Perceived Effectiveness of Added Sugar Labels

January 6, 2021 updated by: University of California, Davis
This study aims to develop a restaurant menu label to indicate foods and beverage items on restaurant menus that contain high amounts of added sugars and to test its perceived effectiveness.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Objectives and hypotheses:

The goal of this study is to examine how added sugar restaurant menu labels influence U.S. adults' perceptions and reactions. Predictions:

In a between-subjects experiment with 3 arms (control label, icon-only added sugars label, and icon plus text added sugars label):

  1. Added sugar labels will be perceived as more effective than the control label.
  2. The text plus icon label will be perceived as more effective than the icon-only label.
  3. A larger proportion of participants who see the added sugar labels will report learning something new than those who see the control label.
  4. Added sugar labels will lead participants to more accurately identify restaurant menu items high in added sugars compared to the control label, and the text plus icon label will outperform the icon-only label on this outcome.

Additionally, using a within-subjects design:

The study will examine which label (control, icon, text plus icon) most discourages wanting to consume menu items high in added sugars.

Analyses will compare various icon and text options for the added sugars label to determine which icon and which text variations are perceived as most discouraging for wanting to consume items high in added sugars. The is no hypothesis about which will be perceived as more discouraging.

Planned analyses:

For predictions 1-2: linear regression model (OLS) regressing PME on indicator variables for experimental condition. The margins command in STATA will be used to conduct pairwise comparisons between each condition (i.e., icon-only vs. icon plus text label). Also, PME will be regressed on an indicator variable combining the added sugar label groups.

For predictions 3-4, Poisson regression with robust standard errors will be used to estimate relative probability, regressing each dichotomous outcome on indicator variables for experimental condition. The margins command in STATA will be used to conduct pairwise comparisons between each condition. The outcomes will be regressed on an indicator variable combining the added sugar label groups. If the Poisson regressions do not converge, logistic regression will be used.

For the within-subjects comparisons, mixed effects linear models will be used to assess the relationship between condition and rating of label discouragement for consuming items high in added sugars.

A critical alpha 0.05 will be used, and statistical tests will be two-tailed. Because this is an initial, exploratory study to help identify the best performing label to use in a larger trial, alpha level will not be adjusted to control for multiple comparisons.

If there is evidence of deviations from modeling assumptions required for the parametric tests above, non-parametric sensitivity analyses will be conducted.

Study Type

Interventional

Enrollment (Actual)

1448

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

  • United States
    • California
      • Davis, California, United States, 95616
        • University of California, Davis

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 and older (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Equal or greater than 18 years of age
  • Less than 100 years of age
  • English-speaking
  • U.S. residents
  • Had to have purchased food from a restaurant at least once per month prior to the COVID-19 pandemic
  • Participants will reflect the U.S. Census Bureau's 2018 American Community Survey 5-year estimates for gender, race/ethnicity, educational attainment, and age

Exclusion criteria:

  • Failing the attention check question
  • Completing the survey in less than 30% of the median completion time
  • Straightlining
  • Providing nonsensical responses to open-ended questions

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Control label
Participant will see a QR code and footnote saying, "Scan the QR code for more menu information." The label will be applied to all menu items displayed.
Other: Menu label
Participants will be shown a sample of items from a restaurant menu, displayed with labels
Experimental: Icon plus text added sugars label
Participant will see a label containing an icon plus text label with an explanatory footnote. The label will be applied to items high in added sugars (exceeding half the daily value). Participants will randomly view one of 18 variations of icons and text in this arm.
Other: Menu label
Participants will be shown a sample of items from a restaurant menu, displayed with labels
Experimental: Icon only added sugars label
Participant will see a label containing an icon only with an explanatory footnote. The label will be applied to items high in added sugars (exceeding half the daily value). Participants will randomly view one of 6 variations of icons in this arm.
Other: Menu label
Participants will be shown a sample of items from a restaurant menu, displayed with labels

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Perceived message effectiveness (PME)
Time Frame: Up to approximately 5 minutes
Measured using 3 items adapted from Baig et al. (2018): scale 1-5, "This label makes me concerned about the health effects of consuming menu items high in added sugars", "This label makes consuming menu items high in added sugars seem unpleasant", "This label discourages me from wanting to consume menu items high in added sugars." This outcome is for the between-subjects experiment.
Up to approximately 5 minutes
Perception of how discouraging the label is for wanting to consume items high in added sugars
Time Frame: Up to approximately 7 minutes
Based on a single item adapted from Baig et al. (2018): "This label discourages me from wanting to consume menu items high in added sugar" (scale 1-5). This outcome is the within-subjects objectives.
Up to approximately 7 minutes
Perception of knowledge gain
Time Frame: Up to approximately 1 minute
Dichotomous response (yes/no) to the question, "Did you learn something new from this label?" This outcome is for the between-subjects experiment.
Up to approximately 1 minute
Correct identification of items high in added sugars
Time Frame: Up to approximately 2 minutes
"Now please look at the menu items below, and select all the ones you think have more than half the daily value for added sugars" with 8 possible responses. A dichotomous outcome variable based on the distribution of correct answers in the sample will be created. This outcome is for the between-subjects experiment.
Up to approximately 2 minutes

Collaborators and Investigators

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

Sponsor

University of California, Davis

Collaborators

Center for Science in the Public Interest (CSPI)

Investigators

  • Principal Investigator: Jennifer Falbe, ScD, MPH, University of California, Davis

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 13, 2020

Primary Completion (Actual)

December 26, 2020

Study Completion (Actual)

December 26, 2020

Study Registration Dates

First Submitted

November 16, 2020

First Submitted That Met QC Criteria

November 18, 2020

First Posted (Actual)

November 19, 2020

Study Record Updates

Last Update Posted (Actual)

January 8, 2021

Last Update Submitted That Met QC Criteria

January 6, 2021

Last Verified

January 1, 2021

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 1641776

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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