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Cited by 16Smoking Behavior and CessationMobile Health and mHealth ApplicationsSocial Media in Health Education

Assessing the Cross-Cultural Adaptation and Translation of a Text-Based Mobile Smoking Cessation Program in Samoa (TXTTaofiTapaa): Pilot Study

Open access
McCool, Judith, Tanielu, Helen, Umali, Elaine, Whittaker, Robyn·2018·JMIR mHealth and uHealth
DOI 10.2196/mhealth.9033PMC PMC6138826

Published version of a preprint

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Abstract

BACKGROUND: Samoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services. Mobile phones are ubiquitous and generally affordable. OBJECTIVE: This study aimed to adopt a text message (short message service, SMS) smoking cessation program designed in New Zealand (stop smoking with mobile phones, STOMP) for use in Samoa to assist national objectives in reducing the tobacco use. METHODS: Using focus groups with smokers and ex-smokers, we explored the context for tobacco use and preferences for SMS text messages. Postintervention focus groups were held after participants received SMS text messages for 1 week. Frequent face-to-face meetings with the primary partner (Ministry of Health Samoa) and key stakeholders contributed to the adaptation process. Participatory feedback and collaboration from stakeholders became an integral part of the cultural adaptation and translation of the program. Furthermore, detailed document analyses were included as part of the formal evaluation of the initiative to explore the core determinants of success in adapting the program to the Samoan cultural context. RESULTS: The SMS text messages evolved remarkably following an iterative process of consultation, in situ testing, revision, and retesting to arrive at an acceptable country-specific version of the mobile smoking cessation program. The SMS text messages retained in the final set were consistent with the theory of behavioral change but reflected both linguistic and cultural nuances appropriate for Samoa. Adapting messages required simultaneous multilevel processes, including complex high-level engagement, between the team and the stakeholders, along with crafting the precise content for (character limited) messages. CONCLUSIONS: Receiving cessation support messages through a mobile phone is promising and appears to be an acceptable and accessible mode of delivery for tobacco cessation, particularly in the absence of alternative support. Adapting a text-based program in Samoa requires fastidious attention to the nuances of culture, language, and sociopolitical structures in the country.

AI snapshot

Written from the paper’s full text.

TL;DR

This pilot adapted the New Zealand STOMP SMS smoking cessation program into Samoan TXTTaofiTapaa through iterative translation, focus groups, and stakeholder consultation. Participants found SMS cessation support acceptable, with messages refined for Samoan language, tone, timing, and cultural context.

Key findings

  • In Apia, 36 smokers and ex-smokers participated: 27 (75%) were smokers and 9 (25%) were ex-smokers; 22 (61%) were male. Participants received 14 pretested SMS messages, 2 per day for 1 week, and were reimbursed 20 tala (approximately US $8).
  • The SMS messages evolved through iterative consultation, in situ testing, revision, and retesting; the final set remained consistent with behavioral change theory but reflected Samoan linguistic and cultural nuances.
  • Participants preferred positive, practical messages, family-related benefits, and no abbreviated slang; some older males preferred shock/negative-effect messages and images. Midday and evening delivery were preferred, and some participants shared messages with family or friends.
  • After 1 week, many participants reported reducing cigarettes smoked or increased intention to quit, but no quantitative quit outcomes were reported.

Methods

  • The adaptation had three major steps: preliminary translation and adaptation design; adaptation test and formative evaluation by potential users; and linguistic and cultural adaptation and refinement. Researchers collaborated with the Samoa Ministry of Health and the National University of Samoa.
  • Participants were recruited in Apia through posters; inclusion criteria included being a smoker or ex-smoker who quit ≥6 months, aged ≥16 years, mobile phone access, ability to receive SMS for 1 week, written informed consent, and participation in two 1-hour group interviews. Six focus groups were held with 36 participants.
  • Focus groups were digitally recorded, transcribed, translated into English, and analyzed using general inductive thematic analysis; two researchers independently coded initially, and stakeholder consultations and document analyses informed the adaptation.

