Online Food and Beverage Labels and Vending Machine Selections

Not Applicable

Completed

Conditions: Obesity
Weight Gain
Food Preferences

Interventions: Behavioral: Exposure to calorie information
Behavioral: Exposure to healthy labels only
Behavioral: Exposure to healthiness information
Behavioral: Exposure to physical activity equivalents
Behavioral: Exposure to "high in" nutrient warning labels

Registration Number: NCT05432271

Lead Sponsor: University of Pennsylvania

Brief Summary: The aim of this study is to compare the impact of 5 different types of front of package (FOP) food and beverage labels: 1) calorie labels \[control\], 2) green labels on healthy foods, 3) red/yellow/green labels on less healthy/moderately healthy/healthy foods, 4) physical activity calorie equivalent labels, and 5) "High in" nutrient warning labels) on consumers' beverage and snack selections.

Detailed Description: This project involves an online randomized experiment. We are working with an external survey company that will recruit 8,000 participants to complete an online survey in which they will be randomized to one of the five different label conditions: 1) calorie labels (control condition); 2) single green traffic light labels (on healthy foods); 3) multiple traffic light labels (red traffic light labels applied to less healthy foods, yellow applied to moderately healthy foods, and green on healthy foods); 4) physical activity labels (calorie content displayed in terms of physical activity equivalents); 5) "High in" warnings (applied to all products exceeding thresholds for calories, saturated fat, sugar, or sodium content). Participants will be instructed to select products to purchase in a mock vending machine. After purchasing their products, they will be asked to answer questions about their perceptions of the different labels.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 8145

Inclusion Criteria

Participants will be US adults
Ages 18 or older
With an over-sample of adults with lower educational attainment (some college or less)

Exclusion Criteria

Younger than 18
Non-US
Educational quota filled

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Green labels	Exposure to healthy labels only	Green label added to front of product packaging for healthy products; no additional labels shown for "less healthy" products
Traffic light labels	Exposure to calorie information	Red/yellow/green labels added to front of product packaging for less healthy/moderately healthy/healthy products, respectively
Traffic light labels	Exposure to healthiness information	Red/yellow/green labels added to front of product packaging for less healthy/moderately healthy/healthy products, respectively
Control	Exposure to calorie information	Calorie labels shown on front of product packaging
Green labels	Exposure to calorie information	Green label added to front of product packaging for healthy products; no additional labels shown for "less healthy" products
Physical activity calorie equivalent labels	Exposure to calorie information	Labels added to front of product packaging that display products' calorie content in terms of physical activity required to burn those calories
Physical activity calorie equivalent labels	Exposure to physical activity equivalents	Labels added to front of product packaging that display products' calorie content in terms of physical activity required to burn those calories
"High in" nutrient warning labels	Exposure to calorie information	Labels added to front of product packaging that signal when the product exceeds thresholds for sugar, sodium, saturated fat, or calorie content
"High in" nutrient warning labels	Exposure to "high in" nutrient warning labels	Labels added to front of product packaging that signal when the product exceeds thresholds for sugar, sodium, saturated fat, or calorie content

Primary Outcome Measures

Name	Time	Method
Calories Purchased From Beverages, if Beverage With Calories Chosen	The survey will take up to 20 minutes.	Participants will select a beverage to purchase from the online vending machine. Outcome is calories in beverage chosen to purchase - only for those participants who chose a beverage with calories.
Calories Purchased From Snacks	The survey will take up to 20 minutes.	Participants will select a snack to purchase from the online vending machine. Outcome is calories in snacks chosen to purchase.
Number of Participants Purchasing Beverages With Calories	The survey will take up to 20 minutes.	Participants will select a beverage to purchase from the online vending machine. Outcome is binary: purchased a beverage with calories or not.

