Testing Product Messages for Colombia

Purpose: To better understand the impact of different front-of-package labels (FOPLs) on consumer purchasing intentions and ability to identify unhealthy foods.

Participants: ~8,000 Colombians, recruited from Offerwise, that are 18 years or older.

Procedures (methods): Participants will be randomly assigned to view images of food and drink products with either a nutrient warning label, Guideline Daily Amount label, Nutriscore label, or no-label control. They will be asked a series of questions about the products and the labels (excluding control group) on them. Questions will also include standard demographic and health related variables.

Study Overview

• Status: Completed
• Conditions: Obesity
• Intervention / Treatment: Other: Control; Other: Nutriscore Label; Other: Adapted Peruvian Nutrient Label; Other: Guideline Daily Amount Label

Detailed Description

Participants will be recruited from Offerwise (an online panel research company). Following online consent, participants will be randomly assigned to view different labels (explained below) on food and drink packaging. Participants will answer self-reported responses to the content (e.g., elaboration, beliefs, perceived healthfulness). After being randomized to one of the four groups and answering questions (e.g. which product is healthier, which product would you buy), the participant will see all three labels and select which is most dissuading from consuming a product high in a nutrient. At the end, the participant will answer demographic questions.

Participants will be randomized to see either a no-label control or 1 of 3 nutrient labels. The participants will see 5 types of products with the labels (fruit drinks, yogurt, sliced bread, cookies, and breakfast cereal).

Nutrient labels:

1. Guideline Daily Amount label
2. Nutriscore label
3. Adapted Peruvian nutrient warning label (high in sugar, high in saturated fat, high in salt/sodium)

• Study Type: Interventional
• Enrollment (Actual): 8071
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27599
      • UNC Carolina Population Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 64 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• 18-64 years old
• Resident of Colombia
• Offerwise panel member (recruitment platform)

Exclusion Criteria:

• <18 years old or >64 years old
• Not a resident of Colombia

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Control; The control arm will show the products with no label.	Other: Control; Participants will be shown images of juice, bread, yogurt, cookies, and cereal without any added front-of-package labels.
Experimental: Nutriscore Label; The Nutriscore label applies a letter grade (A, B, C, D or E) to a product based on certain nutrient criteria.	Other: Nutriscore Label; A front-of-package Nutriscore label will be applied to images of juice, bread, yogurt, cookies, and cereal. This label applies a score of A, B, C, D, or E based on the product's nutrition profile.
Experimental: Adapted Peruvian Nutrient Label; The adapted label is a black octagon with the words in Spanish saying "Excess of sugar,"Excess of saturated fat," or "Excess of salt/sodium" depending on the nutrition contents of the product. Below the octagon is a box with words in Spanish saying "Avoid high consumption"	Other: Adapted Peruvian Nutrient Label; A front-of-package octagonal nutrient label will be applied to images of juice, bread, yogurt, cookies, and cereal. The label text informs consumers if a product is high in sugar, saturated fat, or salt/sodium. These labels were developed by the Peruvian government and adapted by investigators.
Experimental: Guideline Daily Amount Label; The Guideline Daily Amount label highlights the nutrient contents of the product by serving. It lists the calories, total fat, saturated fat, sugar, and sodium, as well are their % of the daily value.	Other: Guideline Daily Amount Label; A front-of-package Guideline Daily Amount label will be applied to images of juice, bread, yogurt, cookies, and cereal. The label shows the amount and percent of daily value of calories, total fat, saturated fat, sugar, and sodium in one serving of a product.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Selection of Product Higher in Sugar	Percentage of participants who select the less healthy product in a set of two products as the product the consumer most wants to buy.	During ~15 minute online survey
Correct Identification of the Product Higher in Sugar	Percentage of participants who correctly select the product higher in sugar (between two products)	During ~15 minute online survey

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Perceived Message Effectiveness	Perceived message effectiveness of the study labels. Response options are on a 1 to 5 scale, with lower scores representing a higher amount of the construct. Perceived message effectiveness is measured using 3 items adapted from Baig et al. (2018): concern, unpleasantness, and discouragement. Responses to the 3 items will be averaged to create a perceived message effectiveness score. Question: How much does this message...; make you concerned about the health effect of consuming an unhealthy product?; discourage you from wanting to eat an unhealthy product?; make eating an unhealthy product seem unpleasant to you? Only asked of the label arms, not control.	During ~15 minute online survey
Purchase Likelihood	Likelihood that participants would purchase this product in the next week if it were available. Response options are on a 1 to 5 scale, with lower scores representing a higher amount of the construct	During ~15 minute online survey
Identify Less Healthy Product	Percentage of participants that correctly identify the less healthy product when selecting between two products.	During ~15 minute online survey
Ability to Identify Product as Having Excess of Sugar/Saturated Fat/Sodium	Percentage of participants who correctly identify that the product contains excess sugar, saturated fat, or sodium.	During ~15 minute online survey
Most Discouraging Label	Percentage of participants selecting each nutrient label as most discouraging them from consuming the product.	During ~15 minute online survey

Collaborators and Investigators

• Sponsor: University of North Carolina, Chapel Hill
• Collaborators: The Bloomberg Family Foundation, Inc.
• Investigators: Principal Investigator: Lindsey S Taillie, PhD, University of North Carolina, Chapel Hill

Publications and helpful links

General Publications

• Mora-Plazas M, Aida Higgins IC, Gomez LF, Hall M, Parra MF, Bercholz M, Murukutla N, Taillie LS. Impact of nutrient warning labels on choice of ultra-processed food and drinks high in sugar, sodium, and saturated fat in Colombia: A randomized controlled trial. PLoS One. 2022 Feb 10;17(2):e0263324. doi: 10.1371/journal.pone.0263324. eCollection 2022.

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2020
• Primary Completion (Actual): October 8, 2020
• Study Completion (Actual): October 8, 2020

Study Registration Dates

• First Submitted: September 22, 2020
• First Submitted That Met QC Criteria: September 22, 2020
• First Posted (Actual): September 28, 2020

Study Record Updates

• Last Update Posted (Actual): March 15, 2023
• Last Update Submitted That Met QC Criteria: March 14, 2023
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Other Study ID Numbers: 20-0401a

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