This document may contain the wordings that you
might not understand, please ask the principal investigator or representative to explain
until understanding. You may take the document to read at home to consult or discuss with
relatives or close friends, your physician or other physicians to help making decision in
Project title Development of health care System and
community health through a healthcare database (Bangkoknoi model 2)
Name of Principle Investigator Assoc.Prof.Dr.Naris
Research site Bangkoknoi district
Affiliation and Telephone number of principle investigator which can be reached in and after
office hours Tel.02-419- 9065 and 090-990- 6184
Source of funding Thai Health Promotion Foundation
No Conflict of interest declare
Duration of research Research period 1 October 2016 – 30 September 2018
The Bangkoknoi model is the healthcare model for urban communities. It was established by
the Faculty of Medicine Siriraj Hospital. This project is collaborating with Thai Health
Promotion Foundation and various agencies to create a health database with many factors that
affect the health and wellbeing of people who live in Bangkoknoi district, Bangkok,
Thailand. This model will help healthcare providers and citizens to prevent some diseases or
illnesses and promote health. This project meets the needs of Thai health policy and
supports the Thai situation which will become an aging society in the near future.
The project is divided into three phases. The first phase is studying information and
developing questionnaires including developing a database for information of health in the
Bangkoknoi community and creating a network and learning data management system for
healthcare. Second phase is the planning and implementing process to collect the data by
planning with each local community’s leaders in Bangkoknoi district (Bangkoknoi district has
42 Communities) and Party network in the area. Third phase design data normalization
performed and finding solutions for health promotion in Bangkoknoi district in pilot project
by sending data to Department in Faculty of Medicine Siriraj Hospital and Government
organizations in the area to analyze and create projects or activities to solve the reason
of health problems.
The benefit of this project will help patients to understand their health that leads to
adjusting and modifying behavior and environment to support good health and prevent illness
which will become an aging society. In addition, we will know the incidence of infectious
disease that requires intermediate intervention. The aim of this model is to improve Thai
population health and to be the prototype for the healthcare model for taking care of the
local communities by local organization to other districts in Thailand, especially in urban
communities. So, The Faculty of Medicine Siriraj Hospital is not only the medical school but
we are “beyond a medical school”.
1. To create a community health database in the Bangkoknoi district area by collecting
health data and other factors affecting health care.
2. To study health problems and factors affecting health care in urban communities using
Bangkoknoi community as a case study.
3. To test the effectiveness of health data collection tools, including the Bangkok Noi
model application and applications used on the website.
You are invited to take part in the research because
You are the target group, aged 18 years and over, who have an impact on health and other
factors of the Bangkoknoi community.
There were approximately 177,710
participants/volunteers in this study.
1. Data were collected for all age groups of 42 communities in Bangkoknoi area. The main
target group is elderly group People in Bangkoknoi area 158,533 people (Source: 2010
Population and Housing Census)
2. Personnel of Faculty of Medicine Siriraj Hospital, 15,715 persons (Source: Personnel data
of Faculty of Medicine Siriraj Hospital for the year 2015)
3. 3,462 students under the Faculty of Medicine Siriraj Hospital (Source: Student data,
Faculty of Medicine Siriraj Hospital, 2015)
If you have decided to participate in the research there will be research steps as follows:
Ask those involved or the research team bring the
documents that will be participating in the research project for you to read and know about
it, along with signing consent to participate by asking you to answer the questionnaire
according to attached document so that the research team can collect useful information and
can be used information in the questionnaire.
The risk that may occur when taking part in the research
You will not be exposed to any risks or discomfort when answering the questionnaire, but
there may be questions that affect your discomfort such as uneasy to provide information.
If you have any inquiries regarding the research or if the unwanted side effect from the
research occurs, you can contact
Assoc.Prof.Dr.Naris Kitnarong Tel.02-419- 9065 and
The benefits that are expected to be derived from research
Your information will be a database of hospitals that can be used to plan treatment in the
(There is no compensation that co-researchers/volunteers will receive.)
(There are no costs that the co-researcher/volunteer will be responsible for themselves.)
If there are additional information both advantage and disadvantage involve in the research,
the researcher will inform the participant immediately.
The personal data of the participant/volunteer will be kept confidentially and will not
disclose to public individually. The report of research result is provided as whole
information. It may be posted on http://www.ClinicalTrials.gov or
http://www.ClinicalTrials.in.th. However, the individual subject’s data may be able to
disclose for a body of person to investigator such as sponsor, auditing division of the
government organization and Institutional Review Board Committee.
The subjects have a right to withdraw from the project at any time without giving advance
notice or reason. Furthermore, the withdrawal of project will not affect the received
treatment and services.
If you are not treated as stated in this participant information sheet, you can make a
complaint to the SIRB chairman, Office of Siriraj Institutional Review Board, Room 210, 2nd
floor of His majesty the King’s 80th Birthday Anniversary 5th December 2007 Building,
Telephone 66 2419 2667-72, Fax 66 2411 0162