Social Marketing Risk-Framing Approaches for Dental Sealants in Rural American Indian Children


Laura S. Larsson, Dorothy Champine, Dee Hoyt, Lillian Lin, Emily Salois, Sharon Silvas, Terri Weasel Tail, Matthew Williams


Public Health Nursing


Objective To compare three variants of a culturally relevant and theoretically based message to determine the most influential risk-framing approach for improving intention to place dental sealants for preschool children. Design and Sample A convenience sample of adult, American Indian participants (n = 89) attending a community health fair were assigned to view a gain-framed, loss-framed, or mix-framed dental sealant message. Measures We compared participants' scores on a 46-item survey to determine the relative effect of the frame assignment on seven indices of behavior change. Results The mean difference in participants' stage-of-change scores (x = 1.17, n = 89, SD = 1.90) demonstrated a significant improvement for all groups after watching the dental sealant message t88 = 5.81, p < .0001, 95% CI [0.77–1.57]. Self-efficacy was the only construct for which we detected a statistically significant difference as a function of frame assignment. Overall, the mix-framed message resulted in the highest scores. The gain-framed message was the least influential on four constructs. This finding is in contrast to findings that gain-framed oral health messages are most influential (Gallagher & Updegraff, 2012; O'Keefe & Jensen, 2007). Conclusions Community advisory board members determined to use the mix-framed approach in an oral health social marketing campaign with a rural, American Indian audience.



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