Effects of Sugary Drink Warning Labels on Parent Choices

Study Overview
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Brief Summary
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Sugar-sweetened beverages (SSBs) are a significant contributor to adult and childhood obesity. Policies to place health warning labels on sugar-sweetened beverages are being pursued, but there is little empirical data on how such labels influence people. The proposed research will evaluate the impact of different types of sugar-sweetened beverage warning labels relative to standard calorie labels on the purchasing and consumption behaviors of parents and children.

Detailed Description
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The primary objective of this proposal is to determine, before wide-scale implementation, to what degree SSB warning labels increase consumers' knowledge about the potential health harms of SSBs and reduce SSB intake. The study is designed to answer two additional questions: 1) Do some warning labels work better than others? 3) If warning labels influence behavior, is it because they increase knowledge or simply provide a salient reminder that some drinks are less healthy? This aim is designed to test the effect of warning labels on total kilocalories (kcals) purchased and consumed by parents and children. We will examine how SSB warning labels influence snack and beverage purchases and intake among 405 racially and ethnically diverse parent-child pairs.

Official Title
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Effects of Sugary Drink Warning Labels on Parent Choices for 6-11 Year Olds

Conditions
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Food Preferences

Intervention / Treatment
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* Behavioral: Exposure to sugar-sweetened beverage warning labels
* Behavioral: Exposure to beverage calorie information


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participant pairs must be: Primary caregiver of a child 6-11 years old; 18 years or older; can read and speak English; did not participate in related studies from our group Child is between 6 and 11 years old; drinks SSBs at least 12 times per month ( 3 times per week) Exclusion Criteria: Unable to participate in person in Philadelphia Parent did not purchase food and beverage for their child Parent or caregiver refused to give child permission to participate

Ages Eligible for Study
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Minimum Age: 6 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
Interventional Model Description: This randomized, controlled lab-based study will capture beverage and snack purchases from a concession stand and measure how much participants consume while watching a television show. Participants will be randomized to 1 of 3 groups: 1) calorie labels (control); 2) text warning labels; or 3) graphic warning labels displaying amounts of sugar.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Calorie/Control Label Condition<br>Beverages at the concession stand and in the parent survey in this arm will display solely a calorie label. | Behavioral: Exposure to beverage calorie information<br>* Calories for sugar-sweetened and non-sugar-sweetened beverages<br>|
| Experimental: Text Warning Label Condition<br>Sugary beverages at the concession stand and in the parent survey in this arm will display both a text warning and a calorie label. | Behavioral: Exposure to sugar-sweetened beverage warning labels<br>* Graphic images of the amount of sugar (randomly assigned teaspoons, packets, or cubes) and text warning labels<br>Behavioral: Exposure to beverage calorie information<br>* Calories for sugar-sweetened and non-sugar-sweetened beverages<br>|
| Experimental: Sugar Graphic Label Condition<br>Sugary beverages at the concession stand and in the parent survey in this arm will display a sugar graphic warning label depicting the amount of sugar in the product, the same text warning, and a calorie label. | Behavioral: Exposure to sugar-sweetened beverage warning labels<br>* Graphic images of the amount of sugar (randomly assigned teaspoons, packets, or cubes) and text warning labels<br>Behavioral: Exposure to beverage calorie information<br>* Calories for sugar-sweetened and non-sugar-sweetened beverages<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total beverage calories purchased for the child | Total number of calories for all beverages purchased for the child during the study visit | Study visit, one hour | 
| Total calories purchased for the child | Total number of calories for all food and beverages (summed) purchased for the child during the study visit | Study visit, one hour | 
| Total calories the child consumes | Total number of calories consumed by the child for all food and beverages (summed) during the study visit | Study visit, one hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total beverage calories purchased for the adult | Total number of calories for all beverages purchased for the adult during the study visit | Study visit, one hour | 
| Total calories purchased for the adult | Total number of calories for all food and beverages (summed) purchased for the adult during the study visit | Study visit, one hour | 
| Beverage calories the child consumes | Total number of calories consumed by the child for all beverages during the study visit | Study visit, one hour | 
| Beverage calories the adult consumes | Total number of calories consumed by the adult for all beverages during the study visit | Study visit, one hour | 
| Total calories the adult consumes | Total number of calories consumed by the adult for all food and beverages (summed) during the study visit | Study visit, one hour | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Food labeling, Child, Sugar-sweetened beverages, Eating, Drinking, Choice behavior