Limitations

  • Stated: a local Samoan-speaking coinvestigator conducted the interviews, which may have introduced social desirability response owing to socially connected group settings.
  • Stated: translation challenges included retaining message integrity within the 160-character limit and identifying the definitive authority for translation; New Zealand-based Samoan translators were least preferred over local officially appointed translators.
  • Evident from the text: this was a qualitative pilot with 36 participants, 1-week message exposure, and self-reported smoking reduction or intention to quit; no biochemical verification or long-term quit outcomes were reported, limiting generalizability.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/mhealth.9033

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 47 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    The majority of participants who received the messages were positive about the potential of the program in assisting them to quit smoking.

    “The majority of participants who received the messages were positive about the potential of the program in assisting them to quit smoking.”
    Quote in the paperSubstantial claim
  • Findingown data

    The SMS text messages evolved remarkably following an iterative process of consultation, in situ testing, revision, and retesting to arrive at an acceptable country-specific version of the mobile smoking cessation program.

    “The SMS text messages evolved remarkably following an iterative process of consultation, in situ testing, revision, and retesting to arrive at an acceptable country-specific version of the mobile smoking cessation program.”
    Quote in the paperSubstantial claim
  • Findingown data

    Participants suggested avoiding times when messages would be disruptive to important events or rituals.

    “Generally, participants suggested avoiding times when the messages would be disruptive to important events (Bingo night, church services) or rituals (during a meal).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Some participants preferred SMS text messages that contained information about the negative effects of smoking-the shock effect perceived to be a necessary motivator for attracting attention and potentially nudging behavioral change.

    “Some participants preferred SMS text messages that contained information about the negative effects of smoking—the shock effect perceived to be a necessary motivator for attracting attention and potentially nudging behavioral change.”
    Quote in the paperNot a substantial claim
  • Findingown data

    A number of participants reported sharing SMS text messages with family or friends by forwarding or relaying the content.

    “A number of participants reported that they shared the SMS text messages with family or friends, through either actual forwarding the SMS text message or relaying the content of the SMS text messages to family and friends.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 25
  • Classified as probably not a substantial claim. 45

  • May combine two claims.

    Findingown data

    A few participants said nothing changed but expressed that SMS text messages increased their intention to quit.

    “A few said nothing changed, but expressed that the SMS text messages increased their intention to quit.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Another message aroused humor and curiosity; that cigarettes contain chemicals found in toilet cleaner.

    “Another message aroused humor and curiosity; that cigarettes contain chemicals found in toilet cleaner.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The SMS text messages retained in the final set were consistent with the theory of behavioral change but reflected both linguistic and cultural nuances appropriate for Samoa.

    “The SMS text messages retained in the final set were consistent with the theory of behavioral change but reflected both linguistic and cultural nuances appropriate for Samoa.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Participants preferred SMS text messages that did not use abbreviated slang language, with some commenting that these SMS text messages will be difficult to understand among older smokers.

    “Participants preferred SMS text messages that did not use abbreviated slang language, with some commenting that these SMS text messages will be difficult to understand among older smokers.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Visual representations of the message were considered important, partly for validation; seeing is believing.

    “Furthermore, visual representations of the message were considered important, partly for validation; seeing is believing.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The themes that informed the development of the adaptation design were: (1) initial program perception; (2) message tone and content; (3) message delivery; and (4) perception of the value of mCessation program in general.

    “The themes that informed the development of the adaptation design were described accordingly: (1) initial program perception; (2) message tone and content; (3) message delivery; and (4) perception of the value of mCessation program in general.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    A few participants expressed doubts about the SMS text messages' effects, comparing them with antismoking advertisements previously viewed on television or billboards.

    “However, a few expressed doubts about the SMS text messages’ effects, comparing them with antismoking advertisements previously viewed on television or billboards.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Some participants suggested they would like to receive more messages to assist them to quit smoking.

    “Some even suggested they would like to receive more messages to assist them to quit smoking.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Some participants suggested providing the option for smokers to choose between receiving English and Samoan SMS text messages.

