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Food PreferencesNCT05079477

Online Study of the Effects of Sugary Drink Warning Labels on Consumption

A study testing Exposure to sugar-sweetened beverage warning labels and Exposure to calorie information in people with Food Preferences, run by University of Pennsylvania at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim of this study is to determine the degree to which sugar-sweetened beverages (SSB) warning labels increase consumers' knowledge about the potential health harms of SSBs and reduce SSB purchases and consumption. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Food Preferences
What is being tested?
Exposure to sugar-sweetened beverage warning labels and Exposure to calorie information
Could I receive a placebo?
No, everyone receives an active treatment
How many people
216 participants
Where
1 siteUnited States
Study dates
6 Oct 2021to 17 Jan 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • a primary caregiver of a child 6-to-11 years old;
  • >=18 years old;
  • can read and speak English;
  • primary grocery shopper for their household;
  • have regular Internet access; and
  • report that the oldest of their children between 6 and 11 years old is consuming sugar sweetened beverages at least twelve times per month or approximately three times a week

Who cannot join

  • not a primary caregiver of a child 6-to-11 years old;
  • <18 years old;
  • cannot read and/or speak English;
  • not the primary grocery shopper for their household;
  • does not have regular Internet access; and
  • does not report that the oldest of their children between 6 and 11 years old is consuming sugar sweetened beverages at least twelve times per month or approximately three times a week

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Pennsylvania

    Philadelphia, Pennsylvania, 19104

Other trials in United States

About this study

Official title: Communicating the Health Risks of Sugar-Sweetened Beverages: A Randomized-controlled Experiment of Different Nutrition Labels on Purchases and Consumption

The aim of this study is to determine the degree to which sugar-sweetened beverages (SSB) warning labels increase consumers' knowledge about the potential health harms of SSBs and reduce SSB purchases and consumption. 216 racially and ethnically diverse parents of children 6-11 years old will be recruited to buy snacks and beverages for four weeks via an online store that ships participants their purchases. Participants will be randomized to either 1) calorie labels (control); or 2) sugar graphic warning labels. The investigators hypothesize that sugar graphic warning labels displayed in an online store in weeks 2-4 will lead to the greatest reductions from week 1 across both primary outcomes compared to the control group that will only see calorie labels.

Read the detailed description

During this study, participants will shop in an online store created using Shopify for four weeks. In this within-participant design, the first week of shopping is baseline. Participants will then be randomized to different store interfaces for the remaining three weeks based on one of two warning label conditions: 1) calorie labels (control); or 2) sugar graphic warning labels. Participants will complete a brief survey at the start of the study to assess demographic information, information about parent and child beverage consumption, and their online shopping experiences. At the end they will complete another survey about their beverage consumption, their experience shopping in the store, whether they noticed and used the warning labels, and their ability to recall the warning label message. Participants will also be asked about their perceptions of a specific type of warning label in this final survey. Upon completion of the survey, participants will be shown a debriefing statement explaining the study purpose. After they read the information, they will be asked whether or not they consent to allow their data to be used in this study.

Being tested
Exposure to sugar-sweetened beverage warning labels, Exposure to calorie information
Keywords
food labeling, child, sugar-sweetened beverages, eating, drinking, choice behavior
Medical subject headings
Food Preferences

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Exposure to sugar-sweetened beverage warning labelsBehavioural

    Graphic images of the amount of sugar (randomly assigned teaspoons, packets, or cubes) and text warning labels

  • Exposure to calorie informationBehavioural

    Calories for all beverages and foods

Study groups in NCT05079477
Study groupRoleWhat they receive
Calorie labelActive comparatorCalorie label (control) will display a calories per package label on all beverages, not just sugary drinks. This is modeled after the American Beverage Association's current "Clear on Calories" labels. Additionally, all snack items will have a calories per serving label.
Receives: Behavioral: Exposure to calorie information
Sugar graphic warning labelExperimentalAll products in this arm will also have calorie labels. Beverages with added sugar will also have sugar graphic warning labels with the text: "WARNING: drinking beverages with added sugars contributes to obesity, diabetes, and tooth decay" along with graphics depicting the amount of sugar in the beverage.
Receives: Behavioral: Exposure to sugar-sweetened beverage warning labels; Behavioral: Exposure to calorie information

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Beverage Calories Purchased, Week 1

    Logged beverage calories/100mL purchased. Number of servings per item and number of items per package varied by product; therefore, calorie amounts were standardized to calories/100mL for beverages.

