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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. Measurements We compared participant's 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 participant's 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 t(88) = 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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