Abstract

Insufficient physical activity (PA) is a significant health challenge among working-age populations. This study aimed to develop context-specific processes to promote PA among adults aged 35–60 years. A participatory action research approach was conducted across seven provinces in upper southern Thailand. The study consisted of three phases: (1) preparation and situation analysis, (2) development and implementation of PA promotion programs, and (3) program evaluation and lessons learned. In Phase 1, the working-age population was categorized into four groups: Group 1: PA occupation and exercise; Group 2: PA occupation but non-exercise; Group 3: non-PA occupation but exercise; Group 4: non-PA occupation and non-exercise. In Phase 2, an exercise program and PA tracking guide were developed and implemented over a 6-month period. In Phase 3, based on the complete-case analysis, 175 participants enrolled, with 101 (57.7%) and 100 (57.1%) remaining at 3 and 6 months, respectively. Based on the last observation carried forward analysis (n = 175 across the 6 months), the proportion achieving global recommended PA levels and time spent in weekly moderate- to vigorous-intensity PA increased significantly in the non-exercise groups (Groups 2 and 4). All participants in the exercise groups (Groups 1 and 3) met the recommended PA level at baseline; however, this level was not maintained at the endpoint. The context-based PA promotion programs improved PA participation among non-exercise working-age adults. Future research should identify strategies to enhance program uptake and sustain engagement.