Food Preferences, Obesity, Weight Gain
Conditions
Keywords
food labeling, sugar-sweetened beverages, eating, drinking, choice behavior
Brief summary
The aim of this study is to compare the impact of 4 different types of front of package (FOP) food and beverage messages: 1) green labels on healthy foods, 2) red/yellow/green labels on less healthy/moderately healthy/healthy foods, 3) physical activity calorie equivalent labels, and 4) posters reminding consumers of the sweetened beverage tax on consumers' beverage and snack selections.
Detailed description
This project involves a randomized field experiment. The investigators worked with the vending contractor for the City of Philadelphia to randomize vending machine locations (covering \ 260 beverage and snack machines) to one of the four different message conditions: 1) single green traffic light labels (on healthy foods); 2) multiple traffic light labels (red traffic light labels applied to less healthy foods, yellow applied to moderately healthy foods, and green on healthy foods); 3) physical activity labels (calorie content displayed in terms of physical activity equivalents); 4) posters reminding consumers of the Philadelphia sweetened beverage tax and encouraging healthier choices. The City's vending machine contractors provided monthly aggregated sales data from each machine for analysis. Customer intercepts were also collected at the point of sale, after customers completed their purchase, to evaluate factors that moderate message influence. They were asked to answer questions about their perceptions of the different labels.
Interventions
BEHAVIORALexposure to healthy labels only
Green labels only for beverages and foods scored as healthy
BEHAVIORALexposure to healthiness information
All beverages and foods labeled as either healthy (green), moderately healthy (yellow), or less healthy (red)
All beverages and foods labeled with physical activity required to burn their calories
BEHAVIORALexposure to sweetened beverage tax messaging
Message reminding consumers to make healthier choices
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
University of Pennsylvania
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Machine locations were randomly assigned to 1 of 4 front-of-package message arms, stratified by baseline machine sales (high/low) and type of machine location (correctional facilities, courts/offices, large offices, police/fire, recreation centers/libraries/other) with equal probability. The investigators first randomized vending locations (e.g., floors) with beverage machines so that all machines on the same floor displayed the same label. They then randomized the remaining solo snack locations. Monthly sales data provided by the City's vending contractor indicated consumer choices. Research assistants also asked a subset of consumers (N=1,065) about their purchases. Intercepts were not allowed in the courts/offices location type and were not conducted at correctional facilities with low traffic. The aim was to collect 10 intercepts per machine visited, distributed over the entire study period, however the study was cut short in March 2020 by the Covid pandemic.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Sales data include all purchases at the machine regardless of customer demographics. Customer purchase assessment data were collected from: Inclusion Criteria: * Any person aged 18 or older making a purchase from the vending machines included in this intervention will be asked to participate in this study.
Exclusion criteria
* People who indicate they have already taken the survey are not eligible to take the survey again.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total snack units sold per month per machine | Every month, for 13 months | Outcome is number of monthly snacks sold per machine |
| Likelihood of selecting a moderately healthy snack | Every month, for 13 months | Outcome is percentage of monthly snacks selected were moderately healthy snacks (yellow labeled in the traffic light condition) |
| Likelihood of selecting a less healthy snack | Every month, for 13 months | Outcome is percentage of monthly snacks selected were less healthy snacks (red labeled in the traffic light condition) |
| Total beverage units sold per month per machine. | Every month, for 13 months | Outcome is number of monthly beverages sold per machine |
| Percentage of beverages sold with calories per month | Every month, for 13 months | Outcome is percentage of monthly beverages selected that had calories |
| Calories sold from beverages per month, if beverages with calories sold | Every month, for 13 months | Outcome is calories in beverages sold per month - only for beverages with calories. |
| Calories sold from snacks per month | Every month, for 13 months | Outcome is calories in snacks sold per month. |
| Likelihood of selecting a healthy beverage | Every month, for 13 months | Outcome is percentage of monthly beverages selected were healthy beverages (green labeled in the traffic light condition) |
| Likelihood of selecting a moderately healthy beverage | Every month, for 13 months | Outcome is percentage of monthly beverages selected were moderately healthy beverages (yellow labeled in the traffic light condition) |
| Likelihood of selecting a less healthy beverage | Every month, for 13 months | Outcome is percentage of monthly beverages selected were less healthy beverages (red labeled in the traffic light condition) |
| Likelihood of selecting a healthy snack | Every month, for 13 months | Outcome is percentage of monthly snacks selected were healthy snacks (green labeled in the traffic light condition) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Total revenue per month per snack machine | Every month, for 13 months | Outcome is the total dollar sales per month per snack machine. |
| Total calories sold per customer trip | 5-minute survey | Customer purchase assessments will be conducted in front of study machines. Outcome is total number of calories (beverage + snack) purchased per customer trip. |
| Total revenue per month per beverage machine | Every month, for 13 months | Outcome is the total dollar sales per month per beverage machine. |
Countries
United States
Outcome results
None listed