Integrating Geographic Information Systems into a Self-Efficacy–Based Health Promotion Model for Foreign Retirees in Elderly Care Centers in Bangkok Metropolitan Area, Thailand

Abstract

Thailand’s rapid transition to an aged society has coincided with increasing numbers of foreign retirees choosing long-stay residence in Bangkok, including within elderly care centers. However, existing care services have often prioritized dependent-care models, leaving a service gap for foreign retirees in Independent Living and Assisted Living categories who require culturally responsive, autonomy-supporting health promotion. Building solely on the attached sequential mixed-methods manuscript, this article consolidates the development and implementation evidence of a self-efficacy–based health promotion model and presents a GIS-enabled integration architecture to strengthen metropolitan-scale planning and delivery. In Phase 1, expert interviews and focus group discussions informed the model structure and activities, resulting in five health promotion dimensions: Health Education, Health Prevention, Health Protection, Spiritual Improvement, and Nutrition Therapy. In Phase 2, a one-group pretest–posttest implementation among foreign retirees (n = 33) residing in elderly care centers in Bangkok demonstrated statistically significant improvements (p < .01) in health promotion knowledge, self-care health behaviors, and physiological indicators, including blood pressure, body mass index, blood sugar, and muscle mass. To enhance scalability without altering the original intervention logic or claims, GIS is incorporated as a cross-cutting operational layer in three strategic applications: (1) risk mapping to visualize spatial patterns relevant to health risks and service access; (2) facility suitability mapping to support evidence-informed site selection for new or expanded elderly care centers using spatial criteria aligned with holistic care; and (3) predictive GIS modeling to forecast future service demand based on spatial-demographic scenarios. Importantly, the geospatial analysis and map outputs are positioned as core decision-support tools rather than illustrative figures. These GIS outputs help identify priority service areas, guide evidence-informed location planning for new or expanded elderly care centers, and support resource allocation according to spatial patterns of access, risk, and projected demand. This integrated approach positions the proven five-dimension model for broader deployment across Bangkok metropolitan areas, supporting Thailand’s direction toward becoming a regional medical and retirement hub.