Food SelectionNCT07536126
Testing Non-Nutrition Menu Labels on Food Selections
A study testing Low Environmental Harm Labels, High Environmental Harm Labels and Environmental Harm Traffic Light Labels in people with Food Selection, run by Johns Hopkins Bloomberg School of Public Health at 1 site in United States.
Trial summary
The primary objective of this study is to test the relative effects of environmental harm menu label designs on the healthfulness of consumers' fast-food meal choices. Participants will complete hypothetical online meal ordering tasks using a survey which emulates the online menus of two types of fast-food chain… Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Food Selection
- What is being tested?
- Low Environmental Harm Labels, High Environmental Harm Labels and Environmental Harm Traffic Light Labels
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 7,000 participants
- Where
- 1 siteUnited States
- Study dates
- 13 Apr 2026to 4 May 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
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
- 18 years of age or older
- Member of the Verasight Panel
- Residing in the United States
Who cannot join
- <18 years of age
- Not residing in the United States
- Completed the survey in less than one-third of the median completion duration of all participants
- Respondents with high refusal rates (skipped or refused more than 50% of questions)
- Respondents who 'straight-line' all question grids with 6 or more items, where responses are not internally consistent
Trial locations and contacts
1 site in 1 country.
United States1 site
Johns Hopkins Bloomberg School of Public Health
Baltimore, Maryland, 21205
About this study
Official title: Testing Non-Nutrition Menu Labels on Food Selections: A Nationally Representative Online Survey Experiment in Two Fast-Food Restaurants
The primary objective of this study is to test the relative effects of environmental harm menu label designs on the healthfulness of consumers' fast-food meal choices. Participants will complete hypothetical online meal ordering tasks using a survey which emulates the online menus of two types of fast-food chain restaurants: a burger restaurant and a sandwich restaurant. Participants will be randomized the view both menus, presented in random order, with one of five labeling conditions applied. Secondary objectives include energy and nutrient content of meals ordered, prices of meals ordered, and, through a post-order survey, noticeability of the labels and perceptions of labels between the conditions.
Read the detailed description
This online randomized trial will test the relative effects of environmental harm menu label designs on the healthfulness of consumers' fast-food meal choices and perceptions of menu items. The survey research firm Verasight will recruit a nationally representative sample of 7,000 adults aged 18 years and older who speak English and reside in the United States from their survey panel.
Participants will complete a between-subjects online experiment in which the participants will be randomized to view two fast-food online ordering menus (in randomized order) with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a low environmental harm label on all low harm items (3) a high environmental harm label on high harm items; (4) traffic light labels on all items by level of environmental harm; and (5) environmental grade labels on all items by level of environmental harm. Each restaurant menu will be presented across 2 pages; page 1 will display all main items, and page 2 will display categories for side, dessert, and drink items. Labels will only appear alongside main menu items and will be assigned using thresholds for environmental harm set a priori which factor in estimated cropland, pastureland, and water usage associated with each food item. Each hypothetical order must include between 1 and 4 items. Participants will be required to select 1 main item and, optionally, up to 3 additional items (drinks, sides, desserts). After completing the meal ordering task, participants will be prompted to answer questions about whether they noticed the correct label for their condition, whether they used the label when making their meal selections, perceptions of the labeled menu items and the labeling condition which the participants were randomized to view. Additionally, participants will be asked about their level of food security, participation in the Supplemental Nutrition Assistance Program (SNAP), support of governmental policies and practices regarding food and nutrition, use of GLP-1 agonists, personal values, dietary patterns, and other demographic information.
The primary outcome will be the healthfulness of meal orders selected from the online menu, indicated by a modified Nutrient Profile Index meal score for all food items ordered. Secondary outcomes will include total calories ordered, whether a sugar-sweetened beverage was ordered, and perceived message effectiveness of the environmental harm labels.
Analyses will be conducted overall (summing the meal selections across both restaurants) and stratified by restaurant.
- Conditions
- Food Selection
- Being tested
- Control (QR) Labels, Low Environmental Harm Labels, High Environmental Harm Labels, Environmental Harm Traffic Light Labels, Environmental Grade Labels
- Keywords
- food labeling, ecolabeling, 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.
Control (QR) LabelsBehavioural
Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Control (QR) labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).
Low Environmental Harm LabelsBehavioural
Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Low Environmental Harm labels will be displayed beneath a subset of items. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).
High Environmental Harm LabelsBehavioural
Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Harm labels will be displayed beneath select items. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).
