The intensive participation of community leaders in teamwork is essential for healthy lifestyle adoption and lifestyle disease prevention. Adult-centered lifestyle education intervention is a simple method and requires less power. However, the effect of community leaders' engagement in education on the effectiveness of intervention, adults' team performance, and satisfaction was not noticed in west Ethiopia. Therefore, this study aims to evaluate the effect of theory-based education intervention through intensive community leaders on the intervention mapping approach to healthy lifestyle adoption of middle-aged Nekemte dwellers. A pretest-post-assessment quasi-experimental control study was conducted from January to July 2019 and post-data was collected in August 2019. Out of 266 apparently healthy, 253 middle-aged final analyzed. After 3 months of intensive education for the intervention group, weekly 1 session of 30 to 50 minutes was given for the other 3 months and the team was led by community leaders. With SPSS version 24 data analyzed for descriptive statistics, difference-in-differences the mean difference, independent t test, and the correlation between variables were analyzed using Spearman, and significance was considered at P value <.05. At baseline there was no significant difference among the 2 groups. While healthy lifestyle adoption improved, anthropometric measures showed a reduction among the intervention group compared to the control group. This study showed that among the middle-aged in the intervention group compared with the control group, preceding behaviors ( P < 0·001), self-efficacy ( P < 0·001), affects related behavior ( P < .001), interpersonal influences ( P < 0·001), perceived benefits ( P = 0·001), barriers ( P = 0·003) and commitment to action of a plan ( P < 0·001) were significantly changed at the end line. The role of the team leader's effort was 92.19% for successful competition of the intervention and the average scaling rate of team effectiveness is 73.19% and significantly associated with effectiveness ( R = 0.82, P < .01), leaders effort ( R = 0.73, P < .01), and satisfaction ( R = 0.84, P < .01). A community-based team leader has a positive correlation with effectiveness and implementations of lifestyle education intervention. The study revealed that theory-based educational intervention through intensive community leaders is effective in participants' retention, healthy lifestyle adoption, anthropometric measure reduction, improving adults' team performance & satisfaction, and rapid implementation of intervention at the community level. Hereby theory-based educational intervention through intensive community leaders is a prominent educational tool to implement lifestyle education, health lifestyle adoption, and prevent chronic diseases. The findings imply the need for targeting the middle-aged in designing healthy lifestyle education interventions.
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