Table 2.

Main themes and operationalizing strategies for text message development.

Main strategies based on themes	Operationalizing strategies for message development based on subthemes	Behavioral change wheel
Use positively framed advocacies, they are more persuasive; avoid negative or non-affirming framing of advocacies	Empower and ease stress by pointing to successes	Motivation
	Inspire	Motivation
	Show respect for receivers	Motivation
	Show compatibility with positive indigenous views of health as “living a good life”	Motivation
Avoid fear- or stress-inducing messages	Do not exacerbate people’s stressful lives (eg, experience of low income or racism)	Motivation
Avoid oppressive or authoritarian messages	Show respect for autonomy: Authoritarian messages are perceived as lacking in respect; invoke historic distrust issues with colonial/medical system; and may cause defiant response	Motivation
	Provide healthy life style education message along with pharmacotherapy	Motivation
Build on healthy cultural and traditional practices whenever possible; avoid incongruity with cultural and traditional practices	Empower with a strengths-based approach to local culture	Capability, opportunity, motivation
	Show respect for culture	Capability, opportunity, motivation
Recognize social determinants of health as drivers of ability to adopt behaviors; avoid disconnect with the reality of social determinants of health and the diversity of cultures within a population	Consider cultural settings and cultural norms related to lifestyle	Capability, opportunity
	Understand affordability and accessibility of foods and medications	Capability, opportunity
	Consider access to providers and/or medications in the health care system	Capability, opportunity
Ensure pragmatic content within the local setting ; avoid lack of clarity and lack practicality of content	Preference for practical tips over higher level advice	Capability
	Avoid ambiguity in wording and assumptions	Capability
	Consider and check the local dialect in translation	Capability