title: Development of macaronic Hindi-English 'Hinglish' text message content for a coronary heart disease secondary prevention programme.
abstract: BACKGROUND
  Coronary heart disease (CHD) is a leading cause of morbidity and mortality in India. Text message based prevention programs have demonstrated reduction in cardiovascular risk factors among patients with CHD in selected populations. Customisation is important as behaviour change is influenced by culture and linguistic context.
  
  
  OBJECTIVE
  To customise a mobile phone text message program supporting behaviour and treatment adherence in CHD for delivery in North India.
  
  
  METHODS
  We used an iterative process with mixed methods involving three phases: (1) Initial translation, (2) Review and incorporation of feedback including review by cardiologists in India to assess alignment with local guidelines and by consumers on perceived utility and clarity and (3) Pilot testing of message management software.
  
  
  RESULTS
  Messages were translated in three ways: symmetrical translation, asymmetrical translation and substitution. Feedback from cardiologists and 25 patients was incorporated to develop the final bank. Patients reported Hinglish messages were easy to understand (93%) and useful (78%). The software located in Australia successfully delivered messages to participants based in Delhi-surrounds (India).
  
  
  CONCLUSIONS
  Our process for customisation of a text message program considered cultural, linguistic and the medical context of potential participants. This is important in optimising intervention fidelity across populations enabling examination of the generalisability of text message programs across populations. We also demonstrated the customised program was acceptable to patients in India and that a centralised cross-country delivery model was feasible. This process could be used as a guide for other groups seeking to customise their programs.
  
  
  BACKGROUND
  TEXTMEDS Australia (Parent study)-ACTRN 12613000793718.
authors.affiliation: The George Institute for Global Health, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia; Westmead Hospital, Sydney, Australia.
authors.forename: Jay
authors.initials: J
authors.lastname: Thakkar
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Ganesan
authors.initials: G
authors.lastname: Karthikeyan
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Purohit
authors.affiliation: Nepean Hospital , Sydney , Australia.
authors.forename: Swetha
authors.initials: S
authors.lastname: Thakkar
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Jitender
authors.initials: J
authors.lastname: Sharma
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Sunilkumar
authors.initials: S
authors.lastname: Verma
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Parakh
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Seth
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Sundeep
authors.initials: S
authors.lastname: Mishra
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Yadav
authors.affiliation: All India Institute of Medical Sciences , New Delhi , India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Singh
authors.affiliation: The George Institute for Global Health, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Rohina
authors.initials: R
authors.lastname: Joshi
authors.affiliation: Sydney Medical School, The University of Sydney, Sydney, Australia; Westmead Hospital, Sydney, Australia.
authors.forename: Aravinda
authors.initials: A
authors.lastname: Thiagalingam
authors.affiliation: The George Institute for Global Health, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia; Westmead Hospital, Sydney, Australia.
authors.forename: Clara K
authors.initials: CK
authors.lastname: Chow
authors.affiliation: The George Institute for Global Health, Sydney, Australia; Sydney Medical School, The University of Sydney, Sydney, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Redfern
keywords: CORONARY ARTERY DISEASE