Effects of Sugary Drinks Counter-marketing Messages

Study Overview
=================
Brief Summary
-----------------
This study aims to examine consumer responses to traditional and counter-marketing messages discouraging sugary drink consumption, including effects on intentions to consume sugary drinks and perceived weight stigma. Because prior research has suggested that counter-marketing may be especially effective among younger populations, the investigators will examine effects overall and by age group (young adults [ages 18-29 years] vs. middle and older adults [ages 30+ years]).

Detailed Description
-----------------
In this online randomized clinical trial, participants will be randomized to one of three arms: 1) Control (neutral) messages, 2) Traditional health messages, and 3) Counter-marketing messages. In each arm, participants will view four messages developed for their randomly assigned arm and answer questions about the messages and their behavioral intentions.

Official Title
-----------------
Effects of Anti-sugar-sweetened-beverage Counter-marketing on Behavioral Intentions and Perceived Weight Stigma

Conditions
-----------------
Obesity, Weight Prejudice, Weight Gain, Dietary Habits

Intervention / Treatment
-----------------
* Behavioral: Exposure to counter-marketing messages
* Behavioral: Exposure to traditional health messages
* Behavioral: Exposure to control (neutral) messages


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

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control (neutral) messages<br>Participants will view counter-marketing messages about sugary drinks that incorporate principles of effective counter-marketing campaigns, including describing industry manipulation of consumers, appealing to emotions (especially anger), describing health consequences, and criticizing the industry for demographic targeting. Messages include text adapted from prior counter-marketing campaigns. Participants will view a total of 4 messages developed for this arm. | Behavioral: Exposure to control (neutral) messages<br>* Control messages approximately matched to the intervention messages on length, but discussing a neutral topic unrelated to sugary drinks (safe driving). Participants will view a total of 4 messages developed for this arm.<br>|
| Experimental: Traditional health messages<br>Participants will view traditional health messages focused on the health consequences of sugar-sweetened beverage consumption, using text adapted from prior sugary drink campaigns. Participants will view a total of 4 messages developed for this arm. | Behavioral: Exposure to traditional health messages<br>* Traditional health messages focused on the health consequences of sugar-sweetened beverage consumption, using text adapted from prior sugary drink campaigns. Participants will view a total of 4 messages developed for this arm.<br>|
| Experimental: Counter-marketing messages<br>Participants will view control messages approximately matched to the intervention messages on length, but discussing a neutral topic unrelated to sugary drinks (safe driving). Participants will view a total of 4 messages developed for this arm. | Behavioral: Exposure to counter-marketing messages<br>* Counter-marketing messages about sugary drinks that incorporate principles of effective counter-marketing campaigns, including describing industry manipulation of consumers, appealing to emotions (especially anger), describing health consequences, and criticizing the industry for demographic targeting. Messages include text adapted from prior counter-marketing campaigns. Participants will view a total of 4 messages developed for this arm.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intentions to consume sugary drinks | We will assess intentions to consume sugary drinks using 2 items: In the next week, I plan to drink sugary drinks like sodas, sports drinks, or fruit drinks, and In the next week, I am likely to drink sugar-sweetened beverages like sodas, sports drinks, or fruit drinks. Response options to both items will use a 5-point Likert scale: the first item's response options will range from definitely not (1) to definitely yes (5), and the second item's response options will range from not at all likely (1) to extremely likely (5). We will average responses to the 2 items. | The survey will take up to 20 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived message effectiveness for discouraging sugary drink consumption | Item: These messages discourage me from wanting to drink sugary drinks. This variable will be measured on a 5-point Likert scale ranging from not at all (1) to a great deal (5). | The survey will take up to 20 minutes | 
| Negative feelings toward drinking sugary drinks | Item: How do these messages make you feel about drinking sugary drinks? This variable will be measured on a 5-point Likert scale ranging from extremely positive (1) to extremely negative (5). | The survey will take up to 20 minutes | 
| Anticipated social interactions | We will examine anticipated social interactions by asking, How likely are you to talk about these messages with others in the next week? This item will be scored on a 5-pt Likert scale ranging from not at all likely (1) to extremely likely (5). | The survey will take up to 20 minutes | 
| Attitudes toward sugary drink companies | We will examine attitudes toward sugary drink companies by asking, How do you feel about companies that make sugary drinks? This item will be scored on a 5-pt Likert scale ranging from dislike them a lot (1) to like them a lot (5). | The survey will take up to 20 minutes | 
| Perceived obesity stigma | We will examine the extent to which participants perceive the messages as contributing to obesity stigma by asking 3 items: These messages promote negative attitudes about people who have overweight or obesity, These messages increase blame towards people for being overweight, and These messages make obesity seem like a much simpler issue than it really is. Each item will be scored on a 5-point Likert scale from not at all (1) to a great deal (5). We will average responses to these items. | The survey will take up to 20 minutes | 
| Message reactance | We will examine psychological reactance to the messages by asking 3 items: These messages are trying to manipulate me, These messages are overblown and How much do these messages make you feel angry? Each item will be scored on a 5-point Likert scale from not at all (1) to a great deal (5). We will average responses to these items, assuming sufficient internal consistency (alpha>=.70). | The survey will take up to 20 minutes | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
counter-marketing, health communication, sugar sweetened beverage