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The Effectiveness of Gain- Versus Loss-Framed Health Messages in Improving Oral Health in Iranian Secondary Schools: A Cluster-Randomized Controlled Trial

  • Original Article
  • Published:
Annals of Behavioral Medicine

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 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.)

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Conflict of interest and source of funding statement

The authors declare that they have no conflict of interests. The study was supported by the Department of Public Health at Qazvin University of Medical Sciences. Falko F. Sniehotta is funded by Fuse, the Centre for Translational Research in Public Health, a UKCRC Public Health Research Centre of Excellence. Funding for Fuse from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged.

Author information

Authors and Affiliations

  1. Qazvin Research Center for Social Determinants of Health, Qazvin University of Medical Sciences, Qazvin, Iran

    Amir H. Pakpour Ph.D.

  2. Department of Public Health, School of Health, Qazvin University of Medical Sciences, Qazvin, Iran

    Amir H. Pakpour Ph.D.

  3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Mir Saeed Yekaninejad Ph.D.

  4. Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK

    Falko F. Sniehotta Ph.D. & Stephan U. Dombrowski Ph.D.

  5. Department of Psychology, Kent State University, Kent, OH, 44242-0001, USA

    John A. Updegraff Ph.D.

  6. School of Natural Sciences, University of Stirling, Cottrell Building, FK9 4LA, Stirling, UK

    Stephan U. Dombrowski Ph.D.

Authors
  1. Amir H. Pakpour Ph.D.
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  2. Mir Saeed Yekaninejad Ph.D.
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  3. Falko F. Sniehotta Ph.D.
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Correspondence to Amir H. Pakpour Ph.D..

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Pakpour, A.H., Yekaninejad, M.S., Sniehotta, F.F. et al. The Effectiveness of Gain- Versus Loss-Framed Health Messages in Improving Oral Health in Iranian Secondary Schools: A Cluster-Randomized Controlled Trial. ann. behav. med. 47, 376–387 (2014). https://doi.org/10.1007/s12160-013-9543-1

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  • DOI: https://doi.org/10.1007/s12160-013-9543-1

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