TY  - JOUR
AU  - Krasuska, Marta
AU  - Davidson, Emma M
AU  - Beune, Erik
AU  - Jenum, Anne Karen
AU  - Gill, Jason MR
AU  - Stronks, Karien
AU  - van Valkengoed, Irene GM
AU  - Diaz, Esperanza
AU  - Sheikh, Aziz
PY  - 2023
DA  - 2023/9/15
TI  - A Culturally Adapted Diet and Physical Activity Text Message Intervention to Prevent Type 2 Diabetes Mellitus for Women of Pakistani Origin Living in Scotland: Formative Study
JO  - JMIR Form Res
SP  - e33810
VL  - 7
KW  - diabetes
KW  - diet
KW  - ethnic minority populations
KW  - Pakistani
KW  - physical activity
KW  - prevention
KW  - South Asian
KW  - text messages
KW  - women
KW  - women’s health
KW  - health intervention
KW  - digital health
KW  - mobile health
KW  - minority
KW  - exercise
KW  - text message
KW  - text messaging
KW  - SMS
KW  - development
KW  - formative
KW  - diabetes mellitus
AB  - Background: Individuals of South Asian origin are at an increased risk of developing type 2 diabetes mellitus (T2DM) compared with other ethnic minority groups. Therefore, there is a need to develop interventions to address, and reduce, this heightened risk. Objective: We undertook formative work to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. Methods: We used a stepwise approach that was informed by the Six Steps in Quality Intervention Development framework, which consisted of gathering evidence through literature review and focus groups (step 1), developing a program theory for the intervention (step 2), and finally developing the content of the text messages and an accompanying delivery plan (step 3). Results: In step 1, we reviewed 12 articles and identified 3 key themes describing factors impacting on diet and physical activity in the context of T2DM prevention: knowledge on ways to prevent T2DM through diet and physical activity; cultural, social, and gender norms; and perceived level of control and sense of inevitability over developing T2DM. The key themes that emerged from the 3 focus groups with a total of 25 women were the need for interventions to provide “friendly encouragement,” “companionship,” and a “focus on the individual” and also for the text messages to “set achievable goals” and include “information on cooking healthy meals.” We combined the findings of the focus groups and literature review to create 13 guiding principles for culturally adapting the text messages. In step 2, we developed a program theory, which specified the main determinants of change that our text messages should aim to enhance: knowledge and skills, sense of control, goal setting and planning behavior, peer support, and norms and beliefs guiding behavior. In step 3, we used both the intervention program theory and guiding principles to develop a set of 73 text messages aimed at supporting a healthy diet and 65 text messages supporting increasing physical activity. Conclusions: We present a theory-based approach to develop a culturally adapted diet and physical activity text message intervention to prevent T2DM for women of Pakistani origin living in Scotland. This study outlines an approach that may also be applicable to the development of interventions for other ethnic minority populations in diverse settings. There is now a need to build on this formative work and undertake a feasibility trial of a text message–based diet and physical activity intervention to prevent T2DM for women of Pakistani origin living in Scotland. 
SN  - 2561-326X
UR  - https://formative.jmir.org/2023/1/e33810
UR  - https://doi.org/10.2196/33810
UR  - http://www.ncbi.nlm.nih.gov/pubmed/37713245
DO  - 10.2196/33810
ID  - info:doi/10.2196/33810
ER  -