Effectiveness of an ecological theory-driven health promotion program on improvement of retirement adjustment, psychological well-being, and coping strategies in Iranian retirees: a randomized controlled trial

BACKGROUND: Retirement is a major life transition that affects psychological well-being and coping. This study evaluated the effect of a health promotion program grounded in an ecological framework on retirement adjustment, psychological well-being, and coping strategies among Iranian retirees. METHODS: A randomized controlled trial was conducted with 178 retirees from retirement centers affiliated with the Departments of Education and the Oil Industry in Fars province, southern Iran. Participants were systematically selected and randomly assigned to intervention (n = 90) and control (n = 88) groups using stratified block randomization. The intervention comprised a multicomponent program including blended learning (face-to-face sessions and mobile-based delivery via WhatsApp) and support from family and organizations. Educational strategies were guided by the PRECEDE-PROCEED model and Lazarus' transactional model of stress and coping. Data were collected at baseline, three months, and six months post-intervention using the Retirement Adjustment Scale, Ryff Psychological Well-Being Scale, and Ways of Coping Questionnaire. Statistical analyses included repeated measures ANOVA, MANCOVA (adjusting for baseline scores), and independent samples t-tests. RESULTS: Groups did not differ significantly at baseline. Over time, the intervention group showed improvements in retirement adjustment, total psychological well-being, subjective well-being, psychological well-being dimension, ways of coping, and problem-focused coping (P < 0.001). Emotion-focused coping showed no significant change. Significant time-by-group interaction effects were observed for all these variables (P < 0.001). CONCLUSION: An ecological, theory-driven health promotion program improved well-being, coping skills, and adjustment in retirees. Multilevel interventions addressing individual, family, and organizational levels may support healthy aging and successful retirement. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT) with a code of IRCT20180516039690N2, registered 16th September 2022.