Secondary Outcome Measures

Name	Time	Method
Perceived Personal Stigmatization	The survey will take up to 20 minutes.	Participants will respond to the item "How personally stigmatized does this label make you feel?" on a 5-pt likert scale from "not at all" to "a great deal".
Saturated Fat Purchased From Beverages	The survey will take up to 20 minutes.	Participants will select a beverage to purchase from the online vending machine. Outcome is saturated fat in beverage chosen to purchase.
Likelihood of Selecting a Healthy Beverage	The survey will take up to 20 minutes.	Participants will select a beverage to purchase in the virtual store. Outcome is percentage of people selecting a healthy beverage (green labeled in the traffic light condition)
Likelihood of Selecting a Less Healthy Snack	The survey will take up to 20 minutes.	Participants will select a snack to purchase in the virtual store. Outcome is percentage of people selecting a less healthy snack (red labeled in the traffic light condition)
Likelihood of Selecting a Moderately Healthy Snack	The survey will take up to 20 minutes.	Participants will select a snack to purchase in the virtual store. Outcome is percentage of people selecting a moderately healthy snack (yellow labeled in the traffic light condition)
Likelihood of Selecting a Moderately Healthy Beverage	The survey will take up to 20 minutes.	Participants will select a beverage to purchase in the virtual store. Outcome is percentage of people selecting a moderately healthy beverage (yellow labeled in the traffic light condition)
Likelihood of Selecting a Less Healthy Beverage	The survey will take up to 20 minutes.	Participants will select a beverage to purchase in the virtual store. Outcome is percentage of people selecting a less healthy beverage (red labeled in the traffic light condition)
Likelihood of Selecting a Healthy Snack	The survey will take up to 20 minutes.	Participants will select a snack to purchase in the virtual store. Outcome is percentage of people selecting a healthy snack (green labeled in the traffic light condition)
Degree of Perceived Label Influence on Beverage Selection	The survey will take up to 20 minutes.	Participants will respond on a 5-point scale ranging from "Not at all" to "A great deal" to the item: "How much did you use this label to help you decide what beverage to buy?"
Attention to Labels	The survey will take up to 20 minutes.	Item: "How much does this label grab your attention?". Responses will be measured on a 5-point Likert scale from "not at all" to "a great deal".
Learned From Labels	The survey will take up to 20 minutes.	Item: "To what extent did you learn something new from this label?". Responses will be measured on a 5-point Likert scale from "not at all" to "a great deal".
Sodium Purchased From Beverages	The survey will take up to 20 minutes.	Participants will select a beverage to purchase from the online vending machine. Outcome is sodium in beverage chosen to purchase.
Saturated Fat Purchased From Snacks	The survey will take up to 20 minutes.	Participants will select a snack to purchase from the online vending machine. Outcome is saturated fat in snack chosen to purchase.
Perceived Healthiness of a Less Healthy Beverage	The survey will take up to 20 minutes.	This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".
Perceived Healthiness of a Healthy Snack	The survey will take up to 20 minutes.	This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".
Perceived Healthiness of a Less Healthy Snack	The survey will take up to 20 minutes.	This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".
Noticing Trial Labels	The survey will take up to 20 minutes.	Participants will respond "yes," "no," or "not sure" to the item: "When you were selecting a beverage and a snack, did you notice any other nutrition labels on or next to the products?"
Reactance to Labels	The survey will take up to 20 minutes.	We will examine the average reactance to the label (said the label is trying to manipulate me, or annoys me). Each reactance item will be scored on a 5-pt likert scale from "not at all" to "a great deal".
Perceived Encouragement	The survey will take up to 20 minutes.	We will examine if they said the label encourages them to choose healthy products. This item will be scored on a 5-pt likert scale from "not at all" to "a great deal"
Negative Emotional Reactions	The survey will take up to 20 minutes.	We will examine the average negative emotional response to the label (said the label made them feel worried, scared, guilty, ashamed, or sad). Each emotion will be scored on a 5-pt likert scale from "not at all" to "a great deal".
Sodium Purchased From Snacks	The survey will take up to 20 minutes.	Participants will select a snack to purchase from the online vending machine. Outcome is sodium in snack chosen to purchase.
Total Sugar Purchased From Snacks	The survey will take up to 20 minutes.	Participants will select a snack to purchase from the online vending machine. Outcome is total sugar in snack chosen to purchase.
Perceived Healthiness of a Moderately Healthy Beverage	The survey will take up to 20 minutes.	This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".
Trust in Labels	The survey will take up to 20 minutes.	Item: "How much do you trust or distrust the information on this label?". Responses will be measured on a 5-point Likert scale from "completely distrust" to "completely trust".
Perceived Obesity Stigma	The survey will take up to 20 minutes.	We will examine the average stigma response to the label (the label stigmatizes people with obesity, the label increases blame toward people for being overweight). Each stigma item will be scored on a 5-pt likert scale from "not at all" to "a great deal".
Total Sugar Purchased From Beverages	The survey will take up to 20 minutes.	Participants will select a beverage to purchase from the online vending machine. Outcome is total sugar in beverage chosen to purchase.
Perceived Healthiness of a Healthy Beverage	The survey will take up to 20 minutes.	This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".
Perceived Discouragement	The survey will take up to 20 minutes.	We will examine if they said the label discourages them from choosing unhealthy products. This item will be scored on a 5-pt likert scale from "not at all" to "a great deal"
Perceived Healthiness of a Moderately Healthy Snack	The survey will take up to 20 minutes.	This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".
Degree of Perceived Label Influence on Snack Selection	The survey will take up to 20 minutes.	Participants will respond on a 5-point scale ranging from "Not at all" to "A great deal" to the item: "How much did you use this label to help you decide what snack to buy?"
Thinking About Health Effects	The survey will take up to 20 minutes.	Item: "How much does this label make you think about the health effects of food and beverages?". Responses will be measured on a 5-point Likert scale from "not at all" to "a great deal"
Perceived Control in Response to Labels	The survey will take up to 20 minutes.	Participants will respond to the item "Overall does this label make you feel..." with one of 3 responses: "less in control of making healthy eating decisions", "more in control of healthy eating decisions", or "neither less nor more in control of making healthy eating decisions"
Disgust Toward People With Obesity	The survey will take up to 20 minutes.	Participants will respond to the item "How disgusted do people with obesity make you feel?" on a 5-pt likert scale from "not at all" to "a great deal".