    Measured: one week

  2. Beverage Calories Purchased, Weeks 2-4

    Logged average beverage calories/100mL purchased per week over Weeks 2-4. Number of servings per item and number of items per package varied by product; therefore, calorie amounts were standardized to calories/100mL for beverages.

    Measured: three weeks

  3. Beverage Added Sugars Purchased, Week 1

    Beverage grams of added sugars/100mL purchased. Number of servings per item and number of items per package varied by product; therefore, added sugar amounts were standardized to grams of added sugar/100mL for beverages.

    Measured: one week

  4. Beverage Added Sugars Purchased, Weeks 2-4

    Average beverage grams of added sugars/100mL purchased per week over Weeks 2-4. Number of servings per item and number of items per package varied by product; therefore, added sugar amounts were standardized to grams of added sugar/100mL for beverages.

    Measured: three weeks

Secondary outcomes (40)
  1. Number Purchasing a Sweetened Beverage, Week 1

    Number of parents buying a sweetened beverage within each condition

    Measured: one week

  2. Number Purchasing a Sweetened Beverage, Weeks 2-4

    Number of parents buying a sweetened beverage at any point during Weeks 2-4, within each condition

    Measured: three weeks

  3. Snack Calories Purchased, Week 1

    Logged snack calories/100g purchased. Number of servings per item and number of items per package varied by product; therefore, calorie amounts were standardized to calories/100g for snacks.

    Measured: one week

  4. Snack Calories Purchased, Weeks 2-4

    Logged average snack calories/100g purchased per week over Weeks 2-4. Number of servings per item and number of items per package varied by product; therefore, calorie amounts were standardized to calories/100g for snacks.

    Measured: three weeks

  5. Snack Added Sugars Purchased, Week 1

    Snack grams of added sugars/100g purchased. Number of servings per item and number of items per package varied by product; therefore, added sugar amounts were standardized to grams of added sugar/100g for snacks.

    Measured: one week

  6. Snack Added Sugars Purchased, Weeks 2-4

    Average snack grams of added sugars/100g purchased per week over Weeks 2-4. Number of servings per item and number of items per package varied by product; therefore, added sugar amounts were standardized to grams of added sugar/100g for snacks.

    Measured: three weeks

  7. Total Calories Purchased, Week 1

    Log of the summed beverage and snack calories purchased

    Measured: one week

  8. Total Calories Purchased, Weeks 2-4

    Log of the average summed beverage and snack calories purchased per week over Weeks 2-4

    Measured: three weeks

  9. Total Added Sugars Purchased, Week 1

    Summed grams of beverage and snack added sugars purchased

    Measured: one week

  10. Total Added Sugars Purchased, Weeks 2-4

    Average summed grams of beverage and snack added sugars purchased per week over Weeks 2-4

    Measured: three weeks

  11. Volume of Sweetened Beverages Consumed by Child, Baseline

    Ounces of sweetened beverages (labeled in sugar condition) consumed per day in the last month by the child as measured by the Beverage Intake Questionnaire (BEV-Q) parent self-report survey.

    Measured: baseline

  12. Volume of Sweetened Beverages Consumed by Child, Final

    Ounces of sweetened beverages (labeled in sugar condition) consumed per day in the last month by the child as measured by the Beverage Intake Questionnaire (BEV-Q) parent self-report survey.

    Measured: Week 4

  13. Volume of Sweetened Beverages Consumed by Parent, Baseline

    Ounces of sweetened beverages (labeled in sugar condition) consumed per day in the last month by the parent as measured by the Beverage Intake Questionnaire (BEV-Q) self-report survey.

    Measured: baseline

  14. Volume of Sweetened Beverages Consumed by Parent, Final

    Ounces of sweetened beverages (labeled in sugar condition) consumed per day in the last month by the parent as measured by the Beverage Intake Questionnaire (BEV-Q) self-report survey.

    Measured: Week 4

  15. Noticing the Label

    Participants will respond "yes," "no," or "I don't know" to the item: "When you selected a beverage to purchase in the store, did you notice any labels on the beverages other than calorie information?"

