Communicating the Health Risks of Sugar-Sweetened Beverages: A Randomized-controlled Experiment of Different Nutrition Labels on Purchases and Consumption
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- University of Pennsylvania
- Enrollment
- 216
- Locations
- 1
- Primary Endpoint
- Beverage Added Sugars Purchased, Week 1
Study Overview
Brief Summary
The aim of this study is to determine the degree to which sugar-sweetened beverages (SSB) warning labels increase consumers' knowledge about the potential health harms of SSBs and reduce SSB purchases and consumption. 216 racially and ethnically diverse parents of children 6-11 years old will be recruited to buy snacks and beverages for four weeks via an online store that ships participants their purchases. Participants will be randomized to either 1) calorie labels (control); or 2) sugar graphic warning labels. The investigators hypothesize that sugar graphic warning labels displayed in an online store in weeks 2-4 will lead to the greatest reductions from week 1 across both primary outcomes compared to the control group that will only see calorie labels.
Detailed Description
During this study, participants will shop in an online store created using Shopify for four weeks. In this within-participant design, the first week of shopping is baseline. Participants will then be randomized to different store interfaces for the remaining three weeks based on one of two warning label conditions: 1) calorie labels (control); or 2) sugar graphic warning labels. Participants will complete a brief survey at the start of the study to assess demographic information, information about parent and child beverage consumption, and their online shopping experiences. At the end they will complete another survey about their beverage consumption, their experience shopping in the store, whether they noticed and used the warning labels, and their ability to recall the warning label message. Participants will also be asked about their perceptions of a specific type of warning label in this final survey. Upon completion of the survey, participants will be shown a debriefing statement explaining the study purpose. After they read the information, they will be asked whether or not they consent to allow their data to be used in this study.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •a primary caregiver of a child 6-to-11 years old;
- •>=18 years old;
- •can read and speak English;
- •primary grocery shopper for their household;
- •have regular Internet access; and
- •report that the oldest of their children between 6 and 11 years old is consuming sugar sweetened beverages at least twelve times per month or approximately three times a week
Exclusion Criteria
- •not a primary caregiver of a child 6-to-11 years old;
- •<18 years old;
- •cannot read and/or speak English;
- •not the primary grocery shopper for their household;
- •does not have regular Internet access; and
- •does not report that the oldest of their children between 6 and 11 years old is consuming sugar sweetened beverages at least twelve times per month or approximately three times a week
Arms & Interventions
Calorie label
Calorie label (control) will display a calories per package label on all beverages, not just sugary drinks. This is modeled after the American Beverage Association's current "Clear on Calories" labels. Additionally, all snack items will have a calories per serving label.
Intervention: Exposure to calorie information (Behavioral)
Sugar graphic warning label
All products in this arm will also have calorie labels. Beverages with added sugar will also have sugar graphic warning labels with the text: "WARNING: drinking beverages with added sugars contributes to obesity, diabetes, and tooth decay" along with graphics depicting the amount of sugar in the beverage.
Intervention: Exposure to sugar-sweetened beverage warning labels (Behavioral)
Sugar graphic warning label
All products in this arm will also have calorie labels. Beverages with added sugar will also have sugar graphic warning labels with the text: "WARNING: drinking beverages with added sugars contributes to obesity, diabetes, and tooth decay" along with graphics depicting the amount of sugar in the beverage.
Intervention: Exposure to calorie information (Behavioral)
Outcomes
Primary Outcomes
Beverage Added Sugars Purchased, Week 1
Time Frame: one week
Beverage grams of added sugars/100mL purchased. Number of servings per item and number of items per package varied by product; therefore, added sugar amounts were standardized to grams of added sugar/100mL for beverages.
Beverage Calories Purchased, Week 1
Time Frame: one week
Logged beverage calories/100mL purchased. Number of servings per item and number of items per package varied by product; therefore, calorie amounts were standardized to calories/100mL for beverages.
Beverage Added Sugars Purchased, Weeks 2-4
Time Frame: three weeks
Average beverage grams of added sugars/100mL purchased per week over Weeks 2-4. Number of servings per item and number of items per package varied by product; therefore, added sugar amounts were standardized to grams of added sugar/100mL for beverages.
Beverage Calories Purchased, Weeks 2-4
Time Frame: three weeks
Logged average beverage calories/100mL purchased per week over Weeks 2-4. Number of servings per item and number of items per package varied by product; therefore, calorie amounts were standardized to calories/100mL for beverages.
Secondary Outcomes
- Child Enjoyment of Orange Juice(Week 4)
- Likely to Serve or Buy Water(Week 4)
- Estimate of How Many Teaspoons of Added Sugar Are in Soda(Week 4)
- Perceived Amount of Added Sugar in Water(Week 4)
- Health Beliefs and Risk Perceptions Index for Water(Week 4)
- Health Beliefs and Risk Perceptions Index for Orange Juice(Week 4)
- Health Beliefs and Risk Perceptions Index for Soda(Week 4)
- Health Beliefs and Risk Perceptions Index for Sports Drinks(Week 4)
- Total Added Sugars Purchased, Week 1(one week)
- Volume of Sweetened Beverages Consumed by Child, Baseline(baseline)
- How Much do You Trust the Information on This Label(Week 4)
- Noticing the Label(Week 4)
- Perceived Label Influence(Week 4)
- Likelihood of Label Changing Thoughts(Week 4)
- Negative Reactions to the Label(Week 4)
- Number Purchasing a Sweetened Beverage, Week 1(one week)
- Number Purchasing a Sweetened Beverage, Weeks 2-4(three weeks)
- Total Calories Purchased, Weeks 2-4(three weeks)
- Volume of Sweetened Beverages Consumed by Parent, Baseline(baseline)
- Encourage You to Give Fewer Beverages to Your Child(Week 4)
- Snack Calories Purchased, Week 1(one week)
- Snack Calories Purchased, Weeks 2-4(three weeks)
- Snack Added Sugars Purchased, Weeks 2-4(three weeks)
- Total Calories Purchased, Week 1(one week)
- Volume of Sweetened Beverages Consumed by Parent, Final(Week 4)
- Child Enjoyment of Sports Drink(Week 4)
- Likely to Serve or Buy Orange Juice(Week 4)
- Likely to Serve or Buy Sports Drinks(Week 4)
- Estimate of How Many Teaspoons of Added Sugar Are in Water(Week 4)
- Snack Added Sugars Purchased, Week 1(one week)
- Total Added Sugars Purchased, Weeks 2-4(three weeks)
- Volume of Sweetened Beverages Consumed by Child, Final(Week 4)
- Child Enjoyment of Water(Week 4)
- Likely to Serve or Buy Soda(Week 4)
- Estimate of How Many Teaspoons of Added Sugar Are in Orange Juice(Week 4)
- Child Enjoyment of Soda(Week 4)
- Perceived Amount of Added Sugar in Orange Juice(Week 4)
- Estimate of How Many Teaspoons of Added Sugar Are in Sports Drinks(Week 4)
- Perceived Amount of Added Sugar in Soda(Week 4)
- Perceived Amount of Added Sugar in Sports Drinks(Week 4)