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Food PreferencesVLONCT05432271

Online Food and Beverage Labels and Vending Machine Selections

A study testing Exposure to calorie information, Exposure to healthy labels only and Exposure to healthiness information in people with Food Preferences and Obesity, run by University of Pennsylvania at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial 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)… Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Food Preferences, Obesity, Weight Gain
What is being tested?
Exposure to calorie information, Exposure to healthy labels only and Exposure to healthiness information
Could I receive a placebo?
No, everyone receives an active treatment
How many people
8,145 participants
Where
1 siteUnited States
Study dates
16 Nov 2022to 3 Dec 2022
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

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

Who cannot join

  • Younger than 18
  • Non-US
  • Educational quota filled

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

Other trials in United States

About this study

Official title: A Large-scale, Long-term, Randomized Trial of Nutrition Labeling Interventions

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.

Read the 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.

Being tested
Exposure to calorie information, Exposure to healthy labels only, Exposure to healthiness information, Exposure to physical activity equivalents, Exposure to "high in" nutrient warning labels
Keywords
food labeling, sugar-sweetened beverages, eating, drinking, choice behavior
Medical subject headings
Food Preferences, Obesity, Weight Gain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exposure to calorie informationBehavioural

    Calories for all beverages and foods

  • Exposure to healthy labels onlyBehavioural

    Green labels only for beverages and foods scored as healthy

  • Exposure to healthiness informationBehavioural

    All beverages and foods labeled as either healthy (green), moderately healthy (yellow), or less healthy (red)

  • Exposure to physical activity equivalentsBehavioural

    All beverages and foods labeled with physical activity required to burn their calories

  • Exposure to "high in" nutrient warning labelsBehavioural

    Warning labels only for beverages and foods that exceed the thresholds for sugar, sodium, saturated fat, or calorie content

Study groups in NCT05432271
Study groupRoleWhat they receive
ControlActive comparatorCalorie labels shown on front of product packaging
Receives: Behavioral: Exposure to calorie information
Green labelsExperimentalGreen label added to front of product packaging for healthy products; no additional labels shown for "less healthy" products
Receives: Behavioral: Exposure to calorie information; Behavioral: Exposure to healthy labels only
Traffic light labelsExperimentalRed/yellow/green labels added to front of product packaging for less healthy/moderately healthy/healthy products, respectively
Receives: Behavioral: Exposure to calorie information; Behavioral: Exposure to healthiness information
Physical activity calorie equivalent labelsExperimentalLabels added to front of product packaging that display products' calorie content in terms of physical activity required to burn those calories
Receives: Behavioral: Exposure to calorie information; Behavioral: Exposure to physical activity equivalents
"High in" nutrient warning labelsExperimentalLabels added to front of product packaging that signal when the product exceeds thresholds for sugar, sodium, saturated fat, or calorie content
Receives: Behavioral: Exposure to calorie information; Behavioral: Exposure to "high in" nutrient warning labels

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Purchasing Beverages With Calories

    Participants will select a beverage to purchase from the online vending machine. Outcome is binary: purchased a beverage with calories or not.

    Measured: The survey will take up to 20 minutes.

  2. Calories Purchased From Beverages, if Beverage With Calories Chosen

    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.

    Measured: The survey will take up to 20 minutes.

  3. Calories Purchased From Snacks

    Participants will select a snack to purchase from the online vending machine. Outcome is calories in snacks chosen to purchase.

    Measured: The survey will take up to 20 minutes.

Secondary outcomes (33)
  1. Likelihood of Selecting a Healthy Beverage

    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)

    Measured: The survey will take up to 20 minutes.

  2. Likelihood of Selecting a Moderately Healthy Beverage

    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)

    Measured: The survey will take up to 20 minutes.

  3. Likelihood of Selecting a Less Healthy Beverage

    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)

    Measured: The survey will take up to 20 minutes.

  4. Likelihood of Selecting a Healthy Snack

    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)

    Measured: The survey will take up to 20 minutes.

  5. Likelihood of Selecting a Moderately Healthy Snack

    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)

    Measured: The survey will take up to 20 minutes.

  6. Likelihood of Selecting a Less Healthy Snack

    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)

    Measured: The survey will take up to 20 minutes.

  7. Saturated Fat Purchased From Beverages

    Participants will select a beverage to purchase from the online vending machine. Outcome is saturated fat in beverage chosen to purchase.

    Measured: The survey will take up to 20 minutes.

  8. Sodium Purchased From Beverages

    Participants will select a beverage to purchase from the online vending machine. Outcome is sodium in beverage chosen to purchase.

    Measured: The survey will take up to 20 minutes.

  9. Total Sugar Purchased From Beverages

    Participants will select a beverage to purchase from the online vending machine. Outcome is total sugar in beverage chosen to purchase.

