Cultural and Linguistic Adaptation of a Healthy Diet Text Message Intervention for Hispanic Adults Living in the United States
Open accessAbstract
Hispanics represent a critical target for culturally adapted diet interventions. In this formative research, we translated HealthyYouTXT, an mHealth program developed by the U.S. National Cancer Institute, into HealthyYouTXT en Español, a linguistically and culturally appropriate version for Spanish speakers in the United States. We report a three-stage, mixed-methods process through which we culturally adapted the text messages, evaluated their acceptability, and revised the program based on the findings. In Stage 1, we conducted initial translations and adaptations of the text libraries using an iterative, principle-guided process. In Stage 2, we used mixed methods including focus groups and surveys with 109 Hispanic adults to evaluate the acceptability and cultural appropriateness of the program. We used survey data to evaluate whether self-determination theory (SDT) factors (used to develop HealthyYouTXT) of autonomous motivation, controlled motivation, and amotivation and Hispanic cultural beliefs about familism, fatalism, and destiny predict program interest and its perceived efficacy. Mixed-methods analyses revealed substantial interest in HealthyYouTXT, with most participants desiring to use it and viewing it as highly efficacious. Both cultural beliefs (i.e., beliefs in destiny and, for men, high familism) and SDT motivations (i.e., autonomy) predicted HealthyYouTXT evaluations, suggesting utility in emphasizing them in messages. Higher destiny beliefs predicted lower interest, suggesting that they could impede program use. In Stage 3, we implemented the mixed-methods findings to finalize HealthyYouTXT en Español. The emergent linguistic principles and multistage, multimethods process can be applied in health communication adaptations.
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Adaptation may transcend linguistic translation and extend to cultural themes and values that affect interpretation and reception of messages.
“The adaptation may transcend linguistic translation and extend to cultural themes and values that affect the interpretation and reception of people receiving the messages [24,27].”
From Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study (2018) · cites this paper as [24]
Adapting mobile phone-based programs for use in another context is complex and challenging because of varied cultural contexts.
“However, adapting mobile phone-based programs for use in another context is complex and challenging because of the varied cultural contexts of countries where the intervention is being adapted [24-26].”
From Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study (2018) · cites this paper as [24]
The current literature provides some guidance on how to adapt mobile phone-based interventions for use in countries where they were not specifically designed, acknowledging the essential role of the end user.
“The current literature provides some guidance on how to adapt mobile phone-based interventions (for use in countries wherein it was not specifically designed), acknowledging the essential role of the end user in this process [24,46,47].”
From Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study (2018) · cites this paper as [24]
Strong evidence indicates that cultural translation markedly contributes to the acceptability and effectiveness of mHealth interventions.
“The value of undertaking a cultural translation cannot be underestimated, with strong evidence of its marked contribution to the acceptability and effectiveness of mHealth interventions [24,44,45].”
From Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study (2018) · cites this paper as [24]
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- Authors
- Cameron, L. D., Durazo, A., Ramírez, A. S., Corona, R., Ultreras, M., & Piva, S.
- Affiliations
- University of California, Merced (US)
- Corresponding author
- Cameron, Linda D.
- Venue
- Journal of Health Communication
- Publisher
- Informa UK Limited
- Published
- 2017-02-19
- Volume
- 22
- Issue
- 3
- Pages
- 262-273
- ISSN
- 1081-0730 (ISSN-L)
- 1087-0415
- PMC
- PMC5555404
- OpenAlex
- W2588086233
- Cited by
- 18
- References
- 52
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 2 · 2018: 6
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Health Communication (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (00)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Social Sciences › Arts and Humanities › Literature and Literary Theory › Media Influence and Health
- Keywords
- culturally tailored interventions, mobile health, Hispanic adults, dietary behavior change, translation and adaptation, familism, fatalism, self-determination theory, autonomous motivation, perceived efficacy, program acceptability
- MeSH terms
- Diet, Healthy, Adult, Cultural Characteristics, Female, Health Promotion, Hispanic or Latino, Humans, Linguistics, Male, Middle Aged, United States, Young Adult, Text Messaging
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