    Measured: Week 4

  16. Perceived Label Influence

    Participants will respond: "yes", "no," or "I did not notice any labels" in response to the question of whether the label influenced their purchase.

    Measured: Week 4

  17. How Much do You Trust the Information on This Label

    "How much do you trust the information on this label?". Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater trust in the label.

    Measured: Week 4

  18. Likelihood of Label Changing Thoughts

    "If this government warning label were on a beverage, how much would it change your thoughts about the healthiness of that beverage for your child?" Responses will be measured with a 5-point Likert scale where 1=Not at all and 5=A lot. Higher numbers indicate the label would be more likely to change perceptions of beverage healthiness.

    Measured: Week 4

  19. Encourage You to Give Fewer Beverages to Your Child

    "If you saw this government warning label on a beverage, would the label encourage you to serve your child that beverage less often?" Responses will be measured with a 5-point Likert scale where 1=Definitely no and 5=Definitely yes. Higher numbers indicate greater likelihood of serving unhealthy beverages less often.

    Measured: Week 4

  20. Negative Reactions to the Label

    Average negative emotional response to the label will be examined (said the warning label made them feel worried, fearful, guilty, or disgusted or grossed out). Responses will be measured with a 5-point Likert scale averaging across the 4 negative emotions where 1=Not at all and 5=Extremely. Higher numbers indicate more negative reactions.

    Measured: Week 4

  21. Child Enjoyment of Water

    "How much do you think your child would enjoy this product?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater enjoyment of the product.

    Measured: Week 4

  22. Child Enjoyment of Orange Juice

    "How much do you think your child would enjoy this product?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater enjoyment of the product.

    Measured: Week 4

  23. Child Enjoyment of Soda

    "How much do you think your child would enjoy this product?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater enjoyment of the product.

    Measured: Week 4

  24. Child Enjoyment of Sports Drink

    "How much do you think your child would enjoy this product?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater enjoyment of the product.

    Measured: Week 4

  25. Likely to Serve or Buy Water

    "How likely are you to serve or buy this product for your child in the next 4 weeks?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater likelihood of serving or buying the product for their child.

    Measured: Week 4

  26. Likely to Serve or Buy Orange Juice

    "How likely are you to serve or buy this product for your child in the next 4 weeks?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater likelihood of serving or buying the product for their child.

    Measured: Week 4

  27. Likely to Serve or Buy Soda

    "How likely are you to serve or buy this product for your child in the next 4 weeks?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater likelihood of serving or buying the product for their child.

    Measured: Week 4

  28. Likely to Serve or Buy Sports Drinks

    "How likely are you to serve or buy this product for your child in the next 4 weeks?" Responses will be measured with a 7-point Likert scale where 1=Not at all and 7=Extremely. Higher numbers indicate greater likelihood of serving or buying the product for their child.

    Measured: Week 4

  29. Health Beliefs and Risk Perceptions Index for Water

    Summed responses to the following 7 health perception questions, 6 of which are prompted with the statement "Drinking this product often would…". The statements end with the following health belief and risk perception language: "lead my child to gain weight," "increase my child's risk of heart disease," "increase my child's risk of diabetes," "make my child feel energized," "help my child focus at school", and "help my child live a healthy life." The other item is: "How healthy do you think this product is for your child?" Responses to questions about weight gain, heart disease, and diabetes will be reverse coded, so higher scores on the summed index will indicate a stronger positive health perception of the beverages. This index ranges 7 to 49.

    Measured: Week 4

  30. Health Beliefs and Risk Perceptions Index for Orange Juice

    Summed responses to the following 7 health perception questions, 6 of which are prompted with the statement "Drinking this product often would…". The statements end with the following health belief and risk perception language: "lead my child to gain weight," "increase my child's risk of heart disease," "increase my child's risk of diabetes," "make my child feel energized," "help my child focus at school", and "help my child live a healthy life." The other item is: "How healthy do you think this product is for your child?" Responses to questions about weight gain, heart disease, and diabetes will be reverse coded, so higher scores on the summed index will indicate a stronger positive health perception of the beverages. This index ranges 7 to 49.

