Development and cultural adaptation of text messages for promoting healthy eating among Amazonian schoolchildren.

Objective: To develop text messages for a mHealth intervention promoting healthy eating among Amazonian schoolchildren.

Design: Two rounds of expert panel analysis and formative research interviews.

Setting: Western Brazilian Amazon, Cruzeiro do Sul, Acre, Brazil.

Participants: Included 17 healthcare professionals and 40 caregivers of school-aged children enrolled in the Maternal and Child Health and Nutrition in Acre birth cohort study.

Main Outcome Measures: Evaluation focused on messages' cultural appropriateness, comprehensibility, and relevance, along with caregivers' understanding and intention to adhere to the recommendations.

Analysis: Quantitative analysis employed the modified Cohen Kappa, the Scale-Content Validity Index Average (S-CVI-Ave), frequency calculations, and a ranking system.

Results: Fifty-five text messages were drafted. In the initial stage, eight messages did not achieve a sufficient score and were subsequently revised and reevaluated, ultimately gaining approval. The S-CVI-Ave for each domain was as follows: cultural appropriateness = 0.97, comprehensibility = 0.96, and relevance = 0.97. Formative research indicated a 92% understanding rate and a 70% intention rate to adhere to the proposed suggestions.

Conclusions And Implications: The final set of messages was successfully culturally adapted and will contribute to the translation and dissemination of Dietary Guidelines for Brazilian Population recommendations to Western Amazon families.