Environmental Harm Traffic Light LabelsBehavioural
Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Harm Traffic Light labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).
Environmental Grade LabelsBehavioural
Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Grade labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).
| Study group | Role | What they receive |
|---|---|---|
| Control (QR) Labels | Placebo comparator | A black label featuring a QR code and white text that reads "SCAN HERE" will be placed beneath all main menu items on two restaurant menus. Explanatory text describing the label's meaning will be displayed at the top of the menu. Receives: Behavioral: Control (QR) Labels |
| Low Environmental Harm Labels | Experimental | A green icon-plus-text label that reads "LOW ENVIRONMENTAL HARM" in white text against a green background will be placed on two restaurant menus beneath main menu items that are less harmful to the environment compared to unlabeled main menu items, based on use of cropland, pastureland, and water. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu. Receives: Behavioral: Low Environmental Harm Labels |
| High Environmental Harm Labels | Experimental | A red icon-plus-text label that reads "HIGH ENVIRONMENTAL HARM" in white text against a red background will be placed on two restaurant menus beneath main menu items that are more harmful to the environment compared to unlabeled main menu items, based on use of cropland, pastureland, and water. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu. Receives: Behavioral: High Environmental Harm Labels |
| Environmental Harm Traffic Light Labels | Experimental | Traffic Light labels will be placed on two restaurant menus beneath all main menu items. Using estimated cropland, pastureland, and water use, each item will be assigned one of three icon-plus-text labels within this scheme: low-, medium-, or high-impact label. Each will read, "HIGH ENVIRONMENTAL HARM" within a red label, "MED. ENVIRONMENTAL HARM" in a yellow label, and "LOW ENVIRONMENTAL HARM" in a green label. Text for all labels will be written in white, and a white globe icon will precede the text. Explanatory text describing the meaning of the labels will be displayed at the top of the menu. Receives: Behavioral: Environmental Harm Traffic Light Labels |
| Environmental Grade Labels | Experimental | Environmental Grade labels will be placed on two restaurant menus beneath all main menu items, using estimated cropland, pastureland, and water use to assign one of five icon-plus-text labels which indicate a specific environmental grade (A, B, C, D, and F). All labels are solid black with a white globe icon followed by white text which reads "ENVIRONMENTAL GRADE". On the left side of each label, a grade is displayed, capitalized and in a white font within a solid-colored box. The color of the box corresponds with each letter grade: A = dark green, B = light green, C = yellow, D = orange, F = red. Beneath the letter grade, a gradient of all possible grades is displayed horizontally in smaller font, each grade atop a small solid box in the respective grade color. Explanatory text describing the meaning of the labels will be displayed at the top of the menu. Receives: Behavioral: Environmental Grade Labels |
What is being measured
The primary outcome is the main question the study is designed to answer.
Modified Nutrient Profile Index score
The primary outcome measure will be the healthfulness of the fast-food meal selections, measured with a modified Nutrient Profile Index (NPI) score. NPI scores are based on the United Kingdom (UK) Ofcom Nutrient Profiling Model, which is used to score individual foods in the UK to determine which ones can be marketed to children. The NPI is a 0 to 100-point score for foods; a score of >=64 is considered healthy. Higher score is better.
Measured: Immediately upon viewing the menus
Secondary outcomes (16)
Nutrient Profile Index score
The healthfulness of the fast-food main item selections, measured with a Nutrient Profile Index (NPI) score. NPI scores are based on the United Kingdom (UK) Ofcom Nutrient Profiling Model, which is used to score individual foods in the UK to determine which ones can be marketed to children. The NPI is a 0 to 100-point score for foods; a score of >=64 is considered healthy. Higher score is better
Measured: Immediately upon viewing the menus
Number of Participants who Notice labels (Attention to label)
Measured by whether participants noticed labels on the menus, in addition to calorie labels. The exact question is, "On the menus you saw, did you notice any labels (other than calories) next to or below the menu items?" Response options are "Yes", "No", and "Don't Know".
Measured: Immediately after viewing the menus
Number of Participants who Recall Label Purpose
Measured by whether participants who noticed labels in addition to calorie labels correctly, identify the purpose of the labels. Response options are "Sugar", "Sodium", "QR code", "Environmental Harm", "Organic", "Healthy", "Unhealthy", "None of these", and "I don't know/ I can't remember".
Measured: Immediately after viewing the menus
Number of Participants Who Use of label
Measured by whether participants who noticed labels in addition to calorie labels, used the labels in selecting a hypothetical meal order. The exact question is, "Did you use these labels you saw when deciding what to order?". Response options are "Yes" and "No".
