Developing and Evaluating Product Messaging

Purpose: To assess the impact of taxes, warnings, and a combination of taxes and warnings on US adults' decisions to purchase products that contain red meat in an online grocery store.

Procedures (methods): Participants will be recruited from Prime Panels (an online panel research company). Following online consent, participants will be assigned to one of four trial arms: 1) Control (no warning and no tax), 2) Warnings (all products that contain red meat have a health warning and environmental warning), 3) Tax (30% tax on products that contain red meat), and 4) Combined warning and tax (all products that contain red meat will have the two warnings and a 30% tax). Then, participant will enter an online grocery store reflecting their assigned arm. The participant will be instructed to complete a shopping task in the online grocery store. After completing the shopping task, participants will be redirected to an online survey and answer a series of questions about the shopping task, labels (excluding tax and control groups), and taxes (excluding warning and control groups). Questions will also include standard demographic and health related variables.

Study Overview

• Status: Completed
• Conditions: Cancer of Colon; Cancer of Rectum
• Intervention / Treatment: Other: Control; Other: Warning Labels; Other: Tax; Other: Combined Warning Labels and Tax

Detailed Description

Participants will be recruited from Prime Panels (an online panel research company). Following online consent, participants will be randomly assigned to one of four trial arms affecting the appearance of an online grocery store. Once in the online grocery store, participants will complete a shopping task. The participants will have 9 specified items to add to their shopping cart (1 pizza, 1 burrito, Burger patties [meat or vegetarian], Breakfast sausages [meat or vegetarian], 1 frozen individual meal, 1 loaf of bread, 1 sandwich filling [for example, ham, turkey, or peanut butter], 1 pack of tortillas, 1 taco filling [for example, steak, chicken, or beans]). Participants will be informed that they will not be spending any of their own money to complete the shopping task. After completing the shopping task, participants will be redirected to a survey. They will provide self-reported responses to survey questions (e.g. perceived healthfulness from eating red meat, perceived risk of cancer from eating red meat, thinking about the health/environmental harms of food products). Participants will also answer demographic and health related questions.

• Study Type: Interventional
• Enrollment (Actual): 4160
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Chapel Hill, North Carolina, United States, 27516
      • Carolina Population Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• 18 years or older
• Consumes red meat at least once per week.
• Responsible for at least 50% of grocery shopping for the household.
• Lives in the United States

Exclusion Criteria:

• Individuals who have participated in research studies from previous aims of this research.

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; Products that contain red meat will not have warning labels or an increase in price.	Other: Control; Participants will complete a shopping task in the online grocery store, and the products that contain red meat will not have warning labels or a 30% increase in price.
Experimental: Warning Labels; The warning labels are black octagons with white text that appear next to images of products that contain red meat. One label says "WARNING: Eating red meat contributes to colon and rectal cancer" and the other label says "WARNING: Eating red meat harms the environment."	Other: Warning Labels; While completing the shopping task in the online grocery store, the health and environmental warning labels will appear next to the image of every product that contains red meat.
Experimental: Tax; The tax is a 30% increase in the price of products that contain red meat.	Other: Tax; While completing the shopping task in the online grocery store, all products containing red meat will have a 30% increase in price.
Experimental: Combined Warning Labels and Tax; The Combined Warning Labels and Tax arm features both the warning labels and tax. The warning labels are black octagons with white text that appear next to images of products that contain red meat. One label says "WARNING: Eating red meat contributes to colon and rectal cancer" and the other label says "WARNING: Eating red meat harms the environment." The tax is a 30% increase in the price of red meat products.	Other: Combined Warning Labels and Tax; While completing the shopping task in the online grocery store, all products containing red meat will have the health and environmental warning labels appear next to the product image and a 30% increase in price.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Count of Products That Contain Red Meat	The number of products in a participant's shopping basket that contain red meat.	At completion of ~15 minute shopping task
Percentage of Red Meat Containing Products	The percentage of products in a participant's shopping basket that contain red meat.	At completion of ~15 minute shopping task

