SCT-Based Health Promotion in Older Adults

Comparison of the Effects of Social Cognitive Theory-Based Peer- and Nurse-Led Health Promotion and Prevention Education Programs on the Health Behavıors of Older Adults: A Study Protocol

This study will be conducted to compare the effects of Peer- and Nurse-Led Health Protection and Promotion Training Programs Based on Social Cognitive Theory (SCT) on the health behaviors of older adults. This research will be carried out in two stages as a mixed-methods study with an embedded mixed-method design. The first stage has been planned as a parallel two-arm non-randomized experimental study. This stage will be conducted between October and December 2025 in two separate elderly homes where older adults are densely located in the Muratpaşa district of Antalya province. The sample size has been calculated as 108 older adults (Intervention-1 Peer Leadership: 54, Intervention-2 Nurse Leadership: 54). In the Intervention-1 group, the intervention will be implemented for 12 weeks through the Health Protection and Promotion Training Program Based on SCT under peer leadership, and the same interventions will be carried out in the Intervention-2 group under nurse leadership. Outcomes will be measured before the intervention and 12 weeks after the intervention using the Elderly Health Promotion Scale, Health Protection and Promotion Behavior Checklist, General Self-Efficacy Scale, and Health Seeking Behavior Scale. In the second stage, in order to evaluate the intervention process and experiences multidimensionally, it is aimed to deeply understand the experiences of older adults receiving peer-led intervention, older adults receiving nurse-led intervention, and peer leaders by using multiple data sources within the framework of qualitative research and a phenomenological approach. In the qualitative phase, the data will be collected based on the maximum variation sampling method through face-to-face in-depth individual interviews using semi-structured interview forms in the workshops of both elderly homes in January 2026.

Inclusion Criteria:

• Older adults aged 65 and over classified as low (for women: 0-4 points; for men: 0-3 points) or moderate (for women: 5-8 points; for men: 4-6 points) according to the Health Promotion and Prevention Behavior Checklist,
• Those who attend the elderly center where the study will be conducted at least once a week,
• Those who reside in the study province,
• Those who have and can use a smartphone,
• Those who can speak and understand Turkish,
• Those who scored nine or above on the Short Form of the Mini Mental State Examination (MMSE) (considered to have sufficient cognitive status to participate in the interview),
• Those who scored three or above on the Katz Activities of Daily Living (ADL) Scale (semi-dependent and independent),
• Those who agreed to participate in the study voluntarily,
• Only one older adult from the same household was included in the study.

Exclusion Criteria:

• Those who had previously participated in similar studies related to health promotion and prevention were not included in the study.

Withdrawal and Loss to Follow-up Criteria

• Those who wished to withdraw from the study,
• Those who moved to another location outside the study setting,
• Those who were hospitalized for more than one week due to various reasons during the study period,
• Those who, according to their own statement, had a general health condition not suitable to continue the study,
• Those who died during the study period,
• Those who completed the pre-test but did not participate in the interventions were excluded from the study.