Metabolic syndrome in rural Australia: An opportunity for primary health care

Abstract

Objective: To measure the impact of a 6-month home-based behaviour change intervention on reducing the risk of chronic disease as determined by metabolic syndrome status and cardiovascular risk score, and discuss implications for primary care in rural areas. Design: A two-arm randomised controlled trial of rural adults. Setting: The rural town of Albany in the Great Southern region of Western Australia.Participants: Participants (n = 401) aged 50-69 years who were classified with or at risk of metabolic syndrome and randomly assigned to intervention (n = 201) or waitlisted control (n = 200) group. Interventions: A 6-month intervention program incorporating goal setting, selfmonitoring and feedback, with motivational interviewing was conducted. Main outcome measures: Change in metabolic syndrome status and cardiovascular risk. Results: Significant improvements in metabolic syndrome status and cardiovascular disease risk score (−0.82) were observed for the intervention group relative to control group from baseline to post-test. Conclusion: This home-based physical activity and nutrition intervention reduced participants' risk of experiencing a cardiovascular event in the next 5 years by 1%. Incorporating such prevention orientated approaches in primary care might assist in reducing the burden of long-term chronic diseases. However, for realistic application in this setting, hurdles such as current national health billing system and availability of resources will need to be considered. K E Y W O R D Scardiovascular diseases, health promotion, obesity, preventive health, rural health

Functional exercise circuit reduce the metabolic risk factor in older people in three months of training

“…Metabolic risk factors such a higher cholesterol, worse lipid profile or higher abdominal circumference are related to the presence of cardiovascular disease and type II diabetes mellitus which are an important health problems worldwide (Beijers et al, 2017;Cho et al, 2019;Kim, 2019). For this reason, health strategies to control these metabolic factors are necessary to reduce the risk of chronic comorbidities, disability and mortality (Jancey et al, 2019).…”

“…The risk factors to develop metabolic syndrome are hypertension, insulin resistance with high fasting plasma glucose, dyslipidemia and visceral adiposity (Bruseghini et al, 2015). In addition, excessive body weight, decreased physical activity, increased sedentary behaviour, poor diet and old age augment the predisposition to develop metabolic syndrome (Jancey et al, 2019).…”

Process evaluation of the ‘Singapore Physical Activity and Nutrition Study’

“…The World Health Organization (WHO) has called upon its 194 global members to intensify their physical activity (PA) and nutrition programs to reduce the rates of NCDs (World Health Organisation, 2017). The effectiveness of community-based PA and dietary programs aimed at combating NCDs is well-supported by evidence-based research (Blackford, et al, 2017;Ding, et al, 2016;Hyseni, et al, 2016;Jancey, et al, 2019).…”

A real opportunity to modify cardiovascular risk through primary care and prevention: A pilot study

“…Risk stratification is intended to target the intensity of the therapeutic or preventive measures to the severity of the patient's risk ( 10 ) and is complementary to the preventive population approach, which deals with population-wide strategies independently of individual risk ( 11 ). General practitioners (GPs) can assess CV risk by using validated risk scores ( 9 , 10 ), such as SCORE (Europe) ( 12 ), Framingham ( 13 ), and ASCVD (US) ( 14 ), based on different combinations of modifiable risk factors that are also targets for prevention ( 15 – 19 ). By means of risk stratification, cardiovascular risk scores (CRS) allow one to plan lifestyle interventions, for instance, physical activity, diet, and smoking interventions ( 15 ).…”

“…General practitioners (GPs) can assess CV risk by using validated risk scores ( 9 , 10 ), such as SCORE (Europe) ( 12 ), Framingham ( 13 ), and ASCVD (US) ( 14 ), based on different combinations of modifiable risk factors that are also targets for prevention ( 15 – 19 ). By means of risk stratification, cardiovascular risk scores (CRS) allow one to plan lifestyle interventions, for instance, physical activity, diet, and smoking interventions ( 15 ). In several cases, interdisciplinary prevention activities have been coordinated by community nurses, creating bridges between primary care and hospitals ( 20 ): virtuous experiences have proved that primary prevention can be led outside of specialist centers and it can result in significant improvements in lifestyles and more effective control of risk factors ( 20 ).…”