Clinical trial NCT04811690: Front-of-package Marketing on Fruit Drinks: Online RCT
Official title: Testing the Impact of Front-of-package Claims, Imagery, Nutrition Disclosures, and Added Sugar Warning Labels on Fruit Drinks in an Online Store: A Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Consumer Behavior
Consumer Preference
Lead sponsor: Harvard School of Public Health (HSPH)
Sponsor class: OTHER
Collaborators: name: Robert Wood Johnson Foundation
First posted: 2021-03-23
Enrollment: 5028
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: This study will test the independent and combined effects of front-of-package claims, imagery, nutrition disclosures, and added sugar warning labels on parents' purchases and perceptions of beverages for their children.

Detailed description: Fruit drinks are widely consumed by 0-5-year-olds. Parents purchase these drinks for their children in part due to misperceptions that they are healthful, which may be driven by front-of-package (FOP) marketing. The FDA is considering changes to FOP marketing regulations but lacks data on how label elements influence consumer behavior. Our study will test the independent and combined effects of FOP claims, imagery, nutrition disclosures, and added sugar warning labels on parents' purchases and perceptions of beverages for their children.

We will conduct an online randomized controlled trial with 5,000 racially/ethnically diverse primary caregivers of children aged 0-5 years. Participants will choose a beverage for their child in an online store and rate health perceptions of different fruit drinks. Participants will be randomized to see high-added-sugar beverages (\>20% DV added sugar/serving) with 1 of 7 FOP label conditions: 1) vitamin C claim and fruit imagery (control); 2) imagery only; 3) claim only; 4) no claim or imagery; 5) claim, imagery, and % juice disclosure; 6) claim, imagery, and added sugar warning; or 7) claim, imagery, and added sugar warning w/teaspoons of added sugar.

Primary outcomes will include total calories and added sugar (grams) from chosen online store beverages. Secondary outcomes will include health perceptions and knowledge of added sugar and % juice content in low- and high-added-sugar fruit drinks.

This research will inform federal regulation to correct health misperceptions of sugary drinks.

Eligibility criteria: Inclusion Criteria:

* Primary caregiver of a child 0-5 years old
* \>= 18 years old
* U.S. citizen

Exclusion Criteria:

* Participants who complete the survey in less than 1/3 of the median completion time
* Observations from duplicate IP addresses (keep first observation that is unique)
* Participants who answer data integrity check incorrectly

Primary outcomes:
measure: Calories in beverage chosen in online store task
timeFrame: through study completion, an average of 15 minutes
measure: Added sugar content (grams) of beverage chosen in online store task
timeFrame: through study completion, an average of 15 minutes
Secondary outcomes:
measure: Percentage of participants that chose a drink high in added sugars in online store task
timeFrame: through study completion, an average of 15 minutes
measure: Percentage of participants that chose each drink category in online store task
timeFrame: through study completion, an average of 15 minutes
measure: Fruit drink perceptions: likelihood to purchase for child, how healthy for child, how appealing to child, disease risk perceptions for child
timeFrame: through study completion, an average of 15 minutes
measure: Knowledge of juice and added sugar content in beverage
timeFrame: through study completion, an average of 15 minutes
Other outcomes:
Locations:
city: Boston
country: United States
facility: Online Recruitment, run via Harvard T.H. Chan School of Public Health
state: Massachusetts
Study officials:
affiliation: Harvard School of Public Health (HSPH)
name: Eric Rimm, ScD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Musicus AA, Roberto CA, Moran AJ, Sorscher S, Greenthal E, Rimm EB. Effect of Front-of-Package Information, Fruit Imagery, and High-Added Sugar Warning Labels on Parent Beverage Choices for Children: A Randomized Clinical Trial. JAMA Netw Open. 2022 Oct 3;5(10):e2236384. doi: 10.1001/jamanetworkopen.2022.36384.