Date of Award


Document Type

Campus Access Dissertation


Health Promotion, Education and Behavior

First Advisor

Edward Frongillo


The elderly club program (ECP), a community-based intervention, has been implemented to support self-help organizations and promote the health and quality of life of seniors in Thailand. Due to dramatic increases in aging populations, it is important to determine whether or not the club implementation has beneficial impacts on the health and well being of seniors. This study aimed to understand factors influencing ECP implementation (needs, coverage, and provision) and factors influencing stakeholders (motivation, capacity, and demands) from the perspectives of three key stakeholders: recipients (seniors), implementers (committee members), and supporters (officials). This approach involved semi-structured in-depth interviews with 22 health officials and local politician administrators, 30 senior recipients (60 years old and older), and 30 committee members. The interview guide was based on an adapted theoretical framework. Two supplement methods were direct observation of activities at elderly clubs and a review of documents related to ECP implementation.

The three stakeholders prioritized seniors' needs differently. Seniors and committee members perceived financial issues as the greatest needs of seniors, whereas officials perceived health as the greatest needs. All three stakeholders perceived that the ECP were not accessible and available for seniors, but they perceived barriers to accessibility and availability differently in some points. The three stakeholders perceived motivation to participate in the ECP implementation differently. Seniors and officials were more motivated by intrinsic factors, whereas implementers were more motivated by extrinsic factors. All three stakeholders perceived themselves have low capacity (knowledge and skills) to perform particular activities in the ECP. Seniors were likely to have high demand (poor health, heavy workload, and poverty) that impeded participation in the ECP. The incongruence of perspectives of the three stakeholders resulted from the difference of their roles, personal background, and values and beliefs.

The ECP is not offering enough of some activities that were identified as important needs of seniors. Exercise and social activities were the most prevalent activities offered in the ECP whereas the greatest needs of seniors were finances and health. Comprehensive strategies are required to improve the ECP implementation to meet senior needs because the factors influencing the three key stakeholders are interrelated and changing one may affect others. Finally, the study demonstrated the importance of the use of the adapted theoretical framework that allowed us to identify these interrelated factors simultaneously. These findings will help guide program implementation and improve program implementation comprehensively.