Effects of Sugary Drink Warning Labels on Parent Choices

Effects of Sugary Drink Warning Labels on Parent Choices for 6-11 Year Olds

Sugar-sweetened beverages (SSBs) are a significant contributor to adult and childhood obesity. Policies to place health warning labels on sugar-sweetened beverages are being pursued, but there is little empirical data on how such labels influence people. The proposed research will evaluate the impact of different types of sugar-sweetened beverage warning labels relative to standard calorie labels on the purchasing and consumption behaviors of parents and children.

Study Overview

• Status: Terminated
• Conditions: Food Preferences
• Intervention / Treatment: Behavioral: Exposure to sugar-sweetened beverage warning labels; Behavioral: Exposure to beverage calorie information

Detailed Description

The primary objective of this proposal is to determine, before wide-scale implementation, to what degree SSB warning labels increase consumers' knowledge about the potential health harms of SSBs and reduce SSB intake. The study is designed to answer two additional questions: 1) Do some warning labels work better than others? 3) If warning labels influence behavior, is it because they increase knowledge or simply provide a salient reminder that some drinks are less healthy? This aim is designed to test the effect of warning labels on total kilocalories (kcals) purchased and consumed by parents and children. We will examine how SSB warning labels influence snack and beverage purchases and intake among 405 racially and ethnically diverse parent-child pairs.

• Study Type: Interventional
• Enrollment (Actual): 1
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Philadelphia, Pennsylvania, United States, 19104
      • University of Pennsylvania

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participant pairs must be:
• Primary caregiver of a child 6-11 years old; 18 years or older; can read and speak English; did not participate in related studies from our group
• Child is between 6 and 11 years old; drinks SSBs at least 12 times per month (~3 times per week)

Exclusion Criteria:

• Unable to participate in person in Philadelphia
• Parent did not purchase food and beverage for their child
• Parent or caregiver refused to give child permission to participate

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Calorie/Control Label Condition; Beverages at the concession stand and in the parent survey in this arm will display solely a calorie label.	Behavioral: Exposure to beverage calorie information; Calories for sugar-sweetened and non-sugar-sweetened beverages
Experimental: Text Warning Label Condition; Sugary beverages at the concession stand and in the parent survey in this arm will display both a text warning and a calorie label.	Behavioral: Exposure to sugar-sweetened beverage warning labels; Graphic images of the amount of sugar (randomly assigned teaspoons, packets, or cubes) and text warning labels; Behavioral: Exposure to beverage calorie information; Calories for sugar-sweetened and non-sugar-sweetened beverages
Experimental: Sugar Graphic Label Condition; Sugary beverages at the concession stand and in the parent survey in this arm will display a sugar graphic warning label depicting the amount of sugar in the product, the same text warning, and a calorie label.	Behavioral: Exposure to sugar-sweetened beverage warning labels; Graphic images of the amount of sugar (randomly assigned teaspoons, packets, or cubes) and text warning labels; Behavioral: Exposure to beverage calorie information; Calories for sugar-sweetened and non-sugar-sweetened beverages

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total beverage calories purchased for the child	Total number of calories for all beverages purchased for the child during the study visit	Study visit, one hour
Total calories purchased for the child	Total number of calories for all food and beverages (summed) purchased for the child during the study visit	Study visit, one hour
Total calories the child consumes	Total number of calories consumed by the child for all food and beverages (summed) during the study visit	Study visit, one hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total beverage calories purchased for the adult	Total number of calories for all beverages purchased for the adult during the study visit	Study visit, one hour
Total calories purchased for the adult	Total number of calories for all food and beverages (summed) purchased for the adult during the study visit	Study visit, one hour
Beverage calories the child consumes	Total number of calories consumed by the child for all beverages during the study visit	Study visit, one hour
Beverage calories the adult consumes	Total number of calories consumed by the adult for all beverages during the study visit	Study visit, one hour
Total calories the adult consumes	Total number of calories consumed by the adult for all food and beverages (summed) during the study visit	Study visit, one hour

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Parent sugary beverage purchase intentions for the child	Average of intentions for 4 sugary beverages (1 (not at all likely) - 5 (extremely likely))	Study visit, 1 hour
Parent non-sugary beverage purchase intentions for the child	Average of intentions for 3 non-sugary beverages (1 (not at all likely) - 5 (extremely likely))	Study visit, 1 hour
Sugary beverage health beliefs and risk perceptions for the child	Average of 9 summed items for 4 sugary beverages (1 (strongly disagree) - 5 (strongly agree))	Study visit, 1 hour
Non-sugary beverage health beliefs and risk perceptions for the child	Average of 9 summed items for 3 non-sugary beverages (1 (strongly disagree) - 5 (agree))	Study visit, 1 hour
Sugary beverage accuracy of calorie knowledge	Average of difference between actual calories in each item from the calories reported by participants across 4 sugary beverages (larger numbers = overestimation)	Study visit, 1 hour
Non-sugary beverage accuracy of calorie knowledge	Average of difference between actual calories in each item from the calories reported by participants across 3 non-sugary beverages (larger numbers = overestimation)	Study visit, 1 hour
Sugary beverage accuracy of sugar knowledge	Average of difference between actual teaspoons of sugar in each item from the number of teaspoons reported by participants across 4 sugary beverages (larger numbers = overestimation)	Study visit, 1 hour
Non-sugary beverage accuracy of sugar knowledge	Average of difference between actual teaspoons of sugar in each item from the number of teaspoons reported by participants across 3 non-sugary beverages (larger numbers = overestimation)	Study visit, 1 hour
Sugary beverage categorical perception of amount of sugar	Proportion of 4 sugary beverages coded as just right or too much vs. none or too little	Study visit, 1 hour
Non-sugary beverage categorical perception of amount of sugar	Proportion of 3 non-sugary beverages coded as none vs. all other options	Study visit, 1 hour

Collaborators and Investigators

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

Study record dates

Study Major Dates

• Study Start (Actual): March 11, 2020
• Primary Completion (Actual): March 12, 2020
• Study Completion (Actual): March 12, 2020

Study Registration Dates

• First Submitted: February 4, 2020
• First Submitted That Met QC Criteria: February 4, 2020
• First Posted (Actual): February 6, 2020

Study Record Updates

• Last Update Posted (Actual): September 20, 2021
• Last Update Submitted That Met QC Criteria: September 13, 2021
• Last Verified: September 1, 2021

More Information

Terms related to this study

• Keywords: Child; Choice behavior; Eating; Drinking; Sugar-sweetened beverages; Food labeling
• Other Study ID Numbers: R01DK111558_2; R01DK111558 (U.S. NIH Grant/Contract); 33648 (Registry Identifier: AsPredicted)

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