A lack of physical activity, tobacco smoking and an unhealthy diet contribute to almost 80% of the world’s risk of cardiovascular disease and type 2 diabetes [1]. Positioned as the leading cause of premature death globally [2], cardiovascular disease is an epidemic driven by type 2 diabetes and the metabolic syndrome [3]. Empirical evidence suggests that the co-occurrence of behavioral risk factors yield greater risks for chronic diseases than the sum of their individual independent effects [4, 5]. For instance, individuals who are diagnosed with metabolic syndrome show a 50-60% higher risk of having a cardiovascular disease than those without metabolic syndrome [6]. With an estimated 20-25% of the world’s adult population presenting metabolic syndrome [3], multiple disease risk factors are increasingly common in adults [7]. Major risk factors of cardiovascular disease and metabolic syndrome are physical inactivity and poor diet [8] with physical inactivity positioned as the primary cause of most chronic diseases [9]. Although compelling evidence exists for the efficacy of improving physical activity and diet [10] in treating individuals with multiple risk factors [11], usual care relies on pharmacotherapies which merely address disease symptoms [12]. Cardiovascular disease is the number one single cause of death in New Zealand, accounting for 33% per annum [13]. In 1998, New Zealand actively addressed this concern by initiating a primary-care intervention strategy called Green Prescription, whereby general practitioners and practice nurses refer or prescribe eligible patients to trained personnel [14]. Nearly 40,000 Green Prescription referrals were written by clinicians in New Zealand from 2013 to 2014 [15]. Green Prescription patients might receive an exercise prescription for any combination of cardiorespiratory, metabolic, physiological or psychological reasons. Once enroled, patients meet with physical activity specialists who customise a physical activity routine which is catered to the patients’ needs and lifestyles while addressing barriers such as asthma, injury, back pain, etc.