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Completed

NCT Number: NCT07214805

Perceptions of and Reactions to Ultra-Processed Menu Label Designs

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.

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Key information

Conditions

Food Choices

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Johns Hopkins Bloomberg School of Public Health

Baltimore, Maryland, 21205, United States

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

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

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

Treatment and study plan

Ultra-Processed, Red, Icon-plus-text Labels

Behavioral

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.

Contains Food Additives, Red, Icon-plus-text Labels

Behavioral

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.

Warning Ultra-Processed, Red, Icon-plus-text Labels

Behavioral

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.

Warning UPF, Red, Icon-plus-text Labels

Behavioral

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.

Ultra-Processed, Yellow, Icon-plus-text Labels

Behavioral

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.

Contains Food Additives, Yellow, Icon-plus-text Labels

Behavioral

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.

Warning Ultra-Processed, Yellow, Icon-plus-text Labels

Behavioral

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.

Warning UPF, Yellow, Icon-plus-text Labels

Behavioral

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.

Ultra-Processed, Red, Text-only Labels

Behavioral

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.

Contains Food Additives, Red, Text-only Labels

Behavioral

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.

Warning Ultra-Processed, Red, Text-only Labels

Behavioral

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.

Warning UPF, Red, Text-only Labels

Behavioral

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.

Ultra-Processed, Yellow, Text-only Labels

Behavioral

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.

Contains Food Additives, Yellow, Text-only Labels

Behavioral

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.

Warning Ultra-Processed, Yellow, Text-only Labels

Behavioral

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.

Warning UPF, Yellow, Text-only Labels

Behavioral

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.

Primary outcomes

  1. Intention to purchase

    Time frame: 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 outcomes

  1. Label interpretation

    Time frame: 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.

  2. Perceived label understandability

    Time frame: 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.

  3. Perceived label believability

    Time frame: 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.

  4. Perception that label grabbed attention

    Time frame: 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.

  5. 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

    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.

  6. Perceived label helpfulness

    Time frame: 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.

Other outcomes

  1. Perceived level of appeal of labeled food item

    Time frame: 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

  2. Perceived level of healthfulness of labeled food item

    Time frame: 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.

Sponsors and collaborators

Lead sponsor

Johns Hopkins Bloomberg School of Public Health

Other

Collaborators

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

Registry information

Official study title

Understanding Perceptions of and Reactions to Ultra-processed Food Label Designs

Important dates

Study start
2025
Primary completion
2025
Study completion
2025
First posted
Oct 9, 2025
Registry last updated
Dec 11, 2025

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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