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Testing the Influence of Different Sugary Drink Warning Label Designs

Primary Purpose

Obesity, Weight Gain, Diabetes Type 2

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Sugary drink warning labels
Sponsored by
University of Pennsylvania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Obesity

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. a primary caregiver of a child 6-to-11 years old;
  2. ≥18 years old; and
  3. can read and speak English

Exclusion Criteria:

  1. not a primary caregiver of a child 6-to-11 years old;
  2. <18 years old; and
  3. cannot read and/or speak English

Sites / Locations

  • Online study with GfK

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Experimental

Experimental

Experimental

Arm Label

Calorie label

Text warning label

Sugar graphic warning label

Health graphic warning label

Arm Description

This arm will display a "Calories per Bottle" label on all beverages, not just sugary beverages. This label is identical to the American Beverage Association's current "Clear on Calories" labels (as of 2018).

This arm will display similar text proposed in a recent sugary drink warning label bill in California. Sample text: WARNING: Drinking beverages with added sugar(s) contributes to obesity, type 2 diabetes, and tooth decay. The calorie label will also appear on all beverages.

This arm will graphically display the amount of sugar in each sugary beverage along with the same text used in the "text warning label" arm. The calorie label will also appear on all beverages.

This arm will graphically display potential negative health effects of over consuming sugary drinks for each sugary beverage, along with the same text used in the "text warning label" arm. The calorie label will also appear on all beverages.

Outcomes

Primary Outcome Measures

Hypothetical beverage choice
Participants will select a beverage to purchase in the virtual store. Our outcome will be the percentage of parents choosing a 20-ounce sugary drink for their child

Secondary Outcome Measures

Likely to serve or buy these beverages:
Item: "How likely are you to serve or buy this product for your child in the next 4 weeks?" This will be answered on a 7-point Likert scale.
Parent feels good serving the beverages
Item: "Serving this product to my child would make me feel like I am doing something good for my child." This will be measured on a 7-point likert scale.
Child enjoyment of beverages
Item: "How much do you think your child would enjoy this product?" This will be answered on a 7-point likert scale.
Health beliefs and risk perceptions index
We will create this outcome by summing responses to the following 7 health perception questions 6 prompted with the statement "Drinking this product often would…". The statements end with the following health belief and risk perception language: "lead my child to gain weight," "increase my child's risk of heart disease," "increase my child's risk of diabetes," "make my child feel energized," "help my child focus at school", and "help my child live a healthy life." The other item is: "How healthy do you think this product is for your child?" Responses to questions about weight gain, heart disease, and diabetes will be reverse coded, so higher scores on the index will indicate a stronger positive health perception of the beverages. These will be scored on 7-point likert scales.
Estimate of how many teaspoons of added sugar are in the beverages
This variable will be measured continuously based on a text box provided to participants.
Perceived amount of added sugar in beverages
This variable will be measured on a 3-point Likert scale ranging from "too little for my child" to "too much for my child".
Noticing the label
Participants will respond "yes," "no," or "I don't know" to the item: "When you selected a beverage to buy for your child at the beginning of this survey, did you notice any labels on the beverages other than calorie information?"
Perceived label influence
Participants will respond: "yes", "no," or "I did not notice any labels" in response to the question of whether the label influenced their purchase.
Favor or oppose sugary drink warning label policy
We will compare the percentage of participants in favor of (combining somewhat favor and strongly favor), opposed to (combining somewhat oppose and strongly oppose), or neutral about the policy based on the following question: "Would you favor or oppose a government policy requiring a warning label to be placed on beverages with added sugars?" Ratings will be from -2 to 2.
Likelihood of label changing thoughts
Item: "If this government warning label were on a beverage, how much would it change your thoughts about the healthiness of that beverage for your child?" This will be measured on a 5-point Likert scale.
Encourage you to give fewer beverages to your child
Item: "If you saw this government warning label on a beverage, would the label encourage you to serve your child that beverage less often?" The responses will be measured on a 5-point Likert scale.
How much do you trust the information on this label
Item: "How much do you trust the information on this label?". Responses will be measured on a 7-point Likert scale.
Negative reactions to the label
We will examine the average negative emotional response to the label (said the warning label made them feel worried, fearful, guilty, or disgusted or grossed out). Each emotion will be scored on a 5-pt likert scale.

Full Information

First Posted
August 7, 2018
Last Updated
March 10, 2020
Sponsor
University of Pennsylvania
Collaborators
Drexel University, New York University, University of Connecticut, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
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1. Study Identification

Unique Protocol Identification Number
NCT03648138
Brief Title
Testing the Influence of Different Sugary Drink Warning Label Designs
Official Title
Testing the Influence of Different Sugary Drink Warning Label Designs
Study Type
Interventional

2. Study Status

Record Verification Date
March 2020
Overall Recruitment Status
Completed
Study Start Date
January 17, 2020 (Actual)
Primary Completion Date
January 28, 2020 (Actual)
Study Completion Date
January 28, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Pennsylvania
Collaborators
Drexel University, New York University, University of Connecticut, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of this study is to compare different sugary drink labels to see which most influence knowledge, beliefs, purchase intentions and choices. Parents of children ages 6-11 will shop in a virtual convenience store after being randomized to 1 of 4 conditions: 1) calorie labels; 2) text warning labels; 3) graphic sugar warning labels; or 4) graphic health warning. This study will provide data comparing the influence of sugary drink text warning labels and two kinds of graphic warning labels.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obesity, Weight Gain, Diabetes Type 2

