{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T17:40:28Z","timestamp":1794073228773,"version":"4.8.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,4,26]],"date-time":"2021-04-26T00:00:00Z","timestamp":1619395200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Future Leader Fellowship","award":["100802"],"award-info":[{"award-number":["100802"]}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","award":["APP1069043"],"award-info":[{"award-number":["APP1069043"]}],"id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Health and Medical Research Council of Australia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,11]]},"abstract":"Abstract<\/jats:title>\n \n Background\u2003<\/jats:title>\n Nurse-led health and lifestyle modification programmes can prevent cardio-metabolic diseases and be advantageous where health disparities exist.<\/jats:p>\n <\/jats:sec>\n \n Aims\u2003<\/jats:title>\n To assess the effectiveness of a nurse-driven health and lifestyle modification programme in improving cardio-metabolic risk parameters for higher-risk regional residing adults.<\/jats:p>\n <\/jats:sec>\n \n Methods\u2003<\/jats:title>\n We conducted an open, parallel-group randomized controlled trial in two sites. Participants were aged 40\u201370\u2009years with no prior cardiovascular disease who had any three or more of; central obesity, elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure (BP) and dysglycaemia. Intervention participants received individual face-to-face and telephone coaching for improving cardio-metabolic risk. Control group participants received standard care and general information about risk factor management. The primary endpoint was the percentage of participants who achieved the target risk factor thresholds or clinically significant minimum changes for any three or more cardio-metabolic risk factors during 24\u2009months of follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results\u2003<\/jats:title>\n Participant average age was 57.6 (SD 7.6) years, 61% were female and 71% were employed. The primary endpoint was achieved by 76% intervention (97 of 127) and 71% usual care (92 of 129) participants [adjusted risk ratio (RR): 1.08; 95% CI 0.94, 1.24; P\u2009=\u20090.298]. Improved BP in the intervention group was more likely than in the control group (84% vs. 65%) (adj. RR: 1.28; 95% CI 1.11, 1.48; P\u2009=\u20090.001) but no other cardio-metabolic component.<\/jats:p>\n <\/jats:sec>\n \n Conclusion\u2003<\/jats:title>\n Nurse intervention to modify cardio-metabolic risk parameters had no enhanced effectiveness compared with usual care. However, participation was associated with improvements in cardio-metabolic abnormalities, with particular emphasis on BP.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Registered with the Australian New Zealand Clinical Trial Registry (ACTRN12616000229471).<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/eurjcn\/zvab042","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T08:00:34Z","timestamp":1617955234000},"page":"26-35","source":"Crossref","is-referenced-by-count":12,"title":["Nurse co-ordinated health and lifestyle modification for reducing multiple cardio-metabolic risk factors in regional adults: outcomes from the MODERN randomized controlled trial"],"prefix":"10.1093","volume":"21","author":[{"given":"Melinda J","family":"Carrington","sequence":"first","affiliation":[{"name":"Pre-Clinical Disease and Prevention Unit, Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Z","family":"Zimmet","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Faculty of Medicine, Nursing and Health Sciences, Monash University, 99 Commercial Road, Melbourne VIC 3004, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,26]]},"reference":[{"key":"2022011303365075800_zvab042-B1","year":"2018"},{"key":"2022011303365075800_zvab042-B2"},{"key":"2022011303365075800_zvab042-B3"},{"key":"2022011303365075800_zvab042-B4","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5334\/aogh.2713","article-title":"Cardiovascular diseases in central and eastern Europe: a call for more surveillance and evidence-based health promotion","volume":"86","author":"Movsisyan","year":"2020","journal-title":"Ann Glob Health"},{"key":"2022011303365075800_zvab042-B5","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1093\/eurheartj\/ehz859","article-title":"European Society of Cardiology: cardiovascular disease statistics 2019","volume":"41","author":"Timmis","year":"2020","journal-title":"Eur Heart J"},{"key":"2022011303365075800_zvab042-B6","first-page":"2047487320908698","article-title":"Primary prevention efforts are poorly developed in people at high cardiovascular risk: a report from the European Society of Cardiology EURObservational Research Programme EUROASPIRE V survey in 16 European countries","author":"Kotseva","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022011303365075800_zvab042-B7","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","article-title":"Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity","volume":"120","author":"Alberti","year":"2009","journal-title":"Circulation"},{"key":"2022011303365075800_zvab042-B8","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.jacc.2010.05.034","article-title":"The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis","volume":"56","author":"Mottillo","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2022011303365075800_zvab042-B9","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.2337\/dc08-0423","article-title":"Metabolic syndrome and incident diabetes: current state of the evidence","volume":"31","author":"Ford","year":"2008","journal-title":"Diabetes Care"},{"key":"2022011303365075800_zvab042-B10","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1463-1326.2012.01571.x","article-title":"Effectiveness of interventions for reducing diabetes and cardiovascular disease risk in people with metabolic syndrome: systematic review and mixed treatment comparison meta-analysis","volume":"14","author":"Dunkley","year":"2012","journal-title":"Diabetes Obes Metab"},{"key":"2022011303365075800_zvab042-B11","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1007\/s11606-007-0399-6","article-title":"Effectiveness of a lifestyle intervention on metabolic syndrome. 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