Effects of 'Pinkwashed' Alcohol Ads in an Online RCT

Study Overview
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Brief Summary
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The primary objective of this study is to examine how exposure to pinkwashed alcohol advertisements (i.e., ads that associate the company with breast cancer awareness or charities) affects consumers' perceptions that alcohol increases the risk of breast cancer. The investigators will randomize participants to view 3 'pinkwashed' social media advertisements for alcohol or 3 control advertisements for alcohol (i.e., 'de-pinked' standard alcohol advertisements that match the intervention advertisements on overall design but do not mention breast cancer). Each participant will view the 3 advertisements for their arm (presented in random order) and respond to survey questions programmed in Qualtrics.

Official Title
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Effects of 'Pinkwashed' Alcohol Ads in an Online RCT

Conditions
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Breast Cancer, Cancer

Intervention / Treatment
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* Behavioral: Pinkwashed Advertisements
* Behavioral: Control - Standard Advertisements


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years old or older Exclusion Criteria: Less than 18 years old

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Control - Standard Advertisements<br>In the control condition, participants will view 3 advertisements for alcohol (shown in random order) that do not mention breast cancer awareness or charities. Advertisements will be real social media posts used by alcohol companies, modified only to remove dates, likes/comments, and references to specific geographic locations. | Behavioral: Control - Standard Advertisements<br>* Real advertisements from the same alcoholic beverage companies' social media accounts that do not contain messaging or other features associated with breast cancer awareness or research.<br>|
| Experimental: Pinkwashed Advertisements<br>In the pinkwashed condition, participants will view 3 advertisements for alcohol (shown in random order) that associate the alcohol company with breast cancer awareness or research (e.g., indicate that a portion of sales will be directed to a breast cancer-related foundation). Advertisements will be real social media posts used by alcohol companies, modified only to remove dates, likes/comments, and references to specific geographic locations. | Behavioral: Pinkwashed Advertisements<br>* Real advertisements from alcoholic beverage companies' social media accounts that contain messaging or other features that associate the alcohol company with breast cancer awareness or research.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breast cancer risk perceptions | This outcome will be measured with an adapted item from the HINTS (2020) survey. The question is worded  In your opinion, how much does drinking [wine/beer/liquor] affect the risk of developing each of the following outcomes... Breast cancer. Response options are on a five point likert-type scale ranging from Decreases risk a lot (=1) to Increases risk a lot  (=5). Participants will be asked to respond to this item three times, once for each type of alcoholic beverage presented (wine, beer, liquor). Scores from the three items will then be averaged for analyses. Higher scores indicate higher risk perceptions. | During  20 minute online survey | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived product healthfulness | This outcome will be measured with one item adapted from Bollard et al (2016). The question will read: How healthy or unhealthy do you think it is to drink this product? and will be measured with a 5-point likert-type response scale ranging from Very unhealthy (1) to Very healthy(5). Higher scores indicate greater healthfulness perceptions. | During  20 minute online survey | 
| Perceived social responsibility of brand | This outcome will be measured with one item adapted from Nan & Heo (2017). The question will read: How socially responsible do you think the company that makes this product is? and will be measured with a 5-point likert-type response scale ranging from Very socially irresponsible (1) to Very socially responsible (5). Higher scores indicate perceptions of social responsibility. | During  20 minute online survey | 
| Favorable attitudes toward brand | This outcome will be measured with one item adapted from Nan & Heo (2017). The question will read: How do you feel about the company that makes this product? and will be measured with a 5-point likert-type response scale ranging from Dislike it a lot (1) to Like it a lot (5). Higher scores indicate more favorable attitudes. | During  20 minute online survey | 
| Purchase intentions | This outcome will be measured with one item adapted from Hall et al (2020). The question will display all three advertisements that the participant was exposed to (either pinkwashed or control). It will then query: How likely would you be to buy any of these products in the next 4 weeks, if they were available? and will be measured with a 5-point likert-type response scale ranging from Not at all likely (1) to Extremely likely (5). Higher scores indicate greater purchase intentions. | During  20 minute online survey | 
| Perceived misleadingness of ads | Measure of how misleading a participant perceives the advertisement. Assessed with 1 item adapted from Hall et al. 2020 | During  20 minute online survey | 
| Support for breast cancer warnings | Measure of participant support of including breast cancer warning labels on alcoholic beverage products. Assessed with 1 item adapted from Hall et al. 2018 | During  20 minute online survey | 
| Stomach cancer risk perceptions | This outcome will be measured with an adapted item from the HINTS (2020) survey. The question is worded  In your opinion, how much does drinking [wine/beer/liquor] affect the risk of developing each of the following outcomes... Stomach cancer. Response options are on a five point likert-type scale ranging from Decreases risk a lot (=1) to Increases risk a lot  (=5). Participants will be asked to respond to this item three times, once for each type of alcoholic beverage presented (wine, beer, liquor). Scores from the three items will then be averaged for analyses. Higher scores indicate higher risk perceptions. | During  20 minute online survey | 
| Mouth and throat cancer risk perceptions | This outcome will be measured with an adapted item from the HINTS (2020) survey. The question is worded  In your opinion, how much does drinking [wine/beer/liquor] affect the risk of developing each of the following outcomes... Mouth and throat cancer. Response options are on a five point likert-type scale ranging from Decreases risk a lot (=1) to Increases risk a lot  (=5). Participants will be asked to respond to this item three times, once for each type of alcoholic beverage presented (wine, beer, liquor). Scores from the three items will then be averaged for analyses. Higher scores indicate higher risk perceptions. | During  20 minute online survey | 
| Liver cancer risk perceptions | This outcome will be measured with an adapted item from the HINTS (2020) survey. The question is worded  In your opinion, how much does drinking [wine/beer/liquor] affect the risk of developing each of the following outcomes... Liver cancer. Response options are on a five point likert-type scale ranging from Decreases risk a lot (=1) to Increases risk a lot  (=5). Participants will be asked to respond to this item three times, once for each type of alcoholic beverage presented (wine, beer, liquor). Scores from the three items will then be averaged for analyses. Higher scores indicate higher risk perceptions. | During  20 minute online survey | 
| Liver disease risk perceptions | This outcome will be measured with an adapted item from the HINTS (2020) survey. The question is worded  In your opinion, how much does drinking [wine/beer/liquor] affect the risk of developing each of the following outcomes... Liver disease. Response options are on a five point likert-type scale ranging from Decreases risk a lot (=1) to Increases risk a lot  (=5). Participants will be asked to respond to this item three times, once for each type of alcoholic beverage presented (wine, beer, liquor). Scores from the three items will then be averaged for analyses. Higher scores indicate higher risk perceptions. | During  20 minute online survey | 
| Hypertension risk perceptions | This outcome will be measured with an adapted item from the HINTS (2020) survey. The question is worded  In your opinion, how much does drinking [wine/beer/liquor] affect the risk of developing each of the following outcomes...Hypertension. Response options are on a five point likert-type scale ranging from Decreases risk a lot (=1) to Increases risk a lot  (=5). Participants will be asked to respond to this item three times, once for each type of alcoholic beverage presented (wine, beer, liquor). Scores from the three items will then be averaged for analyses. Higher scores indicate higher risk perceptions. | During  20 minute online survey |