    Measured: Week 4

  31. Health Beliefs and Risk Perceptions Index for Soda

    Summed responses to the following 7 health perception questions, 6 of which are prompted with the statement "Drinking this product often would…". The statements end with the following health belief and risk perception language: "lead my child to gain weight," "increase my child's risk of heart disease," "increase my child's risk of diabetes," "make my child feel energized," "help my child focus at school", and "help my child live a healthy life." The other item is: "How healthy do you think this product is for your child?" Responses to questions about weight gain, heart disease, and diabetes will be reverse coded, so higher scores on the summed index will indicate a stronger positive health perception of the beverages. This index ranges 7 to 49.

    Measured: Week 4

  32. Health Beliefs and Risk Perceptions Index for Sports Drinks

    Summed responses to the following 7 health perception questions, 6 of which are prompted with the statement "Drinking this product often would…". The statements end with the following health belief and risk perception language: "lead my child to gain weight," "increase my child's risk of heart disease," "increase my child's risk of diabetes," "make my child feel energized," "help my child focus at school", and "help my child live a healthy life." The other item is: "How healthy do you think this product is for your child?" Responses to questions about weight gain, heart disease, and diabetes will be reverse coded, so higher scores on the summed index will indicate a stronger positive health perception of the beverages. This index ranges 7 to 49.

    Measured: Week 4

  33. Estimate of How Many Teaspoons of Added Sugar Are in Water

    This variable will be measured continuously based on a text box provided to participants. Median teaspoons in each condition will be assessed

    Measured: Week 4

  34. Estimate of How Many Teaspoons of Added Sugar Are in Orange Juice

    This variable will be measured continuously based on a text box provided to participants. Median teaspoons in each condition will be assessed

    Measured: Week 4

  35. Estimate of How Many Teaspoons of Added Sugar Are in Soda

    This variable will be measured continuously based on a text box provided to participants. Median teaspoons in each condition will be assessed

    Measured: Week 4

  36. Estimate of How Many Teaspoons of Added Sugar Are in Sports Drinks

    This variable will be measured continuously based on a text box provided to participants. Median teaspoons in each condition will be assessed

    Measured: Week 4

  37. Perceived Amount of Added Sugar in Water

    This variable will be measured with a 3-point ordinal Likert scale with values: 1 = "too little for my child", 2 = "just right for my child" and 3 = "too much for my child". Higher scores indicate beverage is perceived as having too much added sugar.

    Measured: Week 4

  38. Perceived Amount of Added Sugar in Orange Juice

    This variable will be measured with a 3-point ordinal Likert scale with values: 1 = "too little for my child", 2 = "just right for my child" and 3 = "too much for my child". Higher scores indicate beverage is perceived as having too much added sugar.

    Measured: Week 4

  39. Perceived Amount of Added Sugar in Soda

    This variable will be measured with a 3-point ordinal Likert scale with values: 1 = "too little for my child", 2 = "just right for my child" and 3 = "too much for my child". Higher scores indicate beverage is perceived as having too much added sugar.

    Measured: Week 4

  40. Perceived Amount of Added Sugar in Sports Drinks

    This variable will be measured with a 3-point ordinal Likert scale with values: 1 = "too little for my child", 2 = "just right for my child" and 3 = "too much for my child". Higher scores indicate beverage is perceived as having too much added sugar.

    Measured: Week 4

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Oct 2021
  2. Study start6 Oct 2021
  3. Primary completion17 Jan 2023
  4. Study completion17 Jan 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
This randomized, controlled online study will capture beverage and snack purchases from an online store. These products will be mailed to participants for each of the 4 shopping weeks. Participants' consumption will be measured at the beginning and end of the study. As this is a within-participant study, consumption for each arm will be compared to baseline for that participant (Week 1 shopping).
Masking
None (open label)
Enrolment
216 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05079477
Sponsor's protocol ID
844786
Other IDs
R01DK111558
Status last verified
Mar 2024
First submitted
15 Sep 2021
Last updated
4 Apr 2024
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: In the consenting process, participants agreed that de-identified data produced from this project may be distributed for future research studies without additional informed consent. Any de-identified data shared will be done so via PennBox, a secure method to transfer files.

Questions about this trial

What is this clinical trial studying?

A study testing Exposure to sugar-sweetened beverage warning labels and Exposure to calorie information in people with Food Preferences, run by University of Pennsylvania at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 4 Apr 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Beverage Calories Purchased, Week 1 (time frame: one week). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Apr 2024.

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