Abstract
Background: Oral health is considered as a prominent factor that contribute to quality of life. Hormonal changes during pregnancy can influence oral health. Message framing can play an important role in motivating oral health behaviors. The aim of the present study was to investigate the effect of message framing on the oral health behaviors and dental plaque among pregnant women.Methods: This randomized field trial was conducted in 2017 on 108 pregnant women in Izeh county, Iran.The participants were randomly divided into three groups; gain-framed, loss-framed, and control group. The research instrument included a two parts questionnaire containing demographic information and oral health knowledge, attitude, behavioral intention, self-efficacy, practice, and dental plaque index. Gain-and loss-framed messages were sent to the intervention groups via cell phones, but the control group did not receive any messages. The participants’ dental plaque were clinically assessed. Data were analyzed using SPSS version, 23.0. P-value less than 0.05 was considered statistically significant.Results: The mean scores of knowledge, attitude, behavioral intention, and self-efficacy were significantly increased in the gain- and loss-framed intervention groups (gain knowledge (6.05±1.90; CI:5.40-6.71); gain attitude(5.00±3.61; CI:3.75-6.24); gain behavioral intention (2.91±1.59; CI:2.36-3.46); gain self-efficacy (4.42±2.69; CI:3.50-5.35); loss knowledge (5.71±1.52; CI:5.19-6.23); loss attitude (4.54±2.67; CI:3.62-5.46); loss behavioral intention (2.25±1.94; CI:1.58-2.92); loss self-efficacy (3.97±2.60; CI:3.07-4.86) (p<0.001). No significant difference was observed in the control group (knowledge (0.38±1.45; CI:0.12-0.89, p=0.135); attitude (0.88±3.63; CI:0.38-2.14, p= 0.166); behavioral intention (-0.38±1.74; CI: -0.98-0.22, p=0.2); self-efficacy (.0.50±3.23; CI: -1.62-0.62, p=0.37). The rising trend in the mean score of the behaviors in the intervention groups was significantly higher than that in the control group (p<0.001). The ratio of dental plaque on teeth surfaces in the gain- and loss-framed intervention groups also showed a significant decrease compared to control group (gain dental plaque (16.46±11.66; CI:12.46-20.47, p<0.001); loss dental plaque (15.06±8.52; CI:12.13-17.99, p<0.001). Conclusion: Text message intervention improved knowledge, attitude, behavioral intention, self-efficacy, and dental plaque among pregnant women. The results show that text messages mattered, but the framing did not"; because there was a difference between intervention and control groups but not that "message framing matters" because the particular framing of the messages had no pronounced effect.