it is proven that people 's choices as well as their lifestyle have a great influence on their health and life length . healthy lifestyle is defined as a specific living style in which having , maintaining , and promoting the health level and welfare of people are preserved . also , all controlled behaviors or those putting the health of a person into danger are categorized under the topic of lifestyle . different dimensions are considered for lifestyle , such as nutrition , physical activity , self - control , cigarette and alcoholic drugs , social relationships , and controlling the stress . according to world health organization ( one of the important factors for being healthy , controlling and preventing the diseases which are not contagious , is recognized as physical activity . as a significant behavior in improving the health level , there are , also , some evidences verifying that regular physical activity improves mental health , reduces the level of depression or anxiety , and increases the level of satisfaction and quality of life . considering the health of the society , some studies have shown that about 35% of many cancers are due to unhealthy diet . , mental health is the ability to have a proper relationship with people , change or improve personal or social environment , and solve the paradoxes of personal tendencies , logically and properly . nowadays , due to profound changes in people 's lifestyle and culture , many individuals find themselves unable to face difficulties and crises , making them much vulnerable to incoming probable troubles . some contributing factors , hence seem essential in helping individuals to confront such issues in life . one of the essential needs of people for being successful in personal and social life is interacting appropriately with people . no matter in what stage of life a person is , proper social skills make life easier , more enjoyable and prosperous . middle - aged women confront physical and behavioral changes such as wrinkles on the face , body weakness , obesity , and bad conduct . they , therefore , are exposed to lack of self - confidence , depression , and mental problems . that is due to health problems during this stage of life many problems arise causing death and chronic illnesses . analyzing the lifestyle of iranian people and its effect on wellbeing of their body , it was found that 29% of adults in cities and 17% in countries suffer overweight and obesity . considering adolescences , a national study ( 2005 ) showed that > 80% of iranians are inactive . another study ( 2009 ) indicated that 34% of people above 15 in tehran were probable of being mentally disordered ( 37/9% of women and 28/6% of men ) . women are at risk of mental disorders 1.3 times more than men and it increases with aging . the present study has been conducted to analyze the effect of educational intervention on the health promoting lifestyle of middle - aged women in lenjan city of isfahan . according to research studies , lifestyle affects people 's health and life length ; however , no sufficient studies have been done on the effect of lifestyle on middle - ageing , as the transitional period from adulthood to old - ageing . this study was aimed to determine the effect of educational intervention on health promoting lifestyle of middle - aged women in lenjan city of isfahan province , iran . this study a quasi - experimental research was conducted on female patients , aged between 40 and 50 years old who referred to health centers in zarinshahr city , 2012 february - june . the statistical sample , with 95% correlation , consisted of 44 patients for both the intervention and the control groups . inclusion criteria were signing the consent forms and having the ability of answering the questions whereas menopausic women , patients having special diet , disable patients , and mentally disordered women were excluded from the study . randomized control trial was used to select the intervention and control groups from the health centers located in zarinshar . since no standard questionnaire was at hand for lifestyle analysis , a researcher - made questionnaire was used . it consisted of two parts : demographic ( age , education , occupation , income , and marital status ) and life style ( nutrition , physical activity , mental health , interpersonal relationship ) . forty questions were designed to assess life style , 10 questions allocated to each section based on the multiple - choice likert - scale . the scores ranged from 0 to 3 ; however , for the ease of analysis , they were calculated out of 100 . in order to confirm the validity of the questionnaire , the questionnaire was given to 15 nutrition and health experts and their corrective ideas were applied . the questionnaire was also given to 20 middle - aged women , with the same characteristics as the study group to evaluate reliability . the internal consistency of the scale measured by cronbach 's alpha showed the following results : nutrition 74% , physical activity 82% , mental health 85% , and interpersonal relationship 82% . five group discussions and question - answer sessions were held during the educational intervention , focusing on different dimensions of appropriate lifestyle . for every dimension of the lifestyle , the focus was on the importance of a proper diet , the food pyramid , having breakfast and fish , and limited amount of oil and sugar intake . the topics of the discussion , during the second session , were the review of the first session topics and discussing the importance of the kind , level , and extent of physical activity during the middle - age period . in this session , the following tasks were carried on : introducing some stretching exercises suitable for everyday activities , giving some sporting brochures to be attached on walls in their homes , training them to prevent early exhaustion , doing exciting activities , attending walking activity in friendship groups , and introducing some suitable gyms . after a brief overview , the third session focused on changing , retaining , and improving mental health status while paying attention a good diet and exercise , performing relaxation , stress management courses , introducing problem solving strategies , being responsible about one 's health , being optimist , expressing love to people , and trying to achieve personal goals . how verbally interact with others , conveying message skills ( verbally , nonverbally ) , receiving message skills ( listening , observing , responding ) , as well as a very short review of the previous sessions constitute the topics discussed session four . comprehensively reviewing the previous subjects , the last session gave the participants the chance of talking about their personal experiences as well as their behavioral changes . to have more effective education sessions , the participants were given a booklet which all the discussed subjects had been written in . the control group received no intervention and only was given the booklet . after 3 months of educational intervention , the questionnaires were re - given to the control and experimental groups spss ( ibm corp . armonk , ny ) software was used to analyze the data : chi - square test for comparing the marital status in the control and experimental groups , mann whitney test for comparing the educational and financial status in both control and experimental groups . the paired t - test , comparing the mean scores of various dimensions of healthy lifestyle in both control and experimental groups before and the after the educational intervention , p < 0.05 were considered statistically significant . the median age in the intervention group was about 44.2  3.80 and in the control group , it was about 44.40  3.31 . the participants were mostly married