Abstract
This research aimed to achieve 4 main objectives: 1) to study the current situation of primary
healthcare service provision for the prevention of early-onset dementia; 2) to develop a model for
primary healthcare service provision for the prevention of early-onset dementia; 3) to examine the
effectiveness of the developed primary healthcare service model for the prevention of early-onset
dementia; and 4) to develop policy recommendations for primary healthcare service provision for the
prevention of early-onset dementia in Sub-district Health Promoting Hospitals (HPHs) that have been
transferred to Provincial Administrative Organizations (PAOs). The study was divided into 4 phases.
Phase 1 involved gathering data from: 135 executives and practitioners (qualitative data); and 189
individuals identified as being at risk of early-onset dementia (quantitative data). Phase 2 included 13
experts and representatives from health service units, as well as 17 participants in an expert consensus
seminar. Phase 3 comprised 20 executives and practitioners, and 96 citizens aged 45–59 years. Phase 4
involved 30 representatives from PAOs, provincial-level healthcare providers, practitioners, and
community representatives. Research instruments included semi-structured interviews, focus group
discussions, a questionnaire on risk factors for early-onset dementia, the Mini-Mental State ExaminationThai (MMSE-Thai), a health literacy questionnaire for dementia prevention, a dementia prevention
behavior questionnaire, and a satisfaction questionnaire. Data were analyzed using descriptive statistics
(percentage, mean, standard deviation), logistic regression, and content analysis. The key research
findings are as follows:
1. Regarding the initial assessment: 19 individuals (10.05%) scored below the cut-off point
on the MMSE-Thai; 59 individuals (31.22%) were identified with risk factors and risky behaviors; 26
individuals (13.76%) had relatively low cognitive function; 70 individuals (37.04%) required cognitive
function promotion; and 15 individuals (7.94%) had good cognitive function.
2. The developed primary healthcare service model for the prevention of earlyonset dementia is categorized into three formats based on the context of HPHs transferred to PAOs,
covering six aspects: Structure of the health service system: Appointing committees to drive health
service provision at both the PAO and local levels. Service guidelines: Including risk assessment and
screening, promotion and prevention of early-onset dementia, development of necessary capacity and
skills for individuals, families, and communities, and monitoring and evaluation. Inter-facility linkage:
Emphasizing collaborative service linkage across all levels of health facilities. Health data integration:
Establishing guidelines for linking data from all levels of health service facilities. Inter-agency and public
linkage: Connecting services between different agencies and the public sector. Support system and
environment: Creating an environment for early-onset dementia prevention, both online and onsite.
3. Following the implementation of the model, the sample group's mean scores
for health literacy in dementia prevention and preventive behaviors were significantly higher than the
scores before implementation, at the statistical level of .05.
4. The overall satisfaction of practitioners with the model was at a high level (M=4.37,
SD=0.55), and the overall satisfaction of service recipients with the model was at the highest level
(M=4.54, SD=0.56).
