Food Choices
Conditions
Keywords
food labeling, ultra-processed foods
Brief summary
The primary objective of this study is to explore perceptions and understanding of different menu label designs related to ultra-processed foods (UPF). Participants will be randomized to view a fast-food online menu excerpt featuring one of sixteen labeling conditions and then will answer questions about the participant's reactions to and interpretations of the label, perceived label effectiveness, the intention to purchase a menu item with the label, as well as the participant's perceptions of fast-food menu items with and without the label.
Detailed description
This survey will explore the perceptions and understanding of different hypothetical UPF menu label designs. The survey research firm CloudResearch will recruit a sample of \ 12,400 adults aged 18 years and older who reside in the United States. This exploratory study will use a factorial experiment to assess different UPF label designs. Participants will be randomized to view a fast-food menu excerpt with one of sixteen labeling schemes, varying by message (Ultra-Processed vs. Contains Food Additives vs. Warning: Ultra-Processed vs. Warning: UPF), background and text color (red background with white text vs. yellow background with black text), and type (icon-plus-text vs. text-only). All menus will consist of a selection of food and beverage items, and select items will have the UPF label. Participants will be shown the menu and the label in isolation and will then be asked about the participant's interpretations of the label, reactions to the label, perceived message effectiveness (PME) of the label, how helpful the participant finds the label to be, and the participant's intention to purchase a menu item with the label. The participants will also be shown two different individual fast-food items with the label to which the participant was randomized in random order and asked about the perceived appeal and healthfulness of the menu items. The primary outcome will be intention to purchase a hypothetical menu item with the label. Secondary outcomes include label interpretation, perceived label understandability, perceived label believability, perception that the label grabbed attention, perceived message effectiveness (PME) of the label, perceived helpfulness of the label. Other outcomes include perceived level of appeal of menu items, and perceived level of healthfulness of menu items.
Interventions
BEHAVIORALUltra-Processed, Red, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALContains Food Additives, Red, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning Ultra-Processed, Red, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning UPF, Red, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALUltra-Processed, Yellow, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALContains Food Additives, Yellow, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning Ultra-Processed, Yellow, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning UPF, Yellow, Icon-plus-text Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALUltra-Processed, Red, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALContains Food Additives, Red, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning Ultra-Processed, Red, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning UPF, Red, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALUltra-Processed, Yellow, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALContains Food Additives, Yellow, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning Ultra-Processed, Yellow, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
BEHAVIORALWarning UPF, Yellow, Text-only Labels
Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.
Sponsors
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Johns Hopkins Bloomberg School of Public Health
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Participants will be randomized to view a fast-food online ordering menu with one of sixteen labeling schemes, varying by message (Ultra-Processed vs. Contains Food Additives vs. Warning: Ultra-Processed vs. Warning: UPF), background and text color (red with white text vs. yellow with black text), and type (icon-plus-text vs. text-only). Participants will be asked about a hypothetical intention to purchase a menu item with the label to which the participants were randomized.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* \- 18 years of age or older * Member of the CloudResearch panel * Residing in the United States
Exclusion criteria
* \<18 years of age * Not residing in the United States * Completed the survey implausibly quickly based on the distribution of the time to complete the survey among all participants * Failed the built-in Qualtrics survey fraud detection measures * Failed attention check question included in the survey
