DOI: 10.14457/tu.the.2023.282
title: The development of a family and community based care model for sarcopenic obesity in older adults

description: Sarcopenic obesity is considered one of the health challenges, arising from the aging process and health behaviors that are commonly found in the elderly. It has implications for overall health, including physical, mental, emotional, and social aspects, as well as the quality of life for the elderly and caregivers. Health literacy promoting about sarcopenic obesity and encouraging behavior modification is crucial for the recovery of their health and the prevention of complications. Developing suitable models for this purpose is highly recommended. This study applied participatory action research to develop a family and community-based care model for sarcopenic obesity in older adults. The study was conducted in Chumphon Sub-district, Ongkharak District, Nakhon Nayok Province, Thailand, from March to August 2023. The study was divided into 2 phases, phase 1 explored the perception of sarcopenic obesity, synthesized the factors related to sarcopenic obesity, effects of sarcopenic obesity on the health status, and care needed for sarcopenic obesity, and clarified the necessary and environmental resources for managing sarcopenic obesity in older adults. In this phase, 25 older adults with sarcopenic obesity were included for in-depth interviews and focus group interviews with a total of 15 participants with all stakeholders. The data obtained was used as a basis for creating the preliminary of a care-model in the subsequent phase. Phase 2 consisted of participatory action research aimed to developing a family and community-based care model for sarcopenic obesity in older adults with 4 cycles during a period of 16 weeks. In this phase, there were 15 older adults with sarcopenic obesity. In Phase 1, the findings consisted of 5 main categories consisted of: 1) Lack of sarcopenic obesity awareness; 2) Wellness literacy deficiency; 3) Behavior leading to poor health outcome; 4) Family and community encouraging unhealthy behavior; and 5) Achieving goals in life. The finding from Phase 1 were applied to developed preliminary care model for the PAR process in Phase 2. The action research spiral in each cycle included planning, acting, observing, and reflecting that participant participated in all steps. The cycle of change was created to explain the mechanism of sarcopenic obesity literacy facilitate and behavior transformation process of continuous dynamic change among older adults until set goals were reached. The cycle of change created healthy sarcopenic obesity begins with facilitated sarcopenic obesity literacy, enrichment in healthy behavior, cultivated behavior transformation, and dynamic behavior change process. Finally, the output was healthy sarcopenic obesity, with four main components: 1) Health awareness and sarcopenic obesity literacy; 2) Sarcopenic obesity modified lifestyle; 3) Beyond activities of daily living; and 4) Blissful life.A family and community-based care model for sarcopenic obesity in older adults from this study describes the approach used in implementing a participatory action research method for behavior transformation in older adults. Health awareness and sarcopenic obesity literacy were the important issues for behavior change. In this study's behavior change process, transformative learning is employed, facilitating individual internal changes. This approach helps individuals understand interconnected factors through personal experiences, leading to a profound understanding and readiness to listen, deeply transform, and sustain continuous and meaningful behavioral changes.