This study aimed to describe the social determinants of health influencing obesity for the aged in a community context and based on the perspectives of various stakeholders. This was qualitative content analysis study using data from the focus group, individual in-depth interview, and observation. The study population was domiciled in Pakpoon Village, Mung District, Nakhon Si Thammarat Province, a tight-knit settlement typical of most retirement communities. Data were collected through two focus group discussions, direct observation, and in-depth interviews with 19 participants. Respondents represented key community groups: local nurses and public health officers, elderly residents, family caregivers (family members), and village health volunteers. The participants shared similar perspectives about the social determinants of health influencing obesity in the aged, which spanned three themes. These were: 1) neighborhood food environment (easy access to unhealthy food, no choice to recruit healthy food); 2) social networks influencing obesity (family affects food choices and prohibitions on exercise; belief, and socially imposed body image perceptions contributing to obesity in the aged); and 3) knowledge, attitudes, and beliefs behind lifestyle choices that cause obesity in the elderly (lack of awareness, personal attitudes, job and familial duties as barriers to engaging in physical activities; over-consumption behaviors lead to obesity in older people). These three themes were the root causes of obesity in the elderly in Pakpoon’s retirement community. This finding suggests that policymakers and nurses can create healthy environments, both to treat and prevent obesity, by raising awareness in younger generations, providing aging the provision of healthy food choices for older adults, encouraging health care professionals to share knowledge, and by modifying the attitudes and beliefs of both caregivers and older adults.

Heart failure remains a major global health burden, characterized by high mortality, frequent hospital readmissions, and poor quality of life. These outcomes are closely linked to inadequate self-care behaviors, limited patient knowledge, and insufficient ongoing support. This study aimed to describe self-care behaviors, self-awareness of severe symptoms requiring hospitalization, and symptom management strategies among patients with heart failure, and to provide evidence-based recommendations to inform improved care delivery. A descriptive qualitative study was conducted using individual in-depth interviews with 19 adults living with heart failure in community settings in Nakhon Si Thammarat Province, Thailand. Data were analyzed using content analysis to identify recurring patterns and themes related to self-care experiences. Three key themes were identified. (1) Self-care behaviors shaped patients’ lifestyles, with family caregiving influencing engagement in daily activities, medication adherence, and integrated self-care practices that supported physical and emotional well-being, knowledge-seeking, and healthcare support. (2) Self-awareness of severe symptoms requiring hospitalization, developed through continuous self-monitoring, was central to living with heart failure. Patients relied on physical sensations to guide symptom management, while engagement in daily activities reflected varying levels of self-care capacity or reliance on healthcare professionals. (3) Early self-management of symptoms supported timely rest, effective swelling control, and adherence to professional advice, contributing to reduced hospital readmission and mortality. Effective heart failure management requires individualized self-care approaches that are responsive to patients’ personal and cultural contexts. Enhanced self-awareness of symptoms such as orthopnea and weight gain enables timely self-management actions, including activity pacing, limb elevation, and medication adjustment. Furthermore, digital health tools and home-monitoring devices play an increasingly important role in supporting patient education, symptom tracking, and sustained self-care in heart failure.

Purpose: This study aimed to develop and validate a community-based protective model for COVID-19 prevention among Thai Muslim communities in southern Thailand by examining the roles of primary healthcare services, community nutrition status, social support, public trust, and public compliance. Design/methodology/approach: A cross-sectional survey was conducted among 233 Thai Muslim residents from eight communities in Nakhon Si Thammarat Province, Thailand. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to evaluate the measurement and structural models. Findings: The model demonstrated acceptable reliability, discriminant validity, predictive relevance, and adequate model fit (SRMR = 0.082). Primary healthcare services significantly influenced social support (ß = 0.541, p < 0.001), community nutrition status (ß = 0.358, p < 0.001), and public trust (ß = 0.329, p < 0.001). Community nutrition status showed the strongest direct effect on public compliance (ß = 0.509, p < 0.001) and significantly influenced social support (ß = 0.227, p = 0.001). Public compliance significantly influenced public trust (ß = 0.297, p < 0.001), while social support significantly influenced public trust (ß = 0.164, p < 0.029). The model explained 41.5% of the variance in public compliance and 49.0% of the variance in public trust, and demonstrated predictive relevance across all endogenous constructs (Q2 > 0). Mediation analysis further revealed significant indirect effects of primary healthcare services through nutrition, social support, and trust-building pathways. Research limitations/implications: The findings support a systems-based, prevention-oriented approach to infectious disease control. Policies should prioritize strengthening decentralized, culturally responsive primary healthcare services, given their central role in shaping social support, public trust, and adherence to health protocols. Trust- and nutrition-sensitive strategies should be institutionalized through transparent risk communication, community engagement, and integration of community nutrition into preparedness planning. For nursing practice, the results highlight the expanded preventive role of nurses in community-based primary care, including leadership in culturally sensitive outreach, collaboration with village health volunteers, and routine integration of nutrition assessment and education to sustain preventive behaviors and community resilience. Practical implications: The findings have important implications for health governance and public policy. Pandemic preparedness should prioritize decentralized and culturally responsive primary healthcare systems, as healthcare access alone may be insufficient without public trust and community engagement (Edelman et al., 2025; Waewwab et al., 2022). Strengthening community-based healthcare infrastructure, village health volunteers, and culturally sensitive communication may enhance long-term resilience. The findings also highlight the importance of integrating nutrition and food security into pandemic preparedness policies. Furthermore, transparent communication, collaboration with religious leaders and community participation may improve compliance and reduce misinformation, particularly in culturally diverse and underserved populations. Originality/value: This study extends health governance literature by integrating healthcare services, nutrition, social support, public trust, and public compliance within a single structural framework in a culturally distinct population. The findings support culturally responsive and community-based governance strategies for strengthening pandemic preparedness and community resilience.

Falls among Thai older adults are a significant public health concern requiring collaboration between government institutions, community organizations, and stakeholders. A holistic community‐driven approach to address gaps in coordination and implementation of fall prevention strategies is needed. Therefore, the aim of the study was to develop and evaluate a fall prevention model for older adults in Thailand, leadership by nursing with a participatory action research design. The study consisted of three phases: preparation, model development, and model evaluation, to design a fall prevention model using a mixed‐methods approach. The key activities included leadership training, brainstorming to develop a fall prevention model, and conducting multicampaigns over 12 months with village health volunteers, community nurses, and community leaders. A 16‐week program trial involving 30 high‐risk older adults employed a quasiexperimental one‐group pretest–posttest design. After 1 year, the model was evaluated in a lessons‐learned forum with stakeholders, participants, and experts. Quantitative data were analyzed using frequency, percentage, and paired t ‐tests, while qualitative data were subjected to thematic analysis. The fall prevention program significantly enhanced participants’ strength, balance, and fall prevention behaviors. Lessons learned emphasized the importance of community engagement and recommended the integration of fall prevention into long‐term elderly care systems. Leadership training improved community awareness, capacity, and cooperation in fall prevention. Stakeholders and community members expressed high satisfaction with fall prevention campaigns. This study highlights the feasibility of implementing a community‐based fall prevention model through community participation. It underscores the importance of cross‐sector collaboration for sustainable fall prevention.