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intention to purchase | Immediately after viewing the menu excerpt and label image | Intention to purchase is measured with the survey question: How likely would you be to purchase a menu item with this label? Response options are a 5-point Likert scale: 1=Very unlikely, 2=Unlikely, 3=Somewhat unlikely, 4=Neither likely nor unlikely, 5=Somewhat likely, 6=Likely, 7=Very likely. A higher rating is better. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Label interpretation | Immediately after viewing the menu excerpt and label | Label interpretation is assessed with the survey question: Imagine that you are in a fast-food restaurant (such as Dunkin') to order for yourself. Next, is a question about the label, as displayed on the menu example. If you saw this label next to an item on the menu, what would you think the label indicates about the item? \[check all that apply\]. Response options provided are a range of statements about the menu item, including 1=This menu item is unhealthy, 2=This menu item contains artificial ingredients, 3=This menu item used a lot of natural resources to produce, 4=This menu item will keep you full for a long time, 5=This menu item is bad for the environment, 6=This menu item costs more, 7=This menu item was made using industrial processing techniques, This menu item is high in (8) sugar (9) sodium, (10) saturated fat, (11) calories. Also included are I don't know and an Other option with open-text entry. |
| Perceived label understandability | Immediately after viewing the menu excerpt and label image | After viewing the label, participants will be asked how much the participant agrees or disagrees with the following statement: This label is easy to understand. Response options are a unipolar 5-point Likert scale: 1=Not at all, 2=A little bit, 3=Somewhat, 4=Quite a bit, 5=A great deal. A higher ranking is better. |
| Perceived label believability | Immediately after viewing the menu excerpt and label image | After viewing the label, participants will be asked how much the participant agrees or disagrees with the following statement: This label is believable to me. Response options are a unipolar 5-point Likert scale: 1=Not at all, 2=A little bit, 3=Somewhat, 4=Quite a bit, 5=A great deal. A higher ranking is better. |
| Perceived message effectiveness (PME) as assessed by the University of North Carolina (UNC)-PME scale | Immediately after viewing the menu excerpt and label image | Perceived message effectiveness (PME) is measured using the unipolar 3-item University of North Carolina (UNC)-PME scale. Participants will be asked how much each label discourages consumption of or evokes concern of unpleasantness about consumption of foods with the label. After viewing the label, participants will be asked how much the participant agrees or disagrees with the following statements: This label discourages me from wanting to eat foods with this label, This label makes foods with this label seem unpleasant, and This label makes me concerned about the health effects of eating menu items with this label. Response options are a 5-point Likert scale: 1=Not at all, 2=A little bit, 3=Somewhat, 4=Quite a bit, 5=A great deal. A higher ranking is better. |
| Perceived label helpfulness | Immediately after viewing the menu excerpt and label image | Perceived label helpfulness is measured with the survey question: How helpful would you find this label when deciding what to order at a fast-food restaurant? Response options are a 7-point Likert scale: 1=Very unhelpful, 2=Unhelpful, 3=Somewhat unhelpful, 4=Neither helpful nor unhelpful, 5=Somewhat helpful, 6=Helpful, 7=Very helpful. A higher ranking is better. |
| Perception that label grabbed attention | Immediately after viewing the menu excerpt and label image | After viewing the label, participants will be asked how much the participant agrees or disagrees with the following statement: This label grabs my attention. Response options are a unipolar 5-point Likert scale: 1=Not at all, 2=A little bit, 3=Somewhat, 4=Quite a bit, 5=A great deal. A higher ranking is better. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Perceived level of appeal of labeled food item | Immediately after viewing each menu item | Perceived level of appeal of food item is measured after showing participants two different individual menu items separately by label condition. After showing each item, the survey question asks, How appealing do you think this item is?, and response options are a 7-point Likert scale: 1=Very unappealing, 2=Unappealing, 3=Slightly unappealing, 4=Neither appealing nor unappealing, 5=Slightly appealing, 6=Appealing, 7=Very appealing. A higher ranking is better |
| Perceived level of healthfulness of labeled food item | Immediately after viewing each menu item | Perceived level of healthfulness of labeled food item is measured after showing participants two different individual menu items separately by label condition. After showing each item, the survey question asks, How healthy do you think this item is?, and response options are a 7-point Likert scale: 1=Very unhealthy, 2=Unhealthy, 3=Slightly unhealthy, 4=Neither unhealthy nor healthy, 5=Slightly healthy, 6=Healthy, 7=Very healthy. A higher ranking is better. |
Countries
United States
Outcome results
None listed