Development of a Community-Based Long-Term Care Model for Preventing Depression Among the Elderly in the Northeast of Thailand.

This study aimed to develop and evaluate a culturally grounded community-based long-term care model for preventing depression among older adults in Northeastern Thailand. A sequential mixed-methods design was conducted between January 2023 and December 2025 in three phases: (1) a cross-sectional survey (n=1,522) to identify determinants of depression; (2) participatory action research to develop the intervention; and (3) a quasi-experimental evaluation (intervention n=120; control n=120) over 12 months. Depression was assessed using the Thai Geriatric Depression Scale. Logistic regression, repeated-measures ANOVA, and structural equation modeling (SEM) were applied. Depression prevalence was 18.6%. Key predictors included low social support (AOR=2.85), living alone (AOR=2.47), and low social participation (AOR=3.12). The ISAN-LTC Model-Integrated care, Social participation, Active aging and Networking support, a culturally grounded-significantly reduced depression scores (p<0.001) and improved quality of life (p<0.01). SEM indicated that social participation partially mediated the relationship between social support and depression. The model demonstrates effectiveness, feasibility, and scalability within community health systems.