The Effectiveness of Gain- Versus Loss-Framed Health Messages in Improving Oral Health in Iranian Secondary Schools: A C
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ORIGINAL ARTICLE
The Effectiveness of Gain- Versus Loss-Framed Health Messages in Improving Oral Health in Iranian Secondary Schools: A Cluster-Randomized Controlled Trial Amir H. Pakpour, Ph.D. & Mir Saeed Yekaninejad, Ph.D. & Falko F. Sniehotta, Ph.D. & John A. Updegraff, Ph.D. & Stephan U. Dombrowski, Ph.D.
# The Society of Behavioral Medicine 2013
Electronic supplementary material The online version of this article (doi:10.1007/s12160-013-9543-1) contains supplementary material, which is available to authorized users.
were measured at baseline, two and twenty-four weeks. Data were analyzed using multilevel modeling. Results At 2 weeks, loss-frame participants reported higher brushing and flossing rates, and more favorable attitudes and intentions to brush, compared to the other groups. At 24 weeks, loss-frame participants showed better OHRQOL, gingival health and less dental plaque compared to the other groups. Attitudes and intentions mediated intervention effects for the loss-framed group. Conclusions Loss-framed messages were more effective than gain-framed messages in encouraging oral self-care behaviors among Iranian adolescents. These effects were mediated through attitudes and intentions. (clinicaltrials.gov number NCT01421108.)
A. H. Pakpour Qazvin Research Center for Social Determinants of Health, Qazvin University of Medical Sciences, Qazvin, Iran
Keywords Oral health . Adolescents . Message framing . Persuasion
A. H. Pakpour (*) Department of Public Health, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran e-mail: [email protected]
Introduction
Abstract Background Adherence to oral self-care behaviors is low among adolescents. Purpose This study aims to examine effects of two message framing interventions on oral self-care behaviors and health among Iranian adolescents. Methods Cluster-randomized controlled trial, with four schools randomly assigned to receive gain-framed, loss-framed, or no messages. Brushing/flossing, attitudes, intentions, oral health related quality of life (OHRQOL), and clinical examinations
M. S. Yekaninejad Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran F. F. Sniehotta : S. U. Dombrowski Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK J. A. Updegraff Department of Psychology, Kent State University, Kent, OH 44242-0001, USA S. U. Dombrowski School of Natural Sciences, University of Stirling, Cottrell Building, FK9 4LA Stirling, UK
Worldwide, more than half of all adolescents suffer from oral disease [1]. Adolescents lose an estimated 52 million hours of school time each year due to dental problems and related care [1]. Most oral diseases, such as dental caries, are preventable. Oral self-care behaviors such as brushing and flossing reduce dental plaques [2–4]. In Iran, only 18.2 and 8.4 % of high school students report regular brushing (i.e., twice a day) and flossing (i.e. once a day), respectively [5]. Consequently, effective health co
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