    “Furthermore, some participants suggested providing the option for smokers to choose between receiving English and Samoan SMS text messages.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Many participants preferred a positive tone of the SMS text messages-encouraging messages that reflected the physiological challenges when quitting were perceived to be helpful.

    “During the follow-up focus group discussions, many participants preferred a positive tone of the SMS text messages—encouraging messages that reflected the physiological challenges when quitting were perceived to be helpful.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Findingown data

    These participants suggested that messages should be personalized and tailored to Samoans for greater impact on users.

    “These participants suggested that messages should be personalized and tailored to Samoans for greater impact on users.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Some participants requested photo evidence to be included with the SMS text message.

    “Some requested photo evidence to be included with the SMS text message.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Phone sharing in Samoa and close connectivity with family was believed to help in spreading the message.

    “Phone sharing in Samoa and the close connectivity with family was believed to help in spreading the message.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Although some questioned the validity of that specific message, others suggested that these were the most impactful-clear linkages between smoking, the chemicals, and the risk to body organs.

    “Although some questioned the validity of that specific message, others suggested that these were the most impactful—clear linkages between smoking, the chemicals, and the risk to body organs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Practical suggestions on what to do to avoid smoking were appreciated, as well as those that highlight the benefits of quitting smoking to their family.

    “Practical suggestions on what to do to avoid smoking were appreciated (eg, “Get lots of rest to keep your energy up to fight the cravings. If you get tired, it’s easy to have cravings for a smoke.”), as well as those that highlight the benefits of quitting smoking to their family.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Overall, participants were generally positive toward the idea of receiving supportive messages and concurred the program would offer support to Samoans who smoke.

    “Overall, participants were generally positive toward the idea of receiving supportive messages and concurred the program would offer support to Samoans who smoke.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Participants identified when cravings to smoke were highest and when SMS text messages were most useful in providing timely encouragement.

    “Participants identified when cravings to smoke were the highest and when SMS text messages were most useful in providing timely encouragement.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    The original STOMP messages were revised to include more reference to family and changes to suggested activities and snacks.

    “this led to minor revisions of the original STOMP messages to include more reference to family (eg, messages about the benefits of quitting smoking to family), and changes to suggested activities and snacks (reduce craving to smoke).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    In the authors' experience, New Zealand-based Samoan translators were the least preferred over local officially appointed translators.

    “In our experience, New Zealand-based Samoan translators were the least preferred over local officially appointed translators.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Consultations with experts improved the suitability of messages to the local setting, as well as the accuracy and integrity of translation and language use.

    “Our consultations with experts improved the suitability of messages to the local setting, as well as the accuracy and integrity of translation and language use.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Mobile phones can deliver programs to support behavioral change.

    “Mobile phones can deliver programs to support behavioral change [1,2], data management or surveillance [3,4], and other essential public health activities.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [1] source

      Not checked in the free run.

    • cites [2] source

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  • May combine two claims.

    Premisecitation

    Mobile phones are ubiquitous and generally affordable in Samoa.

    “Mobile phones are ubiquitous and generally affordable.”
    • Also stated in: § Introduction · plain
      “Samoa, having reached one of the highest rates of mobile phone coverage in the Pacific region in recent years [28], is well placed to initiate mobile phone-based health interventions.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [28] World Bank2017Mobile cellular subscriptions (per 100 people)https://data.worldbank.org/indicator/IT.CEL.SETS.P2

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the United Kingdom, the adaptation process of STOMP included reviews by smoking cessation counselors and focus groups among potential participants.

    “In the United Kingdom, the adaptation process of STOMP included reviews by smoking cessation counselors and focus group among potential participants (ie, smokers, ex-smokers, and smokers trying to quit) [37].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [37] Free, C, 2013, Mechael, Editors

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    STOMP has been adapted and used in the United Kingdom and Argentina.

    “STOMP has been adapted and used in the United Kingdom and Argentina [35,36].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [35] source

      Not checked in the free run.

    • cites [36] source

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  • Classified as probably not a substantial claim.

