(1) Background: Cardiometabolic diseases are the most common cause of death worldwide. As part of a collaborative European study, this paper aims to explore the implementation of primary care selective-prevention services in five European countries. We assessed the implementation process of the selective-prevention services, participants' cardiometabolic profile and risk and participants' evaluation of the services, in terms of feasibility and impact in promoting a healthy lifestyle. (2) Methods: Eligible participants were primary care patients, 40-65 years of age, without any diagnosis of cardiometabolic disease. Two hundred patients were invited to participate per country. The extent to which participants adopted and completed the implementation of selective-prevention services was recorded. Patient demographics, lifestyle-related cardiometabolic risk factors and opinions on the implementation's feasibility were also collected. (3) Results: Acceptance rates varied from 19.5% (n = 39/200) in Sweden to 100% (n = 200/200) in the Czech Republic. Risk assessment completion rates ranged from 65.4% (n = 70/107) in Greece to 100% (n = 39/39) in Sweden. On a ten-point scale, the median (25-75% quartile) of participant-reported implementation feasibility ranged from 7.4 (6.9-7.8) in Greece to 9.2 (8.2-9.9) in Sweden. Willingness to change lifestyle exceeded 80% in all countries. (4) Conclusions: A substantial variation in the implementation of selective-prevention receptiveness and patient risk profile was observed among countries. Our findings suggest that the design and implementation of behavior change cardiometabolic programmes in each country should be informed by the local context and provide some background evidence towards this direction, which can be even more relevant during the current pandemic period.

Academic Primary Health Care Centre Stockholm Region 11365 Stockholm Sweden

Centre for Epidemiology and Community Medicine Region Stockholm 11365 Stockholm Sweden

Clinic of Social and Family Medicine School of Medicine University of Crete 70013 Heraklion Greece

Department of General Practice Amsterdam Public Health Research Institute Amsterdam University Medical Centers location VUmc 1081 HV Amsterdam The Netherlands

Division of Family Medicine and Primary Care Department of Neurobiology Care Sciences and Society Karolinska Institutet 14183 Huddinge Sweden

Institute of General Practice 1st Faculty of Medicine Charles University 128 00 Prague 2 Czech Republic

Julius Center for Health Sciences and Primary Care University Medical Center Utrecht 3584 CX Utrecht The Netherlands

Nivel Netherlands Institute for Health Services Research 3513 CR Utrecht The Netherlands

Research Unit of General Practice Department of Public Health University of Southern Denmark 5000 Odense C Denmark

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