A randomized control trial to test the effectiveness, feasibility, and acceptability of an education intervention promoting healthy lifestyle to reduce risk factors for metabolic syndrome, among office workers in Ethiopia.

INTERVENTION: The study will be conducted with bank workers because they are a high risk group, but are relatively educated. The intervention will consist of education about the concept of metabolic syndrome, risk factors, and prevention strategies, the significance of lifestyle modification such as exercise, a healthy diet, avoiding harmful alcohol consumption, quitting smoking, and stress management, as well as motivation for changing behavior. The education will be delivered by a nutritionist, physical therapist, and psychologist in a group setting in a community hall over the course of a single day for 8 hours. Healthy lifestyle booklets which is developed by World Health Organization for cardiovascular disease management which can be accessed at (https://www. who.int/publications‐detail‐redirect/ 9789240001367) will also be provided for them at the starting date of the intervention. Every two weeks, the researcher will send a text message to the participants as a reminder and asking whether they follow the suggested diet, physical activity, and other intervention components. It will also inquire as to whether they recorded their actions using the offered self‐report template. Throughout the intervention (for 9 months), the participants will be encouraged to ask questions, and seek guidance and reply to the texts by sending more texts inquiring as to whether they have any questions. Additionally, a review meeting lasting a half day or si Xhours will be held at the 3rd and 6th month of the intervention to review the main points about prevention of metabolic syndrome and healthy lifestyle, and to assess obstacles faced to adhere to the intervention and define a strategy to overcome these barriers. Adherence to the intervention will be monitored by self‐report checklists, attendance CONDITION: Cardiovascular ‐ Hypertension Diet and Nutrition ‐ Obesity Metabolic and Endocrine ‐ Diabetes Metabolic syndrome;Obesity;Diabetes; Hypertension;Cholesterol ; ; Metabolic syndrome ; Obesity ; Diabetes ; Hypertension ; Cholesterol Public Health ‐ Health promotion/education INCLUSION CRITERIA: Bank employees who fulfill the following WHO metabolic syndrome criteria will be included in the trial. Waist‐to‐hip ratio >0.85 in female; >0.90 in male, body mass inde X>30 kg/m2, Blood pressure greater than 140/90, fasting plasma glucose greater than 110 mg/dl, Plasma triglycerides greater than 150 mg/dL, HDL cholesterol < 35 mg /dL in men or < 39 mg/dL in women. PRIMARY OUTCOME: Attitude towards metabolic syndrome. Attitudes will be assessed using the 43‐item validated knowledge, attitudes, and practices on lifestyle and cardiovascular risk factors questionnaire which was developed and tested in India.[baseline and 9 months after intervention commencement. ] Knowledge about metabolic syndrome. Knowledge will be measured using the 43‐item validated knowledge, attitudes, and practices on lifestyle and cardiovascular risk factors questionnaire which was developed and tested in India.[Baseline and 9 months after intervention commencement ] Obesity level: Obesity level will be measured by measuring waist circumference and hip circumference by using millimeter and calculating body mass index by measuring weight using kg and height using meter. [ Baseline and 9 months after intervention commencement.] SECONDARY OUTCOME: Acceptability of intervention. Acceptability will be measured by a validated 4 item tool Acceptability of Intervention Measure (AIM), and by theoretical framework for acceptability. Acceptability of Intervention Measure' and 'theoretical framework for acceptability a composite secondary outcome.[At 6 months after intervention commencement ] Assessment of the implementation of the intervention. Implementation process will be evaluated by using consolidated framework for implementation research.[Throughout the intervention period ] Blood glucose level: Blood glucose level will be assessed by laboratory testing of fasting plasma glucose level. It is a primary outcome.[Baseline and 9 month after intervention commencement. ] Blood pressure: Blood pressure will be assessed using manual sphygmomanometer. It is a primary outcome. [Baseline and 9 month after intervention commencement. ] Cholesterol level: Cholesterol level will be assessed by laboratory analysis of blood plasma total cholesterol, high density lipoprotein cholesterol, triglyceride level, and low‐density lipoprotein cholesterol. It is a primary outcome. [Baseline and 9 month after intervention commencement.] Fidelity of the intervention. Fidelity will be assessed by participants and providers self‐reports and researcher observations using checklists. [Throughout the intervention phase] Intervention feasibility. Feasibility will be measured by a validated 4 item tool Feasibility of Intervention Measure (FIM).[At 6 months after intervention commencement]