Measured: Immediately after viewing the menus
Participant's Perceived label believability
After viewing images of a labeled menu excerpt and a zoomed in 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.
Measured: Immediately after viewing the menu excerpt and label image
Perception that label grabbed attention
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.
Measured: Immediately after viewing the menu excerpt and label image
Perceived message effectiveness (PME) as assessed by the University of North Carolina (UNC) PME scale
This modified 4-item UNC-PME scale measures how much the label placed beneath high environmental impact menu items discouraged consumption, or evoked concern or unpleasantness about consumption, of high environmental impact foods. Responses measured on a 5-point Likert scale from 1=Not at all to 5= A great deal, with higher scores interpreted as better. Preceding the questions, participants will view a menu excerpt with the assigned label applied and a prompt, and likert scale.
Measured: Immediately after viewing the menu excerpt and label image
Total price of meal order
Measured by the cumulative total price (USD) of participants' hypothetical meal orders per restaurant, based on the prices displayed on the survey menus.
Measured: Immediately upon viewing the menus
Beef item selected
Measured as a dichotomous variable (yes/no) indicating whether participants' hypothetical meal orders include an item containing beef.
Measured: Immediately upon viewing the menus
Total energy selected
The total number of calories in participants' hypothetical meal orders, calculated as the sum of calories across all menu items selected. Higher values indicate more calories selected.
Measured: Immediately upon viewing the menus
Total saturated fat selected
The total amount of saturated fat in participants' hypothetical meal orders, calculated as the sum of saturated fat (grams) across all menu items selected. Higher values indicate more saturated fat selected.
Measured: Immediately upon viewing the menus
Total sugar selected
The total amount of sugar in participants' hypothetical meal orders, calculated as the sum of sugar (grams) across all menu items selected. Higher values indicate more sugar selected.
Measured: Immediately upon viewing the menus
Total protein selected
The total amount of protein in participants' hypothetical meal orders, calculated as the sum of protein (grams) across all menu items selected. Higher values indicate more protein selected.
Measured: Immediately upon viewing the menus
Total fiber selected
The total amount of fiber in participants' hypothetical meal orders, calculated as the sum of fiber (grams) across all menu items selected. Higher values indicate more fiber selected.
Measured: Immediately upon viewing the menus
Total sodium selected
The total amount of sodium in participants' hypothetical meal orders, calculated as the sum of sodium (milligrams) across all menu items selected. Higher values indicate more sodium selected.
Measured: Immediately upon viewing the menus
Sugar-sweetened beverage selected
Measured as a dichotomous variable (yes/no) indicating whether participants' hypothetical meal orders include a sugar-sweetened beverage.
Measured: Immediately upon viewing the menus
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Apr 2026
- Study start13 Apr 2026
- Primary completion4 May 2026
- Study completion4 May 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Food SelectionStudies of the same condition, open and under way.
- More trials run by Johns Hopkins Bloomberg School of Public HealthThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Participants will be randomized to view two fast-food menus presented in random order with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a low environmental harm label on all low harm items (3) a high environmental harm label on high harm items; (4) traffic light labels on all items by level of environmental harm; and (5) environmental grade labels on all items by level of environmental harm. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for environmental harm that factor estimated cropland, pastureland, and water used in the production of the item. Participants will be instructed to select a hypothetical lunch meal order from each menu. The investigators will record participant meal selections and, using publicly available nutritional information for each item selected, calculate a score of overall meal healthfulness.
- Masking
- None (open label)
- Enrolment
- 7,000 participants (actual)
Sponsor and investigators
- Lead sponsor
- Johns Hopkins Bloomberg School of Public Health
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Julia Wolfson, PhD MPP, Principal investigator, Johns Hopkins Bloomberg School of Public Health
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07536126
- Sponsor's protocol ID
- IRB00035394-1
- Status last verified
- Jun 2026
- First submitted
- 8 Apr 2026
- Last updated
- 12 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 12 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Testing Non-Nutrition Menu Labels on Food Selections: A Nationally Representative Online Survey Experiment in Two Fast-Food Restaurants
- ClinicalTrials.gov ID
- NCT07536126
- Acronym / sponsor ID
- IRB00035394-1
- Conditions
- Food Selection
- Keywords
- food labeling, ecolabeling, choice behavior
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 7,000 participants (actual)
- Lead sponsor
- Johns Hopkins Bloomberg School of Public HealthUniversity, hospital or other
- Study start
- 13 Apr 2026 (actual)
- Primary completion
- 4 May 2026 (actual)
- Study completion
- 4 May 2026 (actual)
- First posted
- 17 Apr 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary objective of this study is to test the relative effects of environmental harm menu label designs on the healthfulness of consumers' fast-food meal choices. Participants will complete hypothetical online meal ordering tasks using a survey which emulates the online menus of two types of fast-food chain restaurants: a burger restaurant and a sandwich restaurant. Participants will be randomized the view both menus, presented in random order, with one of five labeling conditions applied. Secondary objectives include energy and nutrient content of meals ordered, prices of meals ordered, and, through a post-order survey, noticeability of the labels and perceptions of labels between the conditions.
