Happy Village Plus: Community-empowered health promotion interventions in Sri Lanka.

Non-communicable diseases (NCDs) account for over 80% of deaths in Sri Lanka. Addressing these diseases is challenging due to their complex social, behavioural, and environmental causes. Community-based health promotion programmes focused solely on single risk factors and education provision show limited effectiveness. This study describes Happy Village Plus (HVP), a grassroots, community-based intervention designed to select and implement health promotion interventions aligned with communities' health-related needs in Western Province, Sri Lanka. HVP was conducted in six communities from November 2022 to June 2024. We recorded Capacity Building and Engagement Activities by type of activity and stakeholders engaged, and Community Interventions by approach and health determinant. Communities' health-related risk factor needs were obtained from individual-level data from 1712 individuals. Regression analyses were conducted to assess whether the community interventions chosen matched communities' health-related needs. A total of 1217 Capacity Building and Engagement activities were recorded. Community interventions (n = 975) most often addressed diet-related determinants, followed by physical activity and BMI, and to a lesser extent, tobacco and alcohol. For most communities, insufficient fruit and vegetable consumption was the most prevalent health-related need, followed by insufficient physical activity, alcohol use, and smoking. Our results show the selected interventions align with identified needs. This paper demonstrates the feasibility of implementing grassroots, holistic, multi-faceted, community interventions covering a wide range of health determinants and NCD risk factors in a developing country context. We highlight that, when empowered, communities can select interventions that align with their health needs, with higher disease prevalence increasing the likelihood of choosing relevant interventions.