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Factorial Assignment
Masking
None (Open Label)
Masking Description
Although participants are not blinded to the study arm to which they are randomized, they are not told the true purpose of the study until after completing the study.
Allocation
Randomized
Enrollment
1016 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Calorie label
Arm Type
Active Comparator
Arm Description
This arm will display a "Calories per Bottle" label on all beverages, not just sugary beverages. This label is identical to the American Beverage Association's current "Clear on Calories" labels (as of 2018).
Arm Title
Text warning label
Arm Type
Experimental
Arm Description
This arm will display similar text proposed in a recent sugary drink warning label bill in California. Sample text: WARNING: Drinking beverages with added sugar(s) contributes to obesity, type 2 diabetes, and tooth decay. The calorie label will also appear on all beverages.
Arm Title
Sugar graphic warning label
Arm Type
Experimental
Arm Description
This arm will graphically display the amount of sugar in each sugary beverage along with the same text used in the "text warning label" arm. The calorie label will also appear on all beverages.
Arm Title
Health graphic warning label
Arm Type
Experimental
Arm Description
This arm will graphically display potential negative health effects of over consuming sugary drinks for each sugary beverage, along with the same text used in the "text warning label" arm. The calorie label will also appear on all beverages.
Intervention Type
Behavioral
Intervention Name(s)
Sugary drink warning labels
Intervention Description
This information appears in the description of the study arms.
Primary Outcome Measure Information:
Title
Hypothetical beverage choice
Description
Participants will select a beverage to purchase in the virtual store. Our outcome will be the percentage of parents choosing a 20-ounce sugary drink for their child
Time Frame
The survey will take up to 20 minutes
Secondary Outcome Measure Information:
Title
Likely to serve or buy these beverages:
Description
Item: "How likely are you to serve or buy this product for your child in the next 4 weeks?" This will be answered on a 7-point Likert scale.
Time Frame
The survey will take up to 20 minutes
Title
Parent feels good serving the beverages
Description
Item: "Serving this product to my child would make me feel like I am doing something good for my child." This will be measured on a 7-point likert scale.
Time Frame
The survey will take up to 20 minutes
Title
Child enjoyment of beverages
Description
Item: "How much do you think your child would enjoy this product?" This will be answered on a 7-point likert scale.
Time Frame
The survey will take up to 20 minutes
Title
Health beliefs and risk perceptions index
Description
We will create this outcome by summing responses to the following 7 health perception questions 6 prompted with the statement "Drinking this product often would…". The statements end with the following health belief and risk perception language: "lead my child to gain weight," "increase my child's risk of heart disease," "increase my child's risk of diabetes," "make my child feel energized," "help my child focus at school", and "help my child live a healthy life." The other item is: "How healthy do you think this product is for your child?" Responses to questions about weight gain, heart disease, and diabetes will be reverse coded, so higher scores on the index will indicate a stronger positive health perception of the beverages. These will be scored on 7-point likert scales.
Time Frame
The survey will take up to 20 minutes
Title
Estimate of how many teaspoons of added sugar are in the beverages
Description
This variable will be measured continuously based on a text box provided to participants.
Time Frame
The survey will take up to 20 minutes
Title
Perceived amount of added sugar in beverages
Description
This variable will be measured on a 3-point Likert scale ranging from "too little for my child" to "too much for my child".
Time Frame
The survey will take up to 20 minutes
Title
Noticing the label
Description
Participants will respond "yes," "no," or "I don't know" to the item: "When you selected a beverage to buy for your child at the beginning of this survey, did you notice any labels on the beverages other than calorie information?"
Time Frame
The survey will take up to 20 minutes
Title
Perceived label influence
Description
Participants will respond: "yes", "no," or "I did not notice any labels" in response to the question of whether the label influenced their purchase.
Time Frame
The survey will take up to 20 minutes
Title
Favor or oppose sugary drink warning label policy
Description
We will compare the percentage of participants in favor of (combining somewhat favor and strongly favor), opposed to (combining somewhat oppose and strongly oppose), or neutral about the policy based on the following question: "Would you favor or oppose a government policy requiring a warning label to be placed on beverages with added sugars?" Ratings will be from -2 to 2.
Time Frame
The survey will take up to 20 minutes
Title
Likelihood of label changing thoughts
Description
Item: "If this government warning label were on a beverage, how much would it change your thoughts about the healthiness of that beverage for your child?" This will be measured on a 5-point Likert scale.
Time Frame
The survey will take up to 20 minutes
Title
Encourage you to give fewer beverages to your child
Description
Item: "If you saw this government warning label on a beverage, would the label encourage you to serve your child that beverage less often?" The responses will be measured on a 5-point Likert scale.
Time Frame
The survey will take up to 20 minutes
Title
How much do you trust the information on this label
Description
Item: "How much do you trust the information on this label?". Responses will be measured on a 7-point Likert scale.
Time Frame
The survey will take up to 20 minutes
Title
Negative reactions to the label
Description
We will examine the average negative emotional response to the label (said the warning label made them feel worried, fearful, guilty, or disgusted or grossed out). Each emotion will be scored on a 5-pt likert scale.
Time Frame
The survey will take up to 20 minutes

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: a primary caregiver of a child 6-to-11 years old; ≥18 years old; and can read and speak English Exclusion Criteria: not a primary caregiver of a child 6-to-11 years old; <18 years old; and cannot read and/or speak English
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Christina A Roberto, PhD
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
Online study with GfK
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
We will share a de-identified dataset via an online data storage website (e.g., open science framework, dataverse, research box)
IPD Sharing Time Frame
The data will be made available soon after the paper is published in a peer-reviewed journal.
IPD Sharing Access Criteria
All researchers will be able to access the data.

Learn more about this trial

Testing the Influence of Different Sugary Drink Warning Label Designs

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