title: Social Marketing Risk-Framing Approaches for Dental Sealants in Rural American Indian Children.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: College of Nursing, Montana State University, Bozeman, Montana.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Larsson
authors.affiliation: Browing WIC, Browning, Montana.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Champine
authors.affiliation: Blackfeet Community College, Browning, Montana.
authors.forename: Dee
authors.initials: D
authors.lastname: Hoyt
authors.affiliation: Department of Mathematical Sciences, Montana State University, Bozeman, Montana.
authors.forename: Lillian
authors.initials: L
authors.lastname: Lin
authors.affiliation: Montana INBRE, Montana State University, Bozeman, Montana.
authors.forename: Emily
authors.initials: E
authors.lastname: Salois
authors.affiliation: Browning Community Hospital, Browning, Montana.
authors.forename: Sharon
authors.initials: S
authors.lastname: Silvas
authors.affiliation: Browing WIC, Browning, Montana.
authors.forename: Terri Weasel
authors.initials: TW
authors.lastname: Tail
authors.affiliation: Montana State University, Bozeman, Montana.
authors.forename: Matthew
authors.initials: M
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002675:Child, Preschool; D005260:Female; D058015:Health Communication / Q000379:methods*; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D033182:Intention; D008297:Male; D008875:Middle Aged; D010895:Pit and Fissure Sealants / Q000627:therapeutic use*; D012306:Risk; D012424:Rural Population / Q000706:statistics & numerical data; D020377:Self Efficacy; D040241:Social Marketing; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D010895:Pit and Fissure Sealants
keywords: Indians; North American; community outreach; oral health; rural health services; social marketing