Effect of an educational intervention using the extended parallel process model on preventive lifestyle for metabolic syndrome among Iranian employees

Given the prevalence of Metabolic Syndrome (MetS) among employees and the role of lifestyle in its prevention, this study examined the effect of an educational intervention based on the Extended Parallel Process Model (EPPM) to promote a preventive lifestyle for MetS among Iranian employees. This parallel-group randomized clinical trial was conducted at Rafsanjan University of Medical Sciences in Iran from 2022 to 2023. A total of 144 employees without MetS were randomly assigned to either the intervention group (n = 72) or the control group (n = 72). Data were collected using two instruments to assess the EPPM variables and preventive lifestyle for MetS at baseline and six months after the intervention. The educational intervention for the intervention group was implemented over four weeks, and the data were analyzed using SPSS software. The primary outcome was the change in the overall preventive lifestyle score. Participants in the intervention group had an average age of 42.81 (± 8.37) years and an average employment duration of 14.85 (± 8.79) years, while the control group had an average age of 41.72 (± 7.55) years and an average employment duration of 12.66 (± 8.34) years. The results showed that prior to and following the intervention, all participants (100%) in both groups were in the danger control process. After the intervention, there was a significant increase in the mean scores of perceived efficacy (p < 0.001), perceived response efficacy (p < 0.001), self-efficacy (p < 0.001), perceived severity (p < 0.001), fear (p < 0.001), intention (p < 0.001), and adoption of a preventive lifestyle for MetS (p < 0.001) in the intervention group compared to the control group. Following the intervention, the scores for defense mechanisms (p < 0.001), and perceived susceptibility (p < 0.001) significantly decreased in the intervention group compared to the control group. Following the intervention, the control group experienced a significant decrease in their attitude score compared to the intervention group (p < 0.001). Public health professionals should prioritize shifting individuals from the fear control process to the danger control process when designing educational interventions to prevent MetS. This approach should ensure that educational content emphasizes perceived efficacy and perceived threat to promote adaptive behavioral changes.Trial registration: Iranian Registry for Clinical Trial (the link to trial: https://www.irct.ir/trial/61288 ; IRCT registration number: IRCT20110727007132N21). Registered 02/02/2022. Prospectively registered.