Health Care Behaviors and Associated Factors Among Older Adults in Thailand: A PRECEDE-PROCEED Approach

Abstract

Background: As Thailand transitions into a super-aged society, promoting health care behaviors among older adults is essential to reduce the chronic disease burden and healthcare costs. Understanding the determinants of these behaviors is crucial for developing targeted interventions. Objectives: This study aimed to examine health care behaviors among older adults in Samut Songkhram Province, Thailand, and identify associated factors using the PRECEDE-PROCEED model. Methods: A cross-sectional study was conducted between February and April 2025 among 420 community-dwelling adults aged ≥ 60 years, selected through multi-stage random sampling. Potential sources of bias were minimized through randomization, standardized questionnaires, and researcher training. Descriptive statistics summarized the data, while chi-square tests, Pearson’s, and Spearman’s correlations examined associations at P < 0.05. Results: Overall, 71.7% of participants reported high health care behavior (Mean = 2.61 ± 0.27). High predisposing (75.5%), enabling (71.0%), and reinforcing (63.1%) factors were observed. Significant associations were found with education (P = 0.024), marital status (P = 0.039), and income sufficiency (P = 0.026). Access to health information, literacy, and community participation were the key associated factors. Conclusions: Older adults’ health care behaviors are shaped by personal, social, and environmental factors. Enhancing health literacy, improving resource access, and strengthening community engagement—particularly via senior clubs—are essential for promoting healthy aging in Thailand’s aging population.