In 2008, at the invitation of the Ministry of Health, the Sri Lanka Medical Association (SLMA), along with other partners developed a project called the National Initiative in Re-Organizing General diabetes care in Sri Lanka (NIROGI–means “wellness”). One of the three parallel components of the NIROGI project was a health promotion intervention in low-income urban settings. Representatives from 28 selected urban settings in Sri Lanka were engaged to generate processes to improve well-being and reduce risk factors associated with noncommunicable diseases, and to identify and address the determinants underlying these factors through collective action. After a slow start, activities spread to a total of 133 settings. Adoption of regular exercise, improved food habits and substantial reductions in BMI values were achieved in virtually all settings. Improved mental well-being and reduced alcohol and tobacco use were reported, but were less widespread. Rarer gains included better money management, less frequent quarrels and domestic conflicts, improved family well-being and community cohesiveness. The main underlying factors recognized and addressed were: time spent watching television, negative influences from within the community (discouraging initiatives to improve health), and “external” commercial influences, including advertising. The results provide support for community health activities implemented by members of the community itself, including the measurement of progress and impact. If the intervention is to be implemented through health sector staff, they will require initial training on how to encourage and improve the…