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total Saturated Fat	Total grams of saturated fat of products in a participant's shopping basket. This will be calculated by adding together the total saturated fat from each product in the participant's shopping basket. Saturated fat for each product will come from the product's nutrition facts panel. All products in the store are real life products that have designated nutrition facts panels.	At completion of ~15 minute shopping task
Total Sodium	Total grams of sodium of products in a participant's shopping basket. This will be calculated by adding together the total sodium from each product in the participant's shopping basket. Sodium for each product will come from the product's nutrition facts panel. All products in the store are real life products that have designated nutrition facts panels.	At completion of ~15 minute shopping task
Total Calories	Total calories of products in a participant's shopping basket. This will be calculated by adding together the total calories from each product in the participant's shopping basket. Calories for each product will come from the product's nutrition facts panel. All products in the store are real life products that have designated nutrition facts panels.	At completion of ~15 minute shopping task
Perceived Healthfulness	Perceived healthfulness of eating red meat. Likert response options are on a 1 to 5 scale, with higher scores representing a higher perceived healthfulness of eating red meat.	~15 minutes post-test computer survey following the ~15 minute shopping task
Perceived Cancer Risk	Perceived risk of colon and rectal cancer from eating red meat. Likert response options are on a 1 to 5 scale, with higher scores representing a higher perceived risk of colon and rectal cancer from eating red meat.	~15 minutes post-test computer survey following the ~15 minute shopping task
Perceived Environmental Risk	Perceived risk of environmental harms from eating red meat. Likert response options are on a 1 to 5 scale, with higher scores representing a higher perceived risk of environmental harms from eating red meat.	~15 minutes post-test computer survey following the ~15 minute shopping task
Cognitive Elaboration (Health)	Thinking about the health harms of food products while completing the shopping task. Likert response options are on a 1 to 5 scale, with higher scores representing a higher amount of thinking about health harms of food products.	~15 minutes post-test computer survey following the ~15 minute shopping task
Cognitive Elaboration (Environment)	Thinking about the environmental harms of food products while completing the shopping task. Likert response options are on a 1 to 5 scale, with higher scores representing a higher amount of thinking about the environmental harms of food products.	~15 minutes post-test computer survey following the ~15 minute shopping task
Cognitive Elaboration (Price)	Thinking about the price of food products while completing the shopping task. Likert response options are on a 1 to 5 scale, with higher scores representing a higher amount of thinking about the price of food products.	~15 minutes post-test computer survey following the ~15 minute shopping task
Specific Perceived Healthfulness	Perceived healthfulness of specific red meat products (burgers, pepperoni pizza, and deli ham). Likert response options are on a 1 to 5 scale, with lower scores representing worse for health and higher scores representing better for health.	~15 minutes post-test computer survey following the ~15 minute shopping task
Specific Perceived Environmental Risk	Perceived environmental harm of specific red meat products (burgers, pepperoni pizza, and deli ham). Likert response options are on a 1 to 5 scale, with lower scores representing worse for the environment and higher scores representing better for the environment.	~15 minutes post-test computer survey following the ~15 minute shopping task
Perceived Cost of the Burger Product.	Perceived cost of the burger product. Likert response options are on a 1 to 5 scale, with lower scores representing less expensive and higher scores representing more expensive.	~15 minutes post-test computer survey following the ~15 minute shopping task
Perceived Cost of the Pizza Product.	Perceived cost of the pizza product. Likert response options are on a 1 to 5 scale, with lower scores representing less expensive and higher scores representing more expensive.	~15 minutes post-test computer survey following the ~15 minute shopping task
Perceived Cost of the Ham Product.	Perceived cost of the ham product. Likert response options are on a 1 to 5 scale, with lower scores representing less expensive and higher scores representing more expensive.	~15 minutes post-test computer survey following the ~15 minute shopping task
Intention to Reduce	Intention to reduce red meat consumption in the next 30 days. Likert response options are on a 1 to 5 scale, with higher scores representing a higher intention to reduce red meat consumption in the next 30 days.	~15 minutes post-test computer survey following the ~15 minute shopping task