    Premisecitation

    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].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [24] source

      Not checked in the free run.

    • cites [27] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two researchers (HT and EU) independently performed an initial coding, which was later categorized and organized into themes by the research team.

    “Two researchers (HT and EU) independently performed an initial coding, which was later categorized and organized into themes by the research team.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Adapting a text-based program in Samoa requires fastidious attention to the nuances of culture, language, and sociopolitical structures in the country.

    “Adapting a text-based program in Samoa requires fastidious attention to the nuances of culture, language, and sociopolitical structures in the country.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The focus group participants' perceptions are representative of the broader Samoan smoker and ex-smoker population.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Ethical approval for this study was granted by the University of Auckland Ethics Committee and the Samoa Ministry of Health Research Committee (reference 016631).

    “Ethical approval for this study was granted by the University of Auckland Ethics Committee and the Samoa Ministry of Health Research Committee (reference 016631).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    The adaptation in Buenos Aires emphasized that nuances in tone and translations may negatively affect acceptability.

    “The adaptation in Buenos Aires, which included translation and back-translation, expert review, and discussions among potential users, emphasized that nuances in tone and translations may negatively affect the acceptability.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Adapting messages required simultaneous multilevel processes, including complex high-level engagement between the team and stakeholders, along with crafting precise content for character-limited messages.

    “Adapting messages required simultaneous multilevel processes, including complex high-level engagement, between the team and the stakeholders, along with crafting the precise content for (character limited) messages.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Receiving cessation support messages through a mobile phone is promising and appears to be an acceptable and accessible mode of delivery for tobacco cessation, particularly in the absence of alternative support.

    “Receiving cessation support messages through a mobile phone is promising and appears to be an acceptable and accessible mode of delivery for tobacco cessation, particularly in the absence of alternative support.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Samoa has few existing cessation support services.
    • Rests on an assumption: The focus group participants' perceptions are representative of the broader Samoan smoker and ex-smoker population.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Participants were grouped according to demographic homogeneity (age and gender) and smoking status.

    “Participants were grouped according to the demographic homogeneity (age and gender) [40] and smoking status (Table 1).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [40] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Rigorous consultations with stakeholders were undertaken to ensure the appropriateness and suitability of messages to local setting or preferences.

    “Rigorous consultations with stakeholders were undertaken to ensure the appropriateness and suitability of messages to local setting or preferences.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The translation process was iterative, drawing upon both the content of interviews and consultation with participants regarding the message content and tone.

    “The translation process was iterative, drawing upon both the content of interviews and consultation with participants regarding the message content and tone.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The results were analyzed using a general inductive thematic analysis method.

    “The results were analyzed using a general inductive thematic analysis method [43].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43] Strauss, A, 1990, Basics of Qualitative Research : Grounded Theory Procedures and Techniques

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The suite of messages was tailored to recognize the iterative phases typical in behavior change: contemplation, action, and maintenance.

    “The suite of messages was tailored to recognize the iterative phases that are typical, but not universal, in the process of behavior change: contemplation (prep for quit date), action (quit day), and maintenance (relapse support) [39].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [39] Prochaska, JO, 1983, J Consult Clin Psychol source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Samoa reduced the percentage of adult smokers from 34.6% in 2002 to 25.6% in 2013.

    “With increased government support, Samoa has made progress toward reducing the percentage of adult smokers from 34.6% in 2002 [31] to 25.6% in 2013 [32,33].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [31] World Health Organization200806GenevaWorld Health OrganizationSamoa NCD Risk Factors STEPS reporthttp://sdd.spc.int/en/resources/document-library?view=preview&format=raw&fileId=230

      Not checked in the free run.

    • cites [32] World Bank2014GenevaWorld Health OrganizationNon-communicable disease (NCD) roadmap report (English)http://documents.worldbank.org/curated/en/534551468332387599/Non-Communicable-Disease-NCD-Roadmap-Report

      Not checked in the free run.

