Preparing communities for population ageing: development of a community-based participatory model for pre-older adults in Thailand

Population ageing poses increasing challenges for health systems, particularly in low- and middle-income countries. In Thailand, rapid demographic transition highlights the need for proactive strategies that support preparation before individuals enter older age. However, practical community-based models targeting adults approaching older age remain limited. This study aimed to develop and evaluate a community-based participatory model for strengthening multidimensional ageing readiness among pre-older adults in rural Thailand. A mixed-methods participatory action research (PAR) design was implemented in three sequential and iterative phases: (1) situational assessment of individual ageing readiness and community context; (2) participatory co-development and refinement of a community-based ageing-readiness model; and (3) implementation, reflection, and pre–post evaluation. The quantitative component included 330 adults aged 50–59 years selected using stratified random sampling across 16 villages. Approximately 30 purposively selected community stakeholders participated in interviews, focus group discussions, participatory workshops, and PAR reflection activities. Quantitative data were analysed using descriptive statistics, chi-square tests, and Pearson’s correlation coefficients for the situational assessment, and paired t-tests with Cohen’s d effect sizes for pre–post comparisons. Qualitative data were analysed thematically. Quantitative and qualitative findings were integrated at key PAR decision points to inform model development and interpretation. The participatory process resulted in the Community-Integrated Ageing Readiness Model (CIARM), comprising five interconnected domains: health, social participation, economic security, living environment, and technology readiness. The situational assessment identified significant relationships between selected participant and preparation-related factors and ageing readiness. Following participation in CIARM, overall mean ageing-readiness scores increased from 3.12 ± 0.54 to 3.58 ± 0.49 (mean difference = 0.46; p < .001; Cohen’s d = 0.86). Higher post-participation scores were observed across all five readiness domains. Qualitative findings identified financial planning, age-friendly living environments, technology confidence, social networks, and intersectoral coordination as important priorities that informed the model and its implementation. Because the study did not include a comparison group, the observed pre–post differences are interpreted as changes associated with participation in the CIARM process rather than causal effects attributable solely to the model. Mixed-methods PAR provided a structured approach for integrating individual ageing-readiness data, community knowledge, and stakeholder decision-making in the development of CIARM. The findings indicate improvements in self-reported multidimensional ageing readiness following participation; however, causal effectiveness cannot be established from the uncontrolled pre–post design. CIARM provides a context-specific framework for supporting preparation for population ageing in rural Thailand. Controlled, multi-site studies with longer follow-up are needed to assess its effectiveness and transferability. Not applicable. This study employed participatory action research design and did not involve a clinical trial or controlled intervention requiring registration.