Introduction
Advances in modern medical science have led to a significant daily increase in the elderly population worldwide. Given the prevalence of physical and psychological problems in the elderly, it is necessary to take action. One of the most important factors in maintaining and promoting health during old age is participation in regular physical activity [21]. The importance of modifying physical activity behavior in the elderly using theory-based educational interventions has been proven [21]. The role of social cognitive function in adopting and maintaining a healthy physical activity level in the elderly has been highlighted in recent research [30]. Social cognitive theory provides a framework that is useful for organizing, understanding, and promoting physical activity [30]. Therefore, the present study aimed at determining the effect of an educational intervention based on social cognitive theory on the physical activity of elderly residents in Isfahan city in 2024. 

Methods & Materials
The present quasi-experimental study was conducted on 88 elderly residents of Isfahan city in 2024. The samples were selected using a multi-stage cluster sampling method and finally were randomly assigned to two intervention and control groups. According to the inclusion criteria and after obtaining permission, elderly individuals who expressed their willingness to participate in the study were invited in person to complete the informed consent form and the pre-test questionnaire. Then, the study objectives were explained to the intervention group. The educational program was presented in the form of six 45-min sessions to the intervention group (44 individuals). Finally, 3 and 12 months after the intervention, the post-test and follow-up questionnaires were completed by inviting the elderly in the group again in person. To adhere to ethical principles, the educational package was also provided to the control group.
Data were collected using a questionnaire with three sections: The first section included 7 demographic and background information questions. The second section was the 12-item standard Physical Activity Scale for the Elderly (PASE) [23]. The third section was a researcher-developed questionnaire investigating cognitive factors affecting the physical activity of the elderly based on the social cognitive theory, comprising three parts: self-efficacy with 10 questions, social support with 9 questions, and outcome expectation and value in the form of 14 questions.
Mean, standard deviation, and frequency were used to describe the data. Data were analyzed using SPSS version 23 software. The Chi-square test was used to compare the two groups in terms of demographic variables. Additionally, to examine the effect of training in the two groups, independent t-tests, multivariate analysis of covariance (MANCOVA), repeated measures ANOVA, and the LSD post-hoc test were used.

Results 
The mean age and gender distribution of participants were as follows: intervention group: 68.38±76.7, control group: 69.70±16.28; female: 44, male: 44. Most participants were married (intervention group: 77.3%, control group: 75%), retired (intervention group: 49.9%, control group: 45.5%), had a medium income (intervention group: 68.2%, control group: 54.5%), and had a university education (intervention group: 43.2%, control group: 40.9%). The independent t-test results showed no significant difference between the mean scores of the two groups in the pre-test (P>0.001). Subsequently, the MANCOVA results revealed that the mean scores for physical activity, self-efficacy, perceived social support, outcome expectation, and outcome value were significantly different between the two groups at the 3-month and 1-year follow-ups (P<0.001). The most significant changes were observed in the mean scores of physical activity at the 3-month (effect size=0.836) and 1-year (effect size=0.824) follow-ups.
Results of repeated measures ANOVA (eta-squared>0.5) indicated a significant difference in the mean scores of pre-test, post-test, and 1-year follow-up in the intervention group over time (P-time<0.001), and this difference increased significantly over time (P-intervention<0.001). The type of group membership also affected the trend of changes; changes in mean scores over time were only observable in the intervention group (P-interaction<0.001) (Table 1).


Subsequently, the LSD test was used to identify significant changes in the mean scores of the variables across the three stages (pre-test, post-test, and follow-up) in the intervention group. The results indicated a significant increase in the mean scores of physical activity, self-efficacy, outcome expectation, and outcome value between all three stages (P>0.05). These changes were not significantly observed between the post-test and follow-up stages for perceived social support (P=0.643).

Conclusion 
The findings of this study, consistent with the study by Anderson-Bill et al. [30], showed that the use of cognitive strategies was effective in promoting the level of physical activity in the intervention group after the intervention. Also, the mean scores of self-efficacy, perceived social support, outcome expectation, and outcome value in the intervention group showed a significant increase in the 3- and 12-month assessments after the intervention. In this regard, Sniehotta et al. reported that increasing or modifying self-efficacy leads to higher levels of physical activity [37]. In the study by Dehghani et al., increased social support for the elderly, and in the study by Son, higher outcome expectations and outcome value were associated with higher levels of physical activity [39, 21]. Therefore, the social cognitive theory-based educational program had a positive and significant effect on the physical activity of older adults. Considering its low cost and practical nature, the application of this model appears beneficial for the elderly.

Ethical Considerations
Compliance with ethical guidelines
Completion of the questionnaires was voluntary and conducted after receiving an introduction letter from the Health Deputy to coordinate with the management of the health centers. Before completing the questionnaires, the consent form was filled out by the participants, and they were assured that the obtained information would remain confidential with the researcher. All stages of this study were conducted in accordance with the ethical standards of the 2013 Declaration of Helsinki, and were approved by the Ethics Committee of Isfahan University of Medical Sciences (Code: IR.MUI.RESEARCH.REC.1401.288).

Funding
This article was a extracted from the master’s thesis in Health Education and Health Promotion. The present research was conducted with financial support from Isfahan University of Medical Sciences.

Authors' contributions
Conceptualization and research management: Zohreh Fathian Dastjerdi; Methodology, validation, and visualization: Mohammad Javad; Design; Analysis, research, and review, sources, draft writing, and editing and finalization: Zahra Mardani. 

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgments
This study was carried out with the cooperation of the health centers affiliated with Isfahan healthcare centers. The authors express their gratitude to the staff and the elderly individuals who participated in this study.

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