    Measured: The survey will take up to 20 minutes.

  10. Saturated Fat Purchased From Snacks

    Participants will select a snack to purchase from the online vending machine. Outcome is saturated fat in snack chosen to purchase.

    Measured: The survey will take up to 20 minutes.

  11. Sodium Purchased From Snacks

    Participants will select a snack to purchase from the online vending machine. Outcome is sodium in snack chosen to purchase.

    Measured: The survey will take up to 20 minutes.

  12. Total Sugar Purchased From Snacks

    Participants will select a snack to purchase from the online vending machine. Outcome is total sugar in snack chosen to purchase.

    Measured: The survey will take up to 20 minutes.

  13. Perceived Healthiness of a Healthy Beverage

    This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".

    Measured: The survey will take up to 20 minutes.

  14. Perceived Healthiness of a Moderately Healthy Beverage

    This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".

    Measured: The survey will take up to 20 minutes.

  15. Perceived Healthiness of a Less Healthy Beverage

    This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".

    Measured: The survey will take up to 20 minutes.

  16. Perceived Healthiness of a Healthy Snack

    This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".

    Measured: The survey will take up to 20 minutes.

  17. Perceived Healthiness of a Moderately Healthy Snack

    This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".

    Measured: The survey will take up to 20 minutes.

  18. Perceived Healthiness of a Less Healthy Snack

    This variable will be measured on a 5-point Likert scale ranging from "very unhealthy" to "very healthy".

    Measured: The survey will take up to 20 minutes.

  19. Noticing Trial Labels

    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?"

    Measured: The survey will take up to 20 minutes.

  20. Degree of Perceived Label Influence on Beverage Selection

    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?"

    Measured: The survey will take up to 20 minutes.

  21. Degree of Perceived Label Influence on Snack Selection

    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?"

    Measured: The survey will take up to 20 minutes.

  22. Trust in Labels

    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".

    Measured: The survey will take up to 20 minutes.

  23. Reactance to Labels

    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".

    Measured: The survey will take up to 20 minutes.

  24. Attention to Labels

    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".

    Measured: The survey will take up to 20 minutes.

  25. Learned From Labels

    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".

    Measured: The survey will take up to 20 minutes.

  26. Thinking About Health Effects

    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"

    Measured: The survey will take up to 20 minutes.

  27. Perceived Discouragement

    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"

    Measured: The survey will take up to 20 minutes.

  28. Perceived Encouragement

    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"

    Measured: The survey will take up to 20 minutes.

  29. Negative Emotional Reactions

    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".

    Measured: The survey will take up to 20 minutes.

  30. Perceived Control in Response to Labels

    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"

    Measured: The survey will take up to 20 minutes.

  31. Perceived Personal Stigmatization

    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".

    Measured: The survey will take up to 20 minutes.

  32. Perceived Obesity Stigma

    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".

    Measured: The survey will take up to 20 minutes.

  33. Disgust Toward People With Obesity

    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".

    Measured: The survey will take up to 20 minutes.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jun 2022
  2. Study start16 Nov 2022
  3. Primary completion3 Dec 2022
  4. Study completion3 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants will be randomly assigned to 1 of 5 front-of-package labeling arms with equal probability: Participants will complete two vending machine choice tasks with their assigned labels shown (one for beverages, one for snack foods, in random order). For each choice task, participants will be asked to select 1 item they most wish to purchase. We will incentivize truthful responding by instructing participants that they could be randomly selected to have their choice delivered to them. We will record participants' selections and match these to nutrition information.
Masking
None (open label)
Enrolment
8,145 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05432271
Sponsor's protocol ID
850263
Other IDs
R01DK113307
Acronym
VLO
Status last verified
Dec 2023
First submitted
15 Jun 2022
Last updated
20 Dec 2023
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: In the consenting process, participants agreed that de-identified data produced from this project may be distributed for future research studies without additional informed consent. After analysis, we will upload the de-identified data to ResearchBox for public sharing.

Publications

  • Grummon AH, Gibson LA, Musicus AA, Stephens-Shields AJ, Hua SV, Roberto CA. Effects of 4 Interpretive Front-of-Package Labeling Systems on Hypothetical Beverage and Snack Selections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Sep 5;6(9):e2333515. doi: 10.1001/jamanetworkopen.2023.33515.

    PubMed 37703015

Questions about this trial

What is this clinical trial studying?

A study testing Exposure to calorie information, Exposure to healthy labels only and Exposure to healthiness information in people with Food Preferences and Obesity, run by University of Pennsylvania at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 20 Dec 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 20 Dec 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Purchasing Beverages With Calories (time frame: The survey will take up to 20 minutes.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05432271, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Dec 2023.

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