    • cites [33] World Health Organization2015Samoa Steps Survey Factsheethttp://www.who.int/ncds/surveillance/steps/2002_Samoa_FactSheet.pdf

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    The adapted and modified SMS text messaging program (txt2stop) doubled biochemically verified continuous abstinence in 6 months compared with unassisted quit attempts (268/2911 (9%) vs 124/2911 (4%), P<.001).

    “In a large randomized controlled trial, the adapted and modified SMS text messaging program (txt2stop) doubled biochemically verified continuous abstinence in 6 months compared with unassisted quit attempts, that is, 268/2911 (9%) versus 124/2911 (4%), respectively, (P<.001) [16].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [16] source

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Conducting a formal cross-cultural adaptation is a necessary step in the adoption of smoking cessation interventions.

    “Hence, conducting a formal cross-cultural adaptation is a necessary step in the adoption of smoking cessation interventions [36].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All 6 focus groups were moderated by a Samoan researcher (HT).

    “All 6 focus groups were moderated by a Samoan researcher (HT).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    SMS text messaging is a simple and effective intervention for improving health service delivery in pregnant women, infectious disease cases, weight loss cases, and diabetes cases, and increasingly for smoking cessation support.

    “Short message service (SMS) text messaging, in particular, has been shown to be a simple and effective intervention for improving health service delivery in pregnant women [9,10], infectious disease cases [11,12], weight loss cases [13], and diabetes cases [14] and increasingly for smoking cessation support [15-18].”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [9] source

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    • cites [10] source

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    • cites [11] source

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    • cites [12] source

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    • cites [13] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Following translation, SMS text messages that exceeded the 160-character limit were paraphrased, but the overall content and tone were retained.

    “Following the translation, SMS text messages that exceeded the 160-character limit were paraphrased, but the overall content and tone were retained.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    SMS text messages can present timely cues, behavioral reinforcement, and social support through an inexpensive delivery medium.

    “SMS text messages can present timely cues, behavioral reinforcement, and social support [19] all through an inexpensive delivery medium.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The process of translation required considerable time and effort.

    “The process of translation required considerable time and effort, a step that could potentially be underestimated.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Samoan words are typically lengthier than their English equivalent.

  • Classified as probably not a substantial claim.

    Premisecitation

    Culturally adapted messages will increase engagement, a predictor of the positive impact of SMS text message programs on health.

    “The aim of this study reflects an appreciation that culturally adapted messages will increase engagement, a predictor of the positive impact of SMS text message programs on health [45,49].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [45] source

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    • cites [49] source

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  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The study recognizes the involvement of key stakeholders who can determine the local acceptability and appropriateness of the intervention.

    “It also recognizes the involvement of key stakeholders who can determine the local acceptability and appropriateness of the intervention.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    A local coinvestigator, fluent in Samoan, conducted the interviews.

    “A local coinvestigator, fluent in Samoan, conducted the interviews.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    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].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [24] source

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    • cites [46] source

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    • cites [47] source

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    This investment is essential for meaningful improvements to the integrity of technology-based health interventions.

    “Hence, this study suggests that this investment is essential for meaningful improvements to the integrity of technology-based health interventions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Another strength of this study is partnership with the Ministry of Health Samoa to undertake the process of adaptation.

    “Another strength of this study is partnership with the Ministry of Health Samoa to undertake the process of adaptation”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationnone given

    This work reflects the reality of adapting an SMS text message program for a limited-resource environment.

    “and the fact that this work reflects the reality of adapting an SMS text message program for a limited-resource environment.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Lessons learned and observations made throughout the process of adapting the intervention provide value for others attempting similar efforts.

    “Lessons learned and observations made throughout the process of adapting the intervention provide value for others attempting similar efforts.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The local coinvestigator conducting interviews might have introduced a social desirability response, owing to the tendency to offer affirmative opinions when researching within socially connected group settings.

    “Although this adds strength to the integrity of the data collection, it might have introduced a social desirability response, owing to the tendency to offer affirmative opinions when researching within socially connected group settings.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Engagement with SMS text message interventions is recognized as important to uptake and behavioral change.

