Photo-enhanced messaging to address dietary sugars as a common risk factor for chronic disease

龋齿在缺乏服务的人群和添加糖的人群中非常普遍 消费是这种疾病最突出和最稳定的风险因素之一。要修改的干预措施 那些受龋齿影响最大的人的行为和尽量减少糖的摄入量是具有挑战性的，到目前为止， 制定有效干预措施的尝试大多未获成功。这可能部分是由于缺乏 基于理论的消息传递是为特定人群的障碍和促进者量身定做的。 我们建议使用基于理论的创新策略来开发针对 阻碍和促进我们服务不足的研究人群--公共住房的居民。我们将利用 社会认知理论，强调个人、他们的行为和他们的环境之间的相互作用 以确保我们开发的信息在理论上是有根据的。PhotoVoice使用由 参与者在研究人员通常无法获得的环境中捕捉社会和环境条件 (例如，房屋)。它允许深入检查行为障碍和促进者。设计的消息 使用PhotoVoice特别适合记录社区中的多种影响， 消费者和组织营养环境(例如，商店货架、邻里聚会等)。 我们的科学前提是，通过针对特定人群的障碍定制信息，它将增加人们的关注 给予信息，改进处理信息的努力，导致更少的反驳和增加 感知到的信息的可信度。我们的目标是开发可供干预使用的消息和传递 在干预科学的新领域使用的协议，例如社交网络。我们的具体目标是： (1)使用PhotoVoice和焦点小组方法，识别环境层面和个人层面 成人减少含糖饮料和食品消费的障碍和促进者 波士顿公共住房居民(n=40)； (2)利用在目标1中获得的信息，开发基于光增强理论的健康促进 旨在减少公共住房人口饮食糖分的信息(n=60)； (3)评估所开发的报文的可接受性和报文的传递偏好 不同的传递渠道-基于短信/应用程序的文本、社交媒体、印刷媒体-在成年公众群体中 住房居民(n=100)。 公共住房居民代表着对健康问题进行干预的高影响力、高回报的人群 贫富差距，因为贫困和贫困的高密度空间集聚使他们特别处于不利地位 健康和相关的耻辱使他们比许多其他弱势群体承受更大的负担。 针对城市穷人的有效干预措施需要创新的技术来实现这些目标 行为改变、降低风险和改善口腔健康结果。

Dental caries is highly prevalent among people from underserved population groups and added sugar consumption is one of the most prominent and consistent risk factors for this disease. Interventions to modify behavior and minimize sugar intake among those most affected by dental caries are challenging and, to date, attempts to develop effective interventions have been largely unsuccessful. This may be due in part to the lack of theoretically-based messaging that is tailored to population-specific barriers and facilitators. We propose to use theoretically-based innovative strategies to develop messages that are tailored to the barriers and facilitators of our underserved study population – residents of public housing. We will draw upon Social Cognitive Theory which highlights interplay among individuals, their behavior, and their environment, in order to ensure that messages we develop are theoretically grounded. PhotoVoice uses photographs taken by participants to capture the social and environmental conditions in settings not typically available to researchers (e.g., homes). It allows for an in-depth examination of behavioral barriers and facilitators. Messages designed using PhotoVoice are particularly well adapted to documenting multiple influences across community, consumer, and organizational nutrition environments (e.g., store shelves, neighborhood parties, etc.). Our scientific premise is that by tailoring messages to population-specific barriers, it will increase attention given to the message, improve efforts to process the message, result in fewer counterarguments and increase the perceived credibility of the message. Our goal is to develop intervention-ready messages and delivery protocols for use in new areas of intervention science, such as social networks. Our Specific Aims are: (1) Using PhotoVoice and focus group methodology, to identify the environmental-level and individual-level barriers and facilitators to reducing consumption of sugar-sweetened beverages and foods among adult residents of Boston public housing (n=40); (2) Using the information gained in Aim 1, to develop photo-enhanced theory-based health promotion messages that target reduction of dietary sugar in a public housing population (n=60); (3) Assess the acceptability of the developed messages and message delivery preferences across three different delivery channels – SMS/App-based text, social media, print media – in a population of adult public housing residents (n=100). Public housing residents represent a high impact, high-reward population for interventions addressing health disparities as they are particularly disadvantaged by the high-density spatial clustering of poverty and poor health and by the associated stigma that burdens them more than many other disadvantaged communities. Effective tailoring of interventions that target the urban poor require innovative techniques to achieve the goals of behavior change, risk reduction and improved oral health outcomes.