inter-agency data sharing and workload–incentive mismatches among VHVs.