Krasuska Marta, Davidson Emma M, Beune Erik, Jenum Anne Karen, Gill Jason Mr, Stronks Karien, van Valkengoed Irene Gm, Diaz Esperanza, Sheikh Aziz
Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.
Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom.
JMIR Form Res. 2023 Sep 15;7:e33810. doi: 10.2196/33810.
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.
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.
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).
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.
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.
与其他少数族裔群体相比，南亚裔个体患2型糖尿病（T2DM）的风险更高。因此，需要制定干预措施来应对并降低这种更高的风险。
我们开展了形成性工作，以开发一种文化适应性饮食和身体活动短信干预措施，用于预防居住在苏格兰的巴基斯坦裔女性患T2DM。
我们采用了一种逐步推进的方法，该方法以质量干预开发框架中的六个步骤为依据，包括通过文献综述和焦点小组收集证据（步骤1）、为干预措施制定项目理论（步骤2），最后制定短信内容及配套的发送计划（步骤3）。
在步骤1中，我们审查了12篇文章，并确定了3个关键主题，描述了在预防T2DM背景下影响饮食和身体活动的因素：通过饮食和身体活动预防T2DM的方法的知识；文化、社会和性别规范；以及对患T2DM的感知控制水平和必然性。在与总共25名女性进行的3个焦点小组中出现的关键主题是，干预措施需要提供“友好鼓励”“陪伴”以及“关注个体”，短信要“设定可实现的目标”并包含“健康膳食烹饪信息”。我们将焦点小组和文献综述的结果相结合，创建了13条针对短信进行文化适应的指导原则。在步骤2中，我们制定了一个项目理论，明确了我们的短信应旨在增强的主要变化决定因素：知识和技能、控制感、目标设定和规划行为、同伴支持以及指导行为的规范和信念。在步骤3中，我们利用干预项目理论和指导原则，开发了一组73条旨在支持健康饮食的短信和65条支持增加身体活动的短信。
我们提出了一种基于理论的方法，用于开发一种文化适应性饮食和身体活动短信干预措施，以预防居住在苏格兰的巴基斯坦裔女性患T2DM。本研究概述了一种也可能适用于为不同环境中的其他少数族裔人群开发干预措施的方法。现在需要在此形成性工作的基础上，对基于短信的饮食和身体活动干预措施进行可行性试验，以预防居住在苏格兰的巴基斯坦裔女性患T2DM。
