This study is a quasi-experimental controlled interventional study. The research population in this study consisted of middle-aged women referring to Karaj health centers. The designed research estimated the sample size by using the results of the survey by Nikpour et al. . The sampling was carried out using a cluster sampling technique. The study randomly identified overweight or obese women who referred to the Karaj health center, and we asked about their willingness to participate in the study. After agreeing to participate in the study, the authors randomly assigned respondents to one of the intervention or control groups. Accordingly, this survey incorporated a total of 140 women (70 in the control group and 70 in the intervention group) and entered into the study. The inclusion criteria in the study were lack of any defect that prevented exercise and willingness from participating to join this study. The authors explained study objectives to observe the ethics of the research, and they trained and educated respondents of the survey. The authors ensured participants of the study that all the data received in this study is strictly confidential.
This survey used an instrument to collect the desired data from the selected population, adjusted the questionnaire according to the requirement of the research, and gathered the desired data through a self-administered questionnaire. The authors collected the information two times, which was before and after two months of the intervention. The questionnaire used in this study contained three parts. It contained nine questions on the information of the respondents such as age, height, weight, level of education, occupation, history of participation in physical activity, and history of smoking. This study adopted items of the questionnaire to measure the constructs of the theory of planned behavior, from the existing literature [17, 18]. The developed questionnaires used a Likert-scale of a 5-point response for the questions of attitude, subjective norms, perceived behavioral control, and was previously designed and used in Iran . The authors executed a pilot study on thirty respondents to examine and determine the reliability of this data collection instrument. Cronbach's alpha coefficient test presented the reliability of the questionnaire equivalent to 0.92.
This questionnaire identifies the amount of physical activity in the participants. It was proposed in 1998 by the World Health Organization and the Center for Disease Control for the age group of 15–69 years old . The questionnaire determines physical activity in the last seven days. The physical exercises, for instance, aerobics, high-speed biking, climbing, and basketball, which require more than six calories per minute, are called intense physical activity. These activities such as volleyball, badminton, and room cleaners, which need 3 to 6 calories per minute are considered the moderate physical activity. Besides, any exercise or event with a duration of fewer than 10 minutes will not find and delete. The International Physical Activity Questionnaire calculates the energy intensity of the total activity in the last seven days performed according to the instructions of IPAQ. If the total energy derived during the week is less than 600/met/min/ week, the intensity of physical activity goes under the rubric of the weak category. If the total energy consumed for physical activity is between 600–3000/met/min/week, it is in a group classified as the middle. If it is more than 3000/met/min/week, it presents a classification of a severe category . In this questionnaire, one-minute walking is equal to 3.3 met, moderate physical activity is similar to 4 met, and one minute of intense physical activity is equivalent to 8 met. Therefore, authors calculated the total amount of physical activity per week, the amount of walking (met × min × day) with moderate physical activity (met × min × day) should be summed up with severe physical activity (met × min × day) last week . Previous studies also used this questionnaire in the country, and the results have confirmed its validity and reliability [21, 22].
In the early stage, the authors conducted the pre-test, and the two groups completed the pre-test questionnaires at this stage.
Second stage: Training intervention was carried out for the intervention group at this stage
Third stage: The two groups completed the post-test questionnaires at this stage
In the first stage, authors were intervening to get acquainted with the goals of the training program to pay attention to educational programs and the role of physical activity on physical and mental health. The authors arranged a meeting in the presence of all participants, both intervention and control groups to receive comments from participants on the extent and possible barriers of their participation in sports activities. In the meeting, after the project executor explained the objectives of the plan and obtained the consent form from the participants, he asked them to fill in the questionnaires on demographic information, the surveys on the theory of planned behavior, and the physical activity questionnaire. Then a session was followed up to provide participants with feedback on their physical activity and the possible needs and obstacles on the physical movement of house-wives and provide practical solutions for them. The authors randomly divided the population into two groups of 70 respondents, and it was decided to discuss the most critical needs and obstacles over the physical activity of the housewives, and list the priority of practical solutions in order. The meeting, which lasted about 60 minutes, addressed the needs and issues faced by women in physical activity at home or elsewhere as well as practical solutions. Then the list of each group was received and at the subsequent meetings, which was formed only with the presence of the intervention group, discussed in the form of brainstorming of possible solutions. Some of the most critical barriers to physical activity provided by these groups included, (1.) Lack of time for sports activities; (2.) Lack of a proper living environment for sports activities; 3. much work and tiredness after work; 4. Shortage of necessary equipment for sports activities; and 5. Shame for doing sports in public.
This research designed the training intervention according to the information obtained in the first stage, examining the related studies and suggestions of scientific sources about the effectiveness of the structures of the theory of planned behavior as well as considering the characteristics of the audience, the conditions and facilities of the community under study. In the first stage, the authors explained respondents the objectives of the project, the confidentiality of the information, and the purpose of this project. The women of the two intervention and control groups filled out the questionnaires, and the authors analyzed the results of this stage. Based on the needs assessment and analysis, the results of the first phase of the training program were prepared and applied to the intervention group, which authors designed as two groups of 17 and two groups of 18 persons in person in 4 sessions of 45 minutes. Two months after the intervention, the questionnaires were completed again by the two groups and analyzed. The training sessions included:
Session 1: Introduction to educational objectives, emphasis on attitudes and health priorities
Session 2: The benefits of desirable physical activity and low-mobility complications and illnesses associated with it
Session 3: The study emphasized on the effect of physical activity and a balanced, as well as the suitable diet in preventing overweight and perceived a controlled construct.
Session 4: The study illustrated the ways to avoid obesity and to highlight the structure of subjective norms, sports exercises in practice.
Results presented as mean ± SD, where appropriated, and analysis results showed frequency tables for categorical variables. This study applied the Shapiro-Wilk non-parametric test to verify the normality distribution of the theory of planned behavior constructs within experimental groups. Using a baseline score of attitude, subjective norms, perceived behavioral control, and IPAQ, an ANCOVA model was employed to compare the differences between control and treated groups.