    “Similarly, engagement with SMS text message interventions is recognized as important to uptake and behavioral change [27].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [27] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Colantonio et al conducted similar consultations, mostly with tobacco cessation experts, to validate their translated messages for suitability and relevance to the local setting.

    “Colantonio et al [36] conducted similar consultations, mostly with tobacco cessation experts, to validate their translated messages for suitability and relevance to the local setting.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Previous qualitative analyses affirm the critical role of the social environment, familial connections, including smokers, and perceived barriers and motivations for quitting.

    “Previous qualitative analyses affirm the critical role of the social environment, familial connections, including smokers, and perceived barriers and motivations for quitting”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The integrated process underscores the vital role of the end user of mHealth tools, in this case smokers, in providing inputs about the shape and design of the adapted program.

    “this process underscores the vital role of the end user of mHealth tools, in this case smokers, to provide inputs about the shape and design of the adapted program.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

    Interpretationreasoning

    Adapting mobile phone-based interventions requires considerable time and resource and keen attention to the nuances of language and meaning, as well as partnerships.

    “Adapting mobile phone-based interventions requires considerable time and resource and keen attention to the nuances of language and meaning—as well as partnerships.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Samoan words are typically lengthier than their English equivalent.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Translation quality was determined according to the integrity of the translator, with the primary challenge being identification of the definitive authority in translation.

    “The translation quality was determined according to the integrity of the translator, with the primary challenge being the identification of the definitive authority in translation [48].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [48] MacPherson, C, 1990, Samoan Medical Belief and Practice

      Not checked in the free run.

59 of 59

  • The paper relies on this without support.

    Samoa has few existing cessation support services.

    “Samoa faces a persistently high prevalence of adult tobacco use and few existing cessation support services.”

  • The paper relies on this without support.

    The focus group participants' perceptions are representative of the broader Samoan smoker and ex-smoker population.

    “The results below reflect participants’ perceptions of the messages after receiving them for a week.”

  • The paper relies on this without support.

    Samoan words are typically lengthier than their English equivalent.

    “As Samoan words are typically lengthier than their English equivalent, alternative words were selected.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

  • Female percentage does not match the count

    Minor

    The table reports 14 female participants out of 36, which is 39%, not 22%.

    Reported 22 · recomputed 38.888889

  • "Most days" SMS-use percentage is incorrect

    Minor

    Eleven of 36 participants is approximately 31%, not 4%.

    Reported 4 · recomputed 30.555556

  • SMS-use category counts exceed the sample size

    Minor

    The five SMS-use frequency categories total 40 participants, although Table 1 states N=36.

    Reported 36 · recomputed 40

3 of 3

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. 10.1186/s12889-016-3062-5 · DOI
  2. Free, C, 2013, Mechael, Editors, 48

Cited by

Sorted by citations

Related

Authors
McCool, J., Tanielu, H., Umali, E., & Whittaker, R.
Affiliations
  • University of Auckland (NZ)
  • National University of Samoa (WS)
Corresponding author
McCool, Judith
ORCID
Venue
JMIR mHealth and uHealth
Publisher
JMIR Publications Inc.
Published
2018-08-31
Volume
6
Issue
8
Pages
e173
ISSN
2291-5222 (ISSN-L)
DOI
10.2196/mhealth.9033
PMC
PMC6138826
OpenAlex
W2809121350
Semantic Scholar
0b2867a730298059cc16b2a6f8911f995c1b4613
Cited by
15
References
44
Citations by year
2026: 1 · 2023: 1 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2
FWCI
1.89
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JMIR mhealth and uhealth (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • ResearchSpace (University of Auckland) (submittedVersion, cc-by)
  • ResearchSpace (University of Auckland) (submittedVersion)
Funders
  • New Zealand Foreign Affairs and Trade
  • Health Research Council of New Zealand
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Health › Social Media in Health Education
Keywords
smoking cessation, text messaging, mobile health, cross-cultural adaptation, program translation, Samoa, tobacco use, stakeholder engagement

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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