PapersConclusions The prevalence of the selected cardiovascular risk factors is common in the adult Sri Lankan population surveyed. Regional differences exist in the prevalence of these risk factors. The prevalence of high level of risk factors requires urgent public health action. AbstractObjective To determine the prevalence of selected cardiovascular risk factors in adult Sri Lankan population in four provinces.Design Cross-sectional, based on a stratified cluster sampling method.Settings Four provinces, namely the Western, North Central, Southern and Uva.Patients Six thousand and forty seven participants (2692 men) between the age of 30 and 65 years were surveyed.Measurements Risk factors measured included height, weight, waist and hip circumference. Waist to hip ratio and body mass index were calculated, and overweight (23 kg/m 2 ) and obesity (≥25 kg/m 2 ) determined. Hypertension (systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or use of antihypertensive medications), and diabetes mellitus (fasting serum plasma glucose level ≥ 7 mmol/L or use of antidiabetic medications) and impaired fasting glycaemia (≥ 6.1 to < 7 mmol/L) were also determined.Results The prevalence of hypertension as defined was 18.8% (CI 14.5-23.1) for men and 19.3% for women. The prevalence of diabetes was 14.2% (CI 11.9-16.5) for men and 13.5% (CI 6.9-20.1) for women while impaired fasting glycaemia was 14.2% for men and 14.1% for women. The mean body mass index was 21.5 kg/m 2 (SD = 3.7) in men. It was lower than that in women, 23.3 kg/m 2 (SD = 4.5). The prevalence of obesity was 20.3% in men and 36.5 % in women.Regional differences were seen in the mean fasting blood glucose and prevalence of diabetes, and mean BMI and prevalence of obesity were highest in Western province. Mean blood pressure and prevalence of hypertension were highest in the Uva Province. Southern Province had the lowest prevalence of hypertension and diabetes, and North Central Province had lowest anthropometric measures of obesity.

Objective: To consider the challenges of communicating COVID-19 directives to culturally and linguistically diverse (CALD) communities in Australia, and present evidence-based solutions to influence policy and practice on promoting relevant health behaviours; to advance participatory research methodologies for health behaviour change. Type of program or service: We present a case study of a participatory research collaboration between CALD community leaders and health behaviour change scientists during the COVID-19 crisis. The goal was to better understand the role of community leaders in shaping health behaviours in their communities and how that role might be leveraged for better health outcomes. Methods: This article is the culmination of a series of dialogues between CALD community and advocacy leaders, and health behaviour change scientists in July 2020. The academic authors recruited 12 prominent CALD community leaders, conducted five semi-structured dialogues with small

Objective: To consider the challenges of communicating COVID-19 directives to culturally and linguistically diverse (CALD) communities in Melbourne and Australia, and present evidence-based solutions to influence policy and practice on promoting relevant health behaviours. Type of program or service: We reflect on the experiences of CALD communities during the COVID-19 crisis, and particularly the role of community leaders in shaping health behaviours in their communities. Methods: This article draws on a series of dialogues between CALD community and advocacy leaders, and health behaviour change scientists in July 2020. We present the challenges experienced, and solutions offered, by CALD leaders in communicating health information throughout the pandemic and consider the importance of behavioural and implementation science in reducing inequities in healthcare communication. Results: During the Covid-19 pandemic, CALD leaders have played a critical role in filling gaps in government messaging by providing up-to-date health advice and cultivating community support for relevant health behaviours (e.g., physical distancing, testing, hand hygiene). Nevertheless, attempts to communicate recommended health behaviours may not be reaching, and/or understood by, all members of CALD communities. In synthesizing the accounts of CALD leaders, three key findings emerged: first, partnerships between CALD leaders, communities and government are key, including the establishment of a national CALD advisory group on COVID-19; second, shifting knowledge into action requires moving beyond disseminating information to designing tailored solutions to reflect the diversity in our society; and third, the diverse needs and circumstances of people and communities must be at the centre of health communication and behaviour change strategies. Implementation science is needed to action the solutions offered by CALD leaders for equity of access and outcomes in COVID-19 health support. Lessons learnt: Insights from behavioural and implementation science can inform communication strategies that help align human behaviour with the recommendations of health experts. This coupled with sustained partnership and collaboration with CALD communities, understanding the cultural context and the appropriate tailoring and delivery of communications will ensure health related messages are not lost in translation. These lessons should be applied not only to the current pandemic but to post-pandemic social and economic recovery.

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