Adaptation of the Content of a Behavioural Text Message Delivered Weight Management Intervention for a Socio-Culturally and Geographically Diverse Population of Postpartum Women in the UK: The Supporting MumS (SMS) Intervention.

Background: The Supporting MumS (SMS) intervention, originally piloted in Northern Ireland, United Kingdom (UK), uses automated text messages aiming to support diet and physical activity behaviour change for weight management in the postpartum period. Before testing the effectiveness of the SMS intervention in a UK-wide randomised controlled trial, it was important to ensure that the core component of the intervention was acceptable and culturally relevant for a diverse range of women across different regions of the UK.

Objective: to undertake Personal and Public Involvement (PPI) to adapt the content of the previously developed library of text messages for a socio-culturally and geographically diverse population of postpartum women.

Setting And Participants: Recruitment focused on mothers who lived in London, Bradford and various locations in Scotland, who had had a child within the last 2 years and had struggled with their weight. Existing PPI networks and community groups helped identify PPI representatives.

Design: The PPI activities employed an iterative process including three stages: (1) an online group session to review some of the text messages and provide immediate feedback; (2) online group sessions to review adaptations made to messages; and (3) working remotely on a one-to-one basis with PPI collaborators to review and provide comments and suggestions on the entire text message library (previously modified based on feedback from stages 1 and 2).

Results: A total of 19 PPI representatives responded to the invitation and 18 contributed to the review of the SMS text messages: n = 12 from England [n = 4 from London (African-Caribbean ethnicity); n = 8 from Bradford (Asian ethnicity]; n = 6 from Scotland (White ethnicity). During a period of 9 months (July 2021-March 2022), they provided unprompted, positive feedback about the overall concept of a text message-delivered intervention to support postpartum weight management. During review and discussion of the original text message content they suggested minor amendments on the length, language, humour and cultural relevance of the text messages. Overall, no messages needed major re-writing.

Conclusion: This PPI work provided useful suggestions for the cultural and regional adaptation of the content of a text message library that aims to support postpartum weight management. Minor modifications to the messages were suggested. The effectiveness of the Supporting MumS intervention will be tested in a UK-wide trial.

Patient Or Public Contribution: Our PPI collaborators were identified through existing PPI networks and community groups. They contributed through online group sessions and on a one-to-one basis through email correspondence. They offered valuable insights into ways of enhancing the cultural and regional relevance of a library of text messages to support diet and physical activity behaviour change for weight loss and weight loss maintenance in the postpartum period.