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage of Participants Who Support Tax	Support of policy for taxes on red meat products in the U.S. Likert response options are on a 1 to 5 scale, with higher scores representing a greater deal of support. Those who indicated '4' or '5' were assumed to more strongly agree to support a red meat product tax. This measure reports the percentage of those with a response of '4' or '5'.	~15 minutes post-test computer survey following the ~15 minute shopping task
Percentage of Participants Who Support Health Warning Label	Support of policy for health warning labels on red meat products in the U.S. Likert response options are on a 1 to 5 scale, with higher scores representing a greater deal of support. Those who indicated '4' or '5' were assumed to more strongly agree to support a health warning label. This measure reports the percentage of those with a response of '4' or '5'.	~15 minutes post-test computer survey following the ~15 minute shopping task
Percentage of Participants Who Support Environmental Warning Label	Support of policy for environmental warning labels on red meat products in the U.S. Likert response options are on a 1 to 5 scale, with higher scores representing a greater deal of support. Support of policy for taxes on environmental warning labels in the U.S. Likert response options are on a 1 to 5 scale, with higher scores representing a greater deal of support. Those who indicated '4' or '5' were assumed to more strongly agree to support an environmental warning label. This measure reports the percentage of participants with a response of '4' or '5'.	~15 minutes post-test computer survey following the ~15 minute shopping task
Mean Modified Waterlander Acceptability Scale Score	Acceptability of the online grocery store. Likert response options are on a 1 to 5 scale, with higher scores representing a higher amount of agreement. Acceptability of the online grocery store is measured using 3 items adapted from Waterlander et al., 2011. Responses to the 3 items will be averaged to create an acceptability score sum ranging from 3-15 then divided by the total number of questions asked (n = 3). Prompt: Say whether you agree or disagree with the following statements. I could easily find all of the food and beverages I was looking for in the online grocery store. There were enough food and beverage options in the online grocery store. This online grocery store felt like a real online grocery store. Waterlander WE, Scarpa M, Lentz D, Steenhuis IHM. The virtual supermarket: an innovative research tool to study consumer food purchasing behavior. 2011;11:589. DOI: 10.1186/1471-2458-11-589.	~15 minutes post-test computer survey following the ~15 minute shopping task
Ease of Store Use	Ease of use of the online grocery store. Likert response options are on a 1 to 5 scale, with higher scores representing more agreement that the online grocery store is easy to use.	~15 minutes post-test computer survey following the ~15 minute shopping task

Collaborators and Investigators

• Sponsor: University of North Carolina, Chapel Hill
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI); Wellcome Trust; University of Edinburgh
• Investigators: Principal Investigator: Lindsey S Taillie, PhD, University of North Carolina, Chapel Hill; Principal Investigator: Lindsay Jaacks, PhD, University of Edinburgh

Study record dates

Study Major Dates

• Study Start (Actual): October 18, 2021
• Primary Completion (Actual): October 28, 2021
• Study Completion (Actual): October 28, 2021

Study Registration Dates

• First Submitted: January 14, 2021
• First Submitted That Met QC Criteria: January 19, 2021
• First Posted (Actual): January 20, 2021

Study Record Updates

• Last Update Posted (Actual): August 18, 2023
• Last Update Submitted That Met QC Criteria: August 3, 2023
• Last Verified: August 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Digestive System Diseases; Neoplasms; Neoplasms by Site; Gastrointestinal Neoplasms; Digestive System Neoplasms; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Intestinal Neoplasms; Rectal Diseases; Colorectal Neoplasms; Rectal Neoplasms; Colonic Neoplasms
• Other Study ID Numbers: 19-3349; K01HL147713 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: A deidentified dataset and the survey codebook will be published to the Harvard Dataverse. The study protocol and statistical analysis plan will be published as supporting information with the study results in a peer-reviewed journal.
• IPD Sharing Time Frame: The deidentified dataset and corresponding survey codebook will be available upon publication of study results and will remain on the Harvard Dataverse indefinitely.
• IPD Sharing Access Criteria: Anyone who wishes to access the data.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

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