Detailed description
This online randomized trial will test the relative effects of environmental harm menu label designs on the healthfulness of consumers' fast-food meal choices and perceptions of menu items. The survey research firm Verasight will recruit a nationally representative sample of 7,000 adults aged 18 years and older who speak English and reside in the United States from their survey panel.
Participants will complete a between-subjects online experiment in which the participants will be randomized to view two fast-food online ordering menus (in randomized order) with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a low environmental harm label on all low harm items (3) a high environmental harm label on high harm items; (4) traffic light labels on all items by level of environmental harm; and (5) environmental grade labels on all items by level of environmental harm. Each restaurant menu will be presented across 2 pages; page 1 will display all main items, and page 2 will display categories for side, dessert, and drink items. Labels will only appear alongside main menu items and will be assigned using thresholds for environmental harm set a priori which factor in estimated cropland, pastureland, and water usage associated with each food item. Each hypothetical order must include between 1 and 4 items. Participants will be required to select 1 main item and, optionally, up to 3 additional items (drinks, sides, desserts). After completing the meal ordering task, participants will be prompted to answer questions about whether they noticed the correct label for their condition, whether they used the label when making their meal selections, perceptions of the labeled menu items and the labeling condition which the participants were randomized to view. Additionally, participants will be asked about their level of food security, participation in the Supplemental Nutrition Assistance Program (SNAP), support of governmental policies and practices regarding food and nutrition, use of GLP-1 agonists, personal values, dietary patterns, and other demographic information.
The primary outcome will be the healthfulness of meal orders selected from the online menu, indicated by a modified Nutrient Profile Index meal score for all food items ordered. Secondary outcomes will include total calories ordered, whether a sugar-sweetened beverage was ordered, and perceived message effectiveness of the environmental harm labels.
Analyses will be conducted overall (summing the meal selections across both restaurants) and stratified by restaurant.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 5
- Model description
- Participants will be randomized to view two fast-food menus presented in random order with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a low environmental harm label on all low harm items (3) a high environmental harm label on high harm items; (4) traffic light labels on all items by level of environmental harm; and (5) environmental grade labels on all items by level of environmental harm. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for environmental harm that factor estimated cropland, pastureland, and water used in the production of the item. Participants will be instructed to select a hypothetical lunch meal order from each menu. The investigators will record participant meal selections and, using publicly available nutritional information for each item selected, calculate a score of overall meal healthfulness.
| Arm | Type | Receives |
|---|---|---|
| Control (QR) Labels | Placebo comparator | Behavioral: Control (QR) LabelsA black label featuring a QR code and white text that reads "SCAN HERE" will be placed beneath all main menu items on two restaurant menus. Explanatory text describing the label's meaning will be displayed at the top of the menu. |
| Low Environmental Harm Labels | Experimental | Behavioral: Low Environmental Harm LabelsA green icon-plus-text label that reads "LOW ENVIRONMENTAL HARM" in white text against a green background will be placed on two restaurant menus beneath main menu items that are less harmful to the environment compared to unlabeled main menu items, based on use of cropland, pastureland, and water. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu. |
| High Environmental Harm Labels | Experimental | Behavioral: High Environmental Harm LabelsA red icon-plus-text label that reads "HIGH ENVIRONMENTAL HARM" in white text against a red background will be placed on two restaurant menus beneath main menu items that are more harmful to the environment compared to unlabeled main menu items, based on use of cropland, pastureland, and water. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu. |
| Environmental Harm Traffic Light Labels | Experimental | Behavioral: Environmental Harm Traffic Light LabelsTraffic Light labels will be placed on two restaurant menus beneath all main menu items. Using estimated cropland, pastureland, and water use, each item will be assigned one of three icon-plus-text labels within this scheme: low-, medium-, or high-impact label. Each will read, "HIGH ENVIRONMENTAL HARM" within a red label, "MED. ENVIRONMENTAL HARM" in a yellow label, and "LOW ENVIRONMENTAL HARM" in a green label. Text for all labels will be written in white, and a white globe icon will precede the text. Explanatory text describing the meaning of the labels will be displayed at the top of the menu. |
