This study investigated factors influencing insect phobia among older adults in Iran and Malaysia using a quasi-experimental design with individual and group-based teaching models. The study included 151 older adults (82 Iranians, 69 Malaysians). Baseline and post-intervention scores were analyzed using paired t-tests, MANOVA, regression analysis, path analysis and a neural network model. Malaysians scored higher on EVI: Disgusting Pre (mean = 8.03 vs. Iranian mean = 7.46, p < 0.05) but showed greater reductions post-intervention (mean difference = 1.03 vs. Iranian mean difference = 0.63, p < 0.01). OAEAS scores decreased more among Malaysians (mean difference = 14.45 vs. Iranian mean difference = 15.08, p < 0.05). Males reported higher fear and disgust levels than females (p < 0.05). Pet ownership reduced phobic responses (p < 0.05), while chronic conditions heightened baseline scores but limited reductions over time. Group-based interventions were more effective for Malaysians, while individual-based approaches worked better for Iranians. The neural network model explained 82% of EVI variance and 79% of OAEAS variance. Culturally tailored interventions effectively reduce insect phobia among older adults. Future research should explore longitudinal effects and broader cultural contexts.