Clinical trial NCT02814604: FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods
Official title: FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Consumer Behavior
Diet, Food, and Nutrition
Keywords: Front-of-Pack Labelling
Star rating system
Traffic light rating system
Consumer Behavior
Health Literacy
Mobile Apps
Nutrition Labeling
Healthy food choices
High-in Warning Labels
Lead sponsor: University of Toronto
Sponsor class: OTHER
Collaborators: name: Heart and Stroke Foundation of Canada
name: Dietitians of Canada
First posted: 2016-06-28
Enrollment: 2008
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: There is a lot of confusion when it comes to understanding nutrition information on food packages, thus making it difficult for consumers to choose healthy products. In today's busy and fast-paced shopping environment, mobile digital technology (for example, Smartphone applications) can help consumers make 'healthier' food choices when they are shopping. This study aims to test the effectiveness of a traffic light front-of-pack system, the Health Star Rating System (HSR or Star System), and the proposed sodium, saturated fat and sugar warning labels proposed by Health Canada. The study will also experimentally test the use of a Smartphone application (app), FoodFlip, to help educate consumers on these systems on food packages to explore the impact of a learning effect on the efficacy of the labelling systems.

Detailed description: The rising rate of obesity and diet-related chronic diseases illustrate that Canadians' eating habits need to change. Equipping Canadians with information and tools to enable healthy food choices that decrease risk for disease is imperative. While the Nutrition Facts table (NFt) is the most standardized and complete form of nutrition labelling, studies have shown that consumers are confused about serving size, nutrient quantities, and the interpretation of the % Daily Value. Thus, expert groups have proposed the introduction of interpretive front-of-pack (FOP) nutrition rating systems (e.g. traffic light labelling or star ratings) that also help consumers understand the significance of the levels of nutrients in relation to the "healthiness" of a food. One of the main barriers to the introduction of such a system is the absence of high quality studies that objectively measure the impact of nutrition information on actual food purchases. This is a consequence of both the practical challenges associated with designing and conducting such studies in 'real-world' settings, and the lack of food industry support to quantitatively examine or publish the potential for enhanced nutrition labels to modify consumer food choices. With the growing burden of diet-related disease, there is an urgent need for robust evidence to evaluate the potential for additional interpretive nutrition labelling systems to modify and improve food purchasing patterns. Given the relative ubiquity of mobile digital technologies, our Canadian Smartphone application (FoodFLIP) provides us with an unprecedented opportunity to examine and improve consumers' diets.

This study will investigate whether a traffic light, a health star rating or a high-in warning label FOP system can help consumers identify and purchase healthier foods.

Objective 1: To evaluate the effects of three FOP systems in helping consumers characterize healthfulness and nutritional content of food items.

Objective 2: To determine which of the three FOP systems support healthier food choices and are preferred by Canadian consumers.

Eligibility criteria: Inclusion Criteria:

* Shop at a supermarket owned by one of the largest four national retailers at least twice a month. This includes Loblaws, Sobeys, Metro or Safeway
* Own a smartphone (iPhone version 3 or later or android)
* Are 18 years or over and provide informed consent to participate
* Reside in Canada, excluding Northern Territories

Primary outcomes:
measure: The accurate characterization of healthfulness and nutritional content of foods as indicated by each intervention group will be compared.
timeFrame: 6 weeks
Secondary outcomes:
measure: A qualitative assessment of the functionality and usability of the smartphone app (FoodFLIP) will be assessed through questionnaires on a 5-point Likert Scale (the percentage of users finding the app easy to use/easy to understand etc).
timeFrame: 6 weeks
measure: The health claims with or without additional labelling elements influence perceptions of healthiness and purchasing intentions will be compared between each FOP system.
timeFrame: 6 weeks
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: University of Toronto
state: Ontario
Study officials:
affiliation: University of Toronto
name: Mary R L'Abbe, Ph.D.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Key TJ, Schatzkin A, Willett WC, Allen NE, Spencer EA, Travis RC. Diet, nutrition and the prevention of cancer. Public Health Nutr. 2004 Feb;7(1A):187-200. doi: 10.1079/phn2003588.
citation: Emrich TE, Qi Y, Mendoza JE, Lou W, Cohen JE, L'abbe MR. Consumer perceptions of the Nutrition Facts table and front-of-pack nutrition rating systems. Appl Physiol Nutr Metab. 2014 Apr;39(4):417-24. doi: 10.1139/apnm-2013-0304. Epub 2013 Oct 24.
citation: The Standing Committee on Health. Healthy Weights for Healthy Kids. 2007
citation: McGuire S. Institute of Medicine. 2012. Front-of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. Washington, DC: The National Academies Press. Adv Nutr. 2012 May 1;3(3):332-3. doi: 10.3945/an.112.001933. No abstract available.