Testing the Influence of Different Sugary Drink Warning Label Designs

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.

Study Overview

• Status: Completed
• Conditions: Obesity; Weight Gain; Diabetes Type 2
• Intervention / Treatment: Behavioral: Sugary drink warning labels

• Study Type: Interventional
• Enrollment (Actual): 1016
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • Online study with GfK

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: PREVENTION
• Allocation: RANDOMIZED
• Interventional Model: FACTORIAL
• Masking: NONE

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: Calorie label; 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).	Behavioral: Sugary drink warning labels; This information appears in the description of the study arms.
EXPERIMENTAL: Text warning label; 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.	Behavioral: Sugary drink warning labels; This information appears in the description of the study arms.
EXPERIMENTAL: Sugar graphic warning label; 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.	Behavioral: Sugary drink warning labels; This information appears in the description of the study arms.
EXPERIMENTAL: Health graphic warning label; 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.	Behavioral: Sugary drink warning labels; This information appears in the description of the study arms.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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	The survey will take up to 20 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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".	The survey will take up to 20 minutes
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?"	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes
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.	The survey will take up to 20 minutes

Collaborators and Investigators

• Sponsor: University of Pennsylvania
• Collaborators: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); New York University; University of Connecticut; Drexel University

Study record dates

Study Major Dates

• Study Start (ACTUAL): January 17, 2020
• Primary Completion (ACTUAL): January 28, 2020
• Study Completion (ACTUAL): January 28, 2020

Study Registration Dates

• First Submitted: August 7, 2018
• First Submitted That Met QC Criteria: August 24, 2018
• First Posted (ACTUAL): August 27, 2018

Study Record Updates

• Last Update Posted (ACTUAL): March 11, 2020
• Last Update Submitted That Met QC Criteria: March 10, 2020
• Last Verified: March 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Glucose Metabolism Disorders; Metabolic Diseases; Endocrine System Diseases; Diabetes Mellitus; Body Weight; Body Weight Changes; Diabetes Mellitus, Type 2; Weight Gain
• Other Study ID Numbers: 828087; R01DK111558 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD 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.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No