| Environmental Grade Labels | Experimental | Behavioral: Environmental Grade LabelsEnvironmental Grade labels will be placed on two restaurant menus beneath all main menu items, using estimated cropland, pastureland, and water use to assign one of five icon-plus-text labels which indicate a specific environmental grade (A, B, C, D, and F). All labels are solid black with a white globe icon followed by white text which reads "ENVIRONMENTAL GRADE". On the left side of each label, a grade is displayed, capitalized and in a white font within a solid-colored box. The color of the box corresponds with each letter grade: A = dark green, B = light green, C = yellow, D = orange, F = red. Beneath the letter grade, a gradient of all possible grades is displayed horizontally in smaller font, each grade atop a small solid box in the respective grade color. Explanatory text describing the meaning of the labels will be displayed at the top of the menu. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 18 years of age or older
- Member of the Verasight Panel
- Residing in the United States
Key exclusion criteria (5 listed)
- <18 years of age
- Not residing in the United States
- Completed the survey in less than one-third of the median completion duration of all participants
- Respondents with high refusal rates (skipped or refused more than 50% of questions)
- Respondents who 'straight-line' all question grids with 6 or more items, where responses are not internally consistent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Control (QR) LabelsParticipants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Control (QR) labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts). | Behavioural | Control (QR) Labels |
| Low Environmental Harm LabelsParticipants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Low Environmental Harm labels will be displayed beneath a subset of items. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts). | Behavioural | Low Environmental Harm Labels |
| High Environmental Harm LabelsParticipants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Harm labels will be displayed beneath select items. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts). | Behavioural | High Environmental Harm Labels |
| Environmental Harm Traffic Light LabelsParticipants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Harm Traffic Light labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts). | Behavioural | Environmental Harm Traffic Light Labels |
| Environmental Grade LabelsParticipants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Grade labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts). | Behavioural | Environmental Grade Labels |
Primary outcome
Modified Nutrient Profile Index score
Time frame: Immediately upon viewing the menus
The primary outcome measure will be the healthfulness of the fast-food meal selections, measured with a modified Nutrient Profile Index (NPI) score. NPI scores are based on the United Kingdom (UK) Ofcom Nutrient Profiling Model, which is used to score individual foods in the UK to determine which ones can be marketed to children. The NPI is a 0 to 100-point score for foods; a score of >=64 is considered healthy. Higher score is better.
16 secondary outcomes
Nutrient Profile Index score
Time frame: Immediately upon viewing the menus
Number of Participants who Notice labels (Attention to label)
Time frame: Immediately after viewing the menus
Number of Participants who Recall Label Purpose
Time frame: Immediately after viewing the menus
Number of Participants Who Use of label
Time frame: Immediately after viewing the menus
Participant's Perceived label believability
Time frame: Immediately after viewing the menu excerpt and label image
Perception that label grabbed attention
Time frame: Immediately after viewing the menu excerpt and label image
Perceived message effectiveness (PME) as assessed by the University of North Carolina (UNC) PME scale
Time frame: Immediately after viewing the menu excerpt and label image
Total price of meal order
Time frame: Immediately upon viewing the menus
Beef item selected
Time frame: Immediately upon viewing the menus
Total energy selected
Time frame: Immediately upon viewing the menus
Total saturated fat selected
Time frame: Immediately upon viewing the menus
Total sugar selected
Time frame: Immediately upon viewing the menus
Total protein selected
Time frame: Immediately upon viewing the menus
Total fiber selected
Time frame: Immediately upon viewing the menus
Total sodium selected
Time frame: Immediately upon viewing the menus
Sugar-sweetened beverage selected
Time frame: Immediately upon viewing the menus
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jun 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Julia Wolfson, PhD MPP principal investigator
Johns Hopkins Bloomberg School of Public Health
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Low Environmental Harm Labels, High Environmental Harm Labels and Environmental Harm Traffic Light Labels in people with Food Selection, run by Johns Hopkins Bloomberg School of Public Health 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 3 inclusion and 5 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 12 Jun 2026. 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. Some participants in this study may receive a placebo. 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Modified Nutrient Profile Index score (time frame: Immediately upon viewing the menus). 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 12 Jun 2026.