Effects of an Educational Planetary Plate Graphic on Meat Consumption

Study Overview
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Brief Summary
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The objective of this research was to determine if adding a plate graphic depicting the components of the Eat Lancet Planetary Health diet (Figure 1) to food labels in Stanford University dining halls would lead to dining hall patrons making dietary decisions that better resemble the Planetary Health diet in comparison to a no signage control group. The study hypothesis was that presenting students with a plate graphic featuring the healthy reference diet would decrease objective measures of the amount of meat taken and therefore the environmental impact of student meals.

Detailed Description
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Research was conducted into the everyday experience of dining hall patrons. All participants were patrons of Florence Moore Dining Hall on the Stanford University campus where all data was collected. Patrons were largely undergraduate students.This investigation was designed as a crossover randomized control trial with two phases: (1) a Planetary Health Plate (PHP) intervention phase where signage promoting the planetary health diet was posted and (2) a control phase with signage as usual. Stanford Dining serves food on a four-week menu cycle; this pattern results in several academic weeks that are intended to be identical in food served. To standardize the conditions and limit potential confounding, the experimental and control phases were each randomized to one of the weeks throughout the quarter when the same, week two menu was to be served. Data was collected for the control phase during week two of the academic winter quarter and data with the PHP posted was collected during week six of the academic winter quarter. On each data collection day, two different types of meat dishes were provided by the Dining Hall and there were two stations with each type. Research assistants weighed each serving tray of meat as it came from the kitchen and again before returning the used serving tray to the kitchen, to determine the total amount of meat taken from the tray. Tally counters were used to count the number of patrons who took meat from the tray. Qualitative notes about patron behavior and possible deviations from data collection protocol were recorded on data collection sheets. After each dinner collection period, Stanford Dining provided the total number of people who entered the dining hall during the designated dinner periods on each of the data collection days. This was based on the number of unique identification card swipes into the dining hall during dinner times. Comparison was made between 1) dietary behavior without signage, and 2) behavior while exposed to PHP during four equivalent dinner meals.

Official Title
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Effects of an Educational Planetary Plate Graphic on Meat Consumption in Stanford University Dining Hall: a Randomized Controlled Trial

Conditions
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Diet, Food and Nutrition

Intervention / Treatment
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* Behavioral: Planetary Health Plate signage


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Patrons of Florence Moore Dining Hall at Stanford. Exclusion criteria: None

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: Crossover Assignment
Interventional Model Description: Crossover randomized control trial with two phases: a Planetary Health Plate intervention phase where signage promoting the planetary health diet was posted and a control phase with signage as usual.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Planetary Health Plate Signage<br>A Planetary Health Plate intervention phase where signage was posted in the dining hall promoting the planetary health diet | Behavioral: Planetary Health Plate signage<br>* A Planetary Health Plate graphic was developed based on the healthy reference diet proposed by the Eat Lancet Commission. The graphic was designed to capture the food groups and proportions of food groups promoted by the Planetary Health diet.<br>|
| No Intervention: Control<br>Control phase with dining hall signage as usual. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Meat-dish weight | Meat-dish weight adjusted for the number of people entering the dining hall. | Control: 4 days (during dinner meals Mon -Thurs) during week 2 of the academic quarter. Intervention: 4 days (during dinner meals Mon -Thurs) during week 6. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Meat-dish servings | Number of meat-dish servings | Control: 4 days (during dinner meals Mon -Thurs) during week 2 of the academic quarter. Intervention: 4 days (during dinner meals Mon -Thurs) during week 6. | 
| Meat-dish serving weight | Average meat-dish serving weight | Control: 4 days (during dinner meals Mon -Thurs) during week 2 of the academic quarter. Intervention: 4 days (during dinner meals Mon -Thurs) during week 6. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Planetary health, Educational signage, Behavior change, Environment, Sustainability, Food choices, Food insecurity, Dietary behavior