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Completed

NCT Number: NCT05079477

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

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University of Pennsylvania

Philadelphia, Pennsylvania, 19104, United States

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 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

Exclusion criteria

  • 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

Treatment and study plan

Exposure to sugar-sweetened beverage warning labels

Behavioral

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

Exposure to calorie information

Behavioral

Calories for all beverages and foods

Primary outcomes

  1. Beverage Calories Purchased, Week 1

    Time frame: one week

    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.

  2. Beverage Calories Purchased, Weeks 2-4

    Time frame: three weeks

    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.

  3. Beverage Added Sugars Purchased, Week 1

    Time frame: one week

    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.

  4. Beverage Added Sugars Purchased, Weeks 2-4

    Time frame: three weeks

    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.

Secondary outcomes

  1. Number Purchasing a Sweetened Beverage, Week 1

    Time frame: one week

    Number of parents buying a sweetened beverage within each condition

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

    Time frame: three weeks

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

  3. Snack Calories Purchased, Week 1

    Time frame: one week

    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.

  4. Snack Calories Purchased, Weeks 2-4

    Time frame: three weeks

    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.

  5. Snack Added Sugars Purchased, Week 1

    Time frame: one week

    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.

  6. Snack Added Sugars Purchased, Weeks 2-4

    Time frame: three weeks

    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.

  7. Total Calories Purchased, Week 1

    Time frame: one week

    Log of the summed beverage and snack calories purchased

  8. Total Calories Purchased, Weeks 2-4

    Time frame: three weeks

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

  9. Total Added Sugars Purchased, Week 1

    Time frame: one week

    Summed grams of beverage and snack added sugars purchased

  10. Total Added Sugars Purchased, Weeks 2-4

    Time frame: three weeks

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

  11. Volume of Sweetened Beverages Consumed by Child, Baseline

    Time frame: 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.

  12. Volume of Sweetened Beverages Consumed by Child, Final

    Time frame: Week 4

    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.

  13. Volume of Sweetened Beverages Consumed by Parent, Baseline

    Time frame: 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.

  14. Volume of Sweetened Beverages Consumed by Parent, Final

    Time frame: Week 4

    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.

  15. Noticing the Label

    Time frame: Week 4

    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?"

  16. Perceived Label Influence

    Time frame: Week 4

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

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

    Time frame: Week 4

    "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.

  18. Likelihood of Label Changing Thoughts

    Time frame: Week 4

    "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.

  19. Encourage You to Give Fewer Beverages to Your Child

    Time frame: Week 4

    "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.

  20. Negative Reactions to the Label

    Time frame: Week 4

    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.

  21. Child Enjoyment of Water

    Time frame: Week 4

    "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.

  22. Child Enjoyment of Orange Juice

    Time frame: Week 4

    "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.

  23. Child Enjoyment of Soda

    Time frame: Week 4

    "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.

  24. Child Enjoyment of Sports Drink

    Time frame: Week 4

    "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.

  25. Likely to Serve or Buy Water

    Time frame: Week 4

    "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.

  26. Likely to Serve or Buy Orange Juice

    Time frame: Week 4

    "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.

  27. Likely to Serve or Buy Soda

    Time frame: Week 4

    "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.

  28. Likely to Serve or Buy Sports Drinks

    Time frame: Week 4

    "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.

  29. Health Beliefs and Risk Perceptions Index for Water

    Time frame: Week 4

    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.

  30. Health Beliefs and Risk Perceptions Index for Orange Juice

    Time frame: Week 4

    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.

  31. Health Beliefs and Risk Perceptions Index for Soda

    Time frame: Week 4

    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.

  32. Health Beliefs and Risk Perceptions Index for Sports Drinks

    Time frame: Week 4

    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.

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

    Time frame: Week 4

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

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

    Time frame: Week 4

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

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

    Time frame: Week 4

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

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

    Time frame: Week 4

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

  37. Perceived Amount of Added Sugar in Water

    Time frame: Week 4

    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.

  38. Perceived Amount of Added Sugar in Orange Juice

    Time frame: Week 4

    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.

  39. Perceived Amount of Added Sugar in Soda

    Time frame: Week 4

    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.

  40. Perceived Amount of Added Sugar in Sports Drinks

    Time frame: Week 4

    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.

Sponsors and collaborators

Lead sponsor

University of Pennsylvania

Other

Collaborators

  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Registry information

Official study title

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

Important dates

Study start
2021
Primary completion
2023
Study completion
2023
First posted
Oct 15, 2021
Registry last updated
Apr 4, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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