Multiphase Evaluation of Healthier Choice Symbol (HCS) Logo: Aim 4. A Randomized Controlled Trial Evaluating the Relative Effectiveness of Two Front-of-pack Nutrition Labels
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 154
- 试验地点
- 2
- 主要终点
- Diet Quality per shopping trip
研究概览
简要总结
In efforts to promote a healthy diet, the Singapore Health Promotion Board (HPB) has attempted to use Front-of-Pack (FOP) labelling to supplement traditional nutrition labelling. The Healthier Choice Symbol (HCS) identifies food items within a specific category of foods as healthier choices. The original logos were enhanced to include additional information focusing on particular macronutrients, taking one of two themes; it either indicates that a product contains more of a healthier ingredient, or less of a less healthy ingredient.
However, there is a lack of scientific evidence on the role of the existing symbols in assisting consumers make healthier food purchasing decisions. Thus far, studies have established that the United Kingdom's Multiple Traffic Lights (MTL) label, and the new French Nutri-Score (NS) label, are amongst the top performers. However, there is little consensus on which is the most effective FOP label to promote diet quality. Thus, the investigators propose to conduct the following:
Use a three arm randomized controlled trial (RCT) and an experimental fully functional web-based grocery store to test two competing approaches of front-of-pack (FOP) labelling on measures of diet quality: 1) United Kingdom's Multiple Traffic Lights label (MTL) or 2) France's Nutri-Score (NS) labelling scheme.
The investigators hypothesize that diet quality as measured by the Alternative Healthy Eating Index (AHEI-2010) (primary outcome) will be highest in the NS arm, followed by MTL, and lowest in the no logo control arm.
详细描述
Research Aims & hypotheses:
To use a three arm randomized controlled trial (RCT), and an experimental online grocery store developed by the team, to test two competing approaches of front-of-pack (FOP) nutrition labelling on measures of diet quality: 1) Multiple Traffic Lights (MTL) and 2) Nutri-Score (NS).
All participants will experience three different shopping conditions:
- Arm 1: A control arm that mirrors a traditional web-grocery store with no HCS or other FOP labels.
- Arm 2: Similar to Arm 1, with additional MTL labels displayed on all products FOP. A 60-second introductory video briefly explaining the MTL scheme will be shown before participants shop as they are assumed not to have pre-existing knowledge of the label.
- Arm 3: Similar to Arm 2, with Nutri-Score labels instead of MTL labels displayed on all products FOP. As with the MTL, a 60-second introductory video briefly explaining the NS scheme will be shown before participants shop.
The investigators hypothesize the following:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Other
- 盲法
- Single (Participant)
盲法说明
While participants will be made aware that there are different versions of NUSMart, the exact details of the arms will not be revealed to ensure validity of results. It will be deleterious to the study to reveal the differences between study arms as that would likely confound participant responses. Since there are 3 shopping conditions (unknown to participants), each participant will be randomly assigned at baseline to 1 of 6 groups that vary the sequence of shopping conditions and which shops will result in an actual food delivery.
入排标准
- 年龄范围
- 21 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Singapore resident
- •Aged 21 years or older.
- •Existing registered RedMart customer.
排除标准
- •Non-Singapore Resident.
- •Less than 21 years old.
- •Not an existing registered RedMart customer.
研究组 & 干预措施
Control
A control arm that mirrors a traditional web-grocery store with no but with no FOP labels.
Multiple Traffic Light Labels
Similar to Arm 1, with Multiple Traffic Light labels displayed on all products FOP. A 60-second introductory video briefly explaining the MTL scheme will be shown before each shop in this Arm.
干预措施: Multiple Traffic Light Label (Behavioral)
Nutri-Score
Similar to Arm 2, with Nutri-Score labels instead of MTL labels displayed on all products FOP. A 60-second introductory video briefly explaining the NS scheme will be shown to shoppers in this condition.
干预措施: Nutri-Score Label (Behavioral)
结局指标
主要结局
Diet Quality per shopping trip
时间窗: Once a week for three weeks
Diet quality per shopping trip, as measured by an index of diet quality, the Alternative Healthy Eating Index (AHEI-2010). The Alternate Healthy Eating Index-2010 (AHEI-2010) is an updated measure of diet quality from the original Alternate Healthy Eating Index. It was constructed based on foods and nutrients predictive of chronic disease risk that incorporates current scientific evidence on diet and health. All AHEI-2010 components are scored from 0 (worst) to 10 (best), for a total of 11 components. The total AHEI-2010 score ranges from 0 (nonadherence) to 110 (perfect adherence). Higher scores on the AHEI-2010 are strongly associated with lower risk of major chronic disease as well as risk of CVD, diabetes, heart failure, colorectal and estrogen-receptor-negative breast cancer, and total and cardiovascular mortality.
次要结局
- Total Energy in kilocalories(Once a week for three weeks)
- Total Sugar in grams(Once a week for three weeks)
- Total fat in grams(Once a week for three weeks)
- Saturated fat in grams(Once a week for three weeks)
- Sodium in milligrams(Once a week for three weeks)
- Fiber in grams(Once a week for three weeks)
- Protein in grams(Once a week for three weeks)
- Energy per serving in kilocalories per serving(Once a week for three weeks)
- Sugar per serving in grams per serving(Once a week for three weeks)
- Fiber per serving in grams per serving(Once a week for three weeks)
- Total spend in dollars(Once a week for three weeks)
- Total fat per serving in grams per serving(Once a week for three weeks)
- Saturated fat per serving in grams per serving(Once a week for three weeks)
- Protein per serving in grams per serving(Once a week for three weeks)
- Sodium per serving in milligrams per serving(Once a week for three weeks)
- Average Nutri-Score across all products purchased(Once a week for three weeks)
- Cost per calorie in dollars per kilocalorie(Once a week for three weeks)
研究者
Eric A. Finkelstein
Professor
Duke-NUS Graduate Medical School