FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods

November 4, 2020 updated by: Mary L'Abbe, University of Toronto
There is a lot of confusion when it comes to understanding nutrition information on food packages, thus making it difficult for consumers to choose healthy products. In today's busy and fast-paced shopping environment, mobile digital technology (for example, Smartphone applications) can help consumers make 'healthier' food choices when they are shopping. This study aims to test the effectiveness of a traffic light front-of-pack system, the Health Star Rating System (HSR or Star System), and the proposed sodium, saturated fat and sugar warning labels proposed by Health Canada. The study will also experimentally test the use of a Smartphone application (app), FoodFlip, to help educate consumers on these systems on food packages to explore the impact of a learning effect on the efficacy of the labelling systems.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The rising rate of obesity and diet-related chronic diseases illustrate that Canadians' eating habits need to change. Equipping Canadians with information and tools to enable healthy food choices that decrease risk for disease is imperative. While the Nutrition Facts table (NFt) is the most standardized and complete form of nutrition labelling, studies have shown that consumers are confused about serving size, nutrient quantities, and the interpretation of the % Daily Value. Thus, expert groups have proposed the introduction of interpretive front-of-pack (FOP) nutrition rating systems (e.g. traffic light labelling or star ratings) that also help consumers understand the significance of the levels of nutrients in relation to the "healthiness" of a food. One of the main barriers to the introduction of such a system is the absence of high quality studies that objectively measure the impact of nutrition information on actual food purchases. This is a consequence of both the practical challenges associated with designing and conducting such studies in 'real-world' settings, and the lack of food industry support to quantitatively examine or publish the potential for enhanced nutrition labels to modify consumer food choices. With the growing burden of diet-related disease, there is an urgent need for robust evidence to evaluate the potential for additional interpretive nutrition labelling systems to modify and improve food purchasing patterns. Given the relative ubiquity of mobile digital technologies, our Canadian Smartphone application (FoodFLIP) provides us with an unprecedented opportunity to examine and improve consumers' diets.

This study will investigate whether a traffic light, a health star rating or a high-in warning label FOP system can help consumers identify and purchase healthier foods.

Objective 1: To evaluate the effects of three FOP systems in helping consumers characterize healthfulness and nutritional content of food items.

Objective 2: To determine which of the three FOP systems support healthier food choices and are preferred by Canadian consumers.

Study Type

Interventional

Enrollment (Actual)

2008

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Canada
    • Ontario
      • Toronto, Ontario, Canada, M5S3E2
        • University of Toronto

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Shop at a supermarket owned by one of the largest four national retailers at least twice a month. This includes Loblaws, Sobeys, Metro or Safeway
  • Own a smartphone (iPhone version 3 or later or android)
  • Are 18 years or over and provide informed consent to participate
  • Reside in Canada, excluding Northern Territories

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Traffic Light

Participants in this group will download an app which features the nutrition information of the selected product in a multiple coloured traffic light format (i.e. the traffic light system shows a coloured round indicator for each of saturated fat, sugar, and sodium; shaded red (high), amber (medium) or green (low), according to thresholds set for each nutrient). In addition, a list of healthier similar products will appear on screen to facilitate comparisons.

Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems
Other: Nutrition Rating Systems
Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.
Other Names:
  • Device: Smartphone
Experimental: Health Star Rating System

Participants in this group will download an app which features the nutrition information of the selected product in a form of 0-5 stars to provide an overall "healthy" rating. The Health Star Rating provides a rating for all products and products not meeting the criteria still carry the symbol (with no colored stars). In addition, a list of healthier similar products will appear on screen to facilitate comparisons.

Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems
Other: Nutrition Rating Systems
Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.
Other Names:
  • Device: Smartphone
No Intervention: Control
Participants in this group will only see the Nutrition Facts Table (as it appears on the product's package) when the product is scanned in the app.
Experimental: High-in Warning Label

Participants in this group will download an app which features the nutrition information of the selected product in a 'high-in' warning label format (i.e. stop signs for each of saturated fat, sugar, and sodium; according to thresholds set for each nutrient). In addition, a list of healthier similar products will appear on screen to facilitate comparisons.

Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems
Other: Nutrition Rating Systems
Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.
Other Names:
  • Device: Smartphone

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The accurate characterization of healthfulness and nutritional content of foods as indicated by each intervention group will be compared.
Time Frame: 6 weeks
In the first series of experimental tasks, participants will be exposed to an image of a food package with the assigned FOP nutrition information and NFt. Participants will be asked to rate the products on how likely they would be to purchase the product, overall healthiness, and the relative amount of specific nutrients in the product (e.g., if the product contains a little or a lot of sodium) using a Likert scale. In the second series of tasks, participants will be shown 5 similar products side by side (5 breakfast cereals, 5 yogurts and 5 pasta dinners). Participants will be asked to rank the products from MOST HEALTHY to LEAST HEALTHY, and which product they would select if they were trying to consume a low sodium, low energy or high fibre diet.
6 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
A qualitative assessment of the functionality and usability of the smartphone app (FoodFLIP) will be assessed through questionnaires on a 5-point Likert Scale (the percentage of users finding the app easy to use/easy to understand etc).
Time Frame: 6 weeks
The functionality and usability of the smartphone app is assessed through questionnaires (e.g easy to use, easy to understand etc). Responses on these questionnaires are scaled using a five-point Likert-scale and scores for each question are recorded separately to assess the usability of the smartphone app (e.g 1 least liked to 5 most liked).
6 weeks
The health claims with or without additional labelling elements influence perceptions of healthiness and purchasing intentions will be compared between each FOP system.
Time Frame: 6 weeks
Participants will be randomized to see products with symbolic and textual health and/or nutrition claims. Participants will first be shown an image with or without claims for 10 seconds (this is slightly longer than the average time an individual spends viewing a product in a food store when making a purchasing decision). The image will then be removed from the screen, and participants will be asked to recall the presence and content of the claim. The image will then be returned to the screen and participants will be asked to rate how healthy the product is and to rate how likely they would be to purchase the product.
6 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Toronto

Collaborators

Heart and Stroke Foundation of Canada
Dietitians of Canada

Investigators

  • Principal Investigator: Mary R L'Abbe, Ph.D., University of Toronto

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2018

Primary Completion (Actual)

December 23, 2019

Study Completion (Actual)

January 30, 2020

Study Registration Dates

First Submitted

May 24, 2016

First Submitted That Met QC Criteria

June 22, 2016

First Posted (Estimate)

June 28, 2016

Study Record Updates

Last Update Posted (Actual)

November 9, 2020

Last Update Submitted That Met QC Criteria

November 4, 2020

Last Verified

November 1, 2020

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 499174

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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