As a health communication, multimedia and graphic design firm, we, like many others, are consumers of high quality royalty-free stock photography for health education materials. Unfortunately, there is a dearth of readily-available images depicting health conditions and behaviors that match characteristics of target audiences defined by race, socio-economic status, age, weight, medical conditions, and physical disabilities. This shortcoming is a theoretic and practical problem for health education, as several common theories guiding successful health interventions predict that communication is more effective when sources and models are attractive and similar to target audiences, producing identification and perceived relevance. In Phase I, our team demonstrated the feasibility of developing a collection of photographs depicting diverse settings, health behaviors, health conditions and demographics, called Real Health, which can be used by health and media professionals to increase effectiveness of health communication by incorporating similar image referents. In this Phase II project, our team proposes to fully-develop the Real Health enterprise, an online image library for use in health communication. First, we will produce Real Health and populate it with photographs taken in Phase I and additional photographs of 240 individuals (African American, Hispanic, Native American, Asian, non-Hispanic white, and GLBT;children/teens, adults, and seniors;overweight and with mobility challenges) taken in Phase II. Potential end users (photographers and public health practitioners) will evaluate the Real Health e-commerce site and business model for efficiency, utility, user participation, and satisfaction. The Real Health website will be subjected to beta and usability testing prior to launch. Next, we will evaluate the ability of photos from Real Health to improve health education message effectiveness in a randomized pretest-posttest 3-group design. Three experimental conditions will be created, i.e., a health education message with 1) all Real Health photos that match the target audience, 2) half Real Health photos, and 3) all mismatched photos (obtained from existing commercial stock photo libraries). The health education message will advocate increased physical activity and improved diet to reduce chronic disease. Photos will be selected based on careful pretesting with target audiences. A sample of individuals who are African Americans, Hispanics, Native Americans, overweight/obese, 65 years of age or older, and with mobility challenges (n=510 per subgroup; n=3060 total) will be recruited from an Internet panel maintained by Knowledge Networks, Inc. Participants will be pretested, assigned to read a health education message in one of the conditions, and post-tested. Analyses will evaluate the effect of Real Health photos on primary (intention) and secondary (positive outcome and self-efficacy expectations) outcomes, test potential effect moderators, and explore theoretical mediators of perceived relevance, appropriateness, similarity and identification in the health education messages. KB is uniquely qualified to create and commercialize the Real Health stock photography enterprise. PUBLIC HEALTH RELEVANCE: Sources and models depicted as attractive and similar to recipients can increase the impact of health messages by capturing attention, improving comprehension, engendering feelings of personalism and cultural appropriateness, and causing recipients to identify with them. Producing health communication that changes health behavior requires access to a much wider variety of photographs than currently available from commercial stock art companies in order to capitalize on the power of physically active and similar sources/models. The purpose of this Phase II SBIR project is to fully develop and test the effectiveness of a collection of photographs depicting diverse settings, activities, health conditions, and demographics called "Real Health" that can be used to increase the effectiveness of health communication.