A systematic review and meta-analysis of primary prevention programmes to improve cardio-metabolic risk in non-urban communities

•There are disparities in cardio-metabolic health between urban and non-urban areas.•Intervention effectiveness may differ by the setting within which it is applied.•Barriers to health behaviour change may differ between urban and non-urban areas.•Context may be important when designing and implementing an effective intervention.•Non-urban interventions utilising community and health resources can be effective.