and at least , had the primary and secondary level of education . therefore , demographically , these two groups showed no meaningful difference [ table 1 ] . demographic characteristics of intervention and control groups according to the paired t - test , it was statistically indicated that in the experimental group , before and after the research no significant difference was observed , regarding nutrition , ( p = 0.13 ) . however , taking the physical activity , mental health , interpersonal relationship , and overall lifestyle into consideration , it was found that the mean scores significantly differed , ( p  0.001 ) . considering the control group , the paired t - test analysis showed no statistical difference with respect to nutrition , physical activity , mental health , interpersonal relationships , and overall lifestyle [ table 2 ] . the mean scores of different dimensions of lifestyle , before and after the intervention in the experimental and control groups the present study was carried out with the aim of studying the effectiveness of health promoting lifestyle on middle - aged women . the findings showed that the mean scores of overall lifestyle in the experimental group significantly improved 3 months after the program , indicating the positive effect of education on having a healthy lifestyle . heidari et al . and bazzano et al . , showed that educational intervention promotes healthy lifestyle in line with the result of this study . the techniques used in this study were : performing a regular educational program , using group discussions , giving the participants the chance of asking and answering the questions to express their personal experiences , giving the educational booklet and focusing on the dimensions of a healthy lifestyle ( nutrition , physical activity , mental health , and interpersonal relationship ) . considering the mean scores of nutrition in the experimental group , there was a sort of increase after the intervention ; however , it was not statistically meaningful . two points should be taken into account : the duration of the educational intervention and the performing method . it is proven that educations being performed in longer periods of time and by means of various methods would be much more effective . that is to say , nutritional behaviors of people are not necessarily affected by their nutritional knowledge ; however , various factors can be influential . the type of the group under study , can also change the results , that is , their ideas and their beliefs have a great impact on their nutritional behavior . therefore , to assess the true impact of education on behavioral changes and actions , it is necessary to take the side factors into consideration as well ( for instance , personal interests , social beliefs , financial issues , and food accessibility ) . an important increase after the intervention was observed in the mean scores of the experimental group which is consistent with those of hashemi et al . probably , the effective educational factors influencing the results are the following : talking about the short - term and long - term consequences of being inactive , introducing proper stretching exercises while doing every day activities in kitchen or after getting up , giving sporting brochures to be attached on an appropriate place at home , training the preventive ways of early exhaustion , doing exciting physical activities , running and exercising with weight , setting up friendship groups to do running based on their interests , introducing some gyms appropriate for old- and middle - aged people . it can also be claimed that the time of conducting the research ( spring and summer ) increasingly helped the women in having more physical activities . after performing the educational intervention , in fact , the improvement of mental health was due to healthy behaviors ( such as nutrition , physical activity , performing relaxation programs , managing the stress , introducing problem solving strategies , being responsible toward one 's health , being optimist , expressing love to others , determining and going for personal goals ) . another increase in the mean score was observed in interpersonal relationship which confirms the results by amini et al . therefore , educational programs focusing on verbal styles , conveying message skills ( verbally and nonverbally ) , and receiving messages skills ( listening , observing , and responding ) are very helpful in having better relationships with others . what differentiates this research from the previous ones is that , four other possible dimensions of healthy lifestyle were taken into account , and based on them , the educational sessions were held whereas the previous studies had only focused on one or two dimensions . since these four dimensions are interrelated , teaching them simultaneously has a great impact on improving lifestyle . moreover , the answers may have been affected by socio - cultural factors ; however , these limitations were inevitable . many affords were made to control for other intervening factors by giving enough explanations about the purpose of the study to the participants and making the needed interaction with them . at the end , since social support has a chief role in improving lifestyle ; therefore , it is suggested that the participants husbands , also , take part in these sessions . the assessment by itself was one of the limitations in front of the research . in all four dimensions , moreover , the answers may have been affected by socio - cultural factors ; however , these limitations were inevitable . many affords were made to control for other intervening factors by giving enough explanations about the purpose of the study to the participants and making the needed interaction with them . at the end , since social support has a chief role in improving lifestyle ; therefore , it is suggested that the participants husbands , also , take part in these sessions . educational intervention may promote lifestyle along with its dimensions . caring about the middle - age women 's lifestyle and their healthy behavioral habits it also can pave the way for having a healthy old - aging period in future .
background : lifestyle affects people 's health and life length , however , no sufficient studies have been done on the effect of lifestyle on middle - ageing , as the transitional period from adulthood to old - ageing , this study has been conducted to study the effect of educational intervention on health promoting lifestyle of middle - aged women in lenjan city of isfahan province , iran.methods:this quasi - experimental study was conducted on 88 middle - aged women were selected through randomized sampling from two health centers in lenjan , and then were categorized into experimental and control groups . to collect data , 
 a researcher - made demographic and life style questionnaire was used . 
 the educational intervention was performed in five sessions . 
 data were collected from both groups in two stages : before the intervention and 3 months after the education . 
 data were analyzed with using spss-20 and p < 0.05 were considered statistically significant.results:the results showed that educational program had a positive significant effect on increasing the mean scores in the intervention group , considering the physical activity , mental health , and interpersonal relationship , p < 0.001 . 
 however , regarding the nutrition , the mean increase was not significant ( p = 0.113).conclusion : according to the findings , it is evident that educational intervention is beneficial for various aspects of middle - aged women 's lifestyle . 
 therefore , applying a healthy lifestyle seems essential for having a healthy aging period , and educational intervention can be effective .