Clinical trial NCT04381481: Studying the Impact of Product Packaging in a Virtual Store Environment
Official title: Studying the Impact of Product Packaging in a Virtual Store Environment
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Obesity, Childhood
Lead sponsor: University of North Carolina, Chapel Hill
Sponsor class: OTHER
Collaborators: name: Robert Wood Johnson Foundation
name: National Heart, Lung, and Blood Institute (NHLBI)
First posted: 2020-05-08
Enrollment: 2374
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Purpose: Examine the impact of nutrition claims on parents' decisions to purchase fruit drinks in a randomized controlled trial in an online virtual convenience store (task 1) and examine the impact of added sugar warnings on parents' snack purchasing decisions in a randomized controlled trial in an online virtual convenience store.

Participants: Participants will consist of approximately 2,500 individuals 18 and older with at least one child ages 1-5. The child 1-5 who had their birthday most recently must have consumed at least one fruit drink in the previous week. Additