Front-of-package Marketing on Fruit Drinks: Online RCT

Study Overview
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Brief Summary
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This study will test the independent and combined effects of front-of-package claims, imagery, nutrition disclosures, and added sugar warning labels on parents' purchases and perceptions of beverages for their children.

Detailed Description
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Fruit drinks are widely consumed by 0-5-year-olds. Parents purchase these drinks for their children in part due to misperceptions that they are healthful, which may be driven by front-of-package (FOP) marketing. The FDA is considering changes to FOP marketing regulations but lacks data on how label elements influence consumer behavior. Our study will test the independent and combined effects of FOP claims, imagery, nutrition disclosures, and added sugar warning labels on parents' purchases and perceptions of beverages for their children. We will conduct an online randomized controlled trial with 5,000 racially/ethnically diverse primary caregivers of children aged 0-5 years. Participants will choose a beverage for their child in an online store and rate health perceptions of different fruit drinks. Participants will be randomized to see high-added-sugar beverages (>20% DV added sugar/serving) with 1 of 7 FOP label conditions: 1) vitamin C claim and fruit imagery (control); 2) imagery only; 3) claim only; 4) no claim or imagery; 5) claim, imagery, and % juice disclosure; 6) claim, imagery, and added sugar warning; or 7) claim, imagery, and added sugar warning w/teaspoons of added sugar. Primary outcomes will include total calories and added sugar (grams) from chosen online store beverages. Secondary outcomes will include health perceptions and knowledge of added sugar and % juice content in low- and high-added-sugar fruit drinks. This research will inform federal regulation to correct health misperceptions of sugary drinks.

Official Title
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Testing the Impact of Front-of-package Claims, Imagery, Nutrition Disclosures, and Added Sugar Warning Labels on Fruit Drinks in an Online Store: A Randomized Controlled Trial

Conditions
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Consumer Behavior, Consumer Preference

Intervention / Treatment
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* Behavioral: front-of-package modification


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary caregiver of a child 0-5 years old >= 18 years old U.S. citizen Exclusion Criteria: Participants who complete the survey in less than 1/3 of the median completion time Observations from duplicate IP addresses (keep first observation that is unique) Participants who answer data integrity check incorrectly

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: claim and imagery<br>control condition (status quo) showing a front-of-package (FOP) vitamin C claim and fruit imagery on all fruit-flavored drinks. | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|
| Experimental: imagery only<br>FOP fruit imagery on all fruit-flavored drinks, no vitamin C claim on drinks high in added sugars (>=20 %DV) | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|
| Experimental: claim only<br>FOP vitamin C claim on all fruit-flavored drinks, no fruit imagery on drinks high in added sugars | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|
| Experimental: no claim or imagery<br>No FOP vitamin C claim or fruit imagery on drinks high in added sugars | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|
| Experimental: claim, imagery, and % juice disclosure<br>FOP fruit imagery, vitamin C claim, and % juice disclosure on all fruit-flavored drinks | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|
| Experimental: claim, imagery, and added sugar warning<br>FOP fruit imagery and vitamin C claim on all fruit-flavored drinks; added sugar warning on drinks high in added sugar | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|
| Experimental: claim, imagery, and added sugar warning with teaspoons of added sugar disclosure<br>FOP fruit imagery and vitamin C claim on all fruit-flavored drinks; added sugar warning with teaspoons of added sugar disclosure on drinks high in added sugar | Behavioral: front-of-package modification<br>* testing front-of-package changes to claims, imagery, disclosures, and added sugar warning labels on fruit-flavored drinks<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Calories in beverage chosen in online store task | Calories in beverage chosen in online store task | through study completion, an average of 15 minutes | 
| Added sugar content (grams) of beverage chosen in online store task | Added sugar content (grams) of beverage chosen in online store task | through study completion, an average of 15 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of participants that chose a drink high in added sugars in online store task | Percentage of participants that chose a drink high in added sugars (>=20%DV) in online store task | through study completion, an average of 15 minutes | 
| Percentage of participants that chose each drink category in online store task | Percentage of participants that chose each drink category (e.g., 100% juice, fruit drinks) in online store task | through study completion, an average of 15 minutes | 
| Fruit drink perceptions: likelihood to purchase for child, how healthy for child, how appealing to child, disease risk perceptions for child | Fruit drink perceptions: likelihood to purchase for child, how healthy for child, how appealing to child, disease risk perceptions for child | through study completion, an average of 15 minutes | 
| Knowledge of juice and added sugar content in beverage | Knowledge of % juice and added sugar content (categorical and continuous in grams) in beverage | through study completion, an average of 15 minutes |