Introduction: Sri Lanka’s healthcare system faces increasing strain from noncommunicable diseases (NCDs), which cause 81% of deaths and 77% of disability-adjusted life years, with cardiovascular diseases contributing the largest share. Primary care challenges include limited consultation times, ineffective NCD management frameworks, high healthcare utilization, and inadequate social prescribing pathways. This study synthesizes evidence from Sri Lanka and comparable low- and middle-income countries (LMICs) to develop a conceptual framework for strengthening primary healthcare-based NCD management employing lifestyle medicine and health promotion principles. Methods: We conducted a Sri Lanka–focused scoping review and conceptual framework synthesis to develop an evidence-informed model for integrated NCD care. Searches across PubMed, Scopus, Cochrane, Embase, and Google (2000–2025) identified peer-reviewed and gray literature. Sri Lanka–based studies were prioritized, supplemented by comparable evidence from other LMICs and a Sri Lanka pilot project. Using Jabareen’s iterative conceptual framework analysis, we mapped the literature, identified key concepts, clustered them into categories, and integrated these into higher-order domains through repeated comparison and refinement. Author discussions validated the emerging framework, resulting in a coherent, evidence-informed model for integrated NCD care delivery in a resource-constrained setting. Results: Evidence supported five pillars: (a) group consultations (virtual, hybrid, or in-person) improved engagement, adherence, and satisfaction; (b) health promotion by trained facilitators enhanced self-efficacy and sustained lifestyle change; (c) social prescribing through community-based programs strengthened follow-up and reduced utilization; (d) technology-assisted follow-up improved continuity and accountability; and (e) innovative financing models (public–private partnerships, social impact bonds) promoted cost-effectiveness and sustainability. Synthesizing these findings yielded the Lifestyle Medicine Healthcare Model (LMHM)—a feasible, equity-focused framework linking intervention components, behavioral mechanisms, and contextual enablers for scalable NCD care in Sri Lanka. Conclusion: The LMHM offers a potentially sustainable, cost-effective approach that integrates group consultations, health promotion, social prescribing, and technology-assisted follow-up to promote lasting health behavior change in primary care.
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Amarasinghe Arachchige Don Nalin Samandika Saparamadu
lawrence cheskin
Emily Godfrey
Circulation
University of Washington
Johns Hopkins University
George Mason University
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Saparamadu et al. (Tue,) studied this question.
www.synapsesocial.com/papers/69fa983604f884e66b531eed — DOI: https://doi.org/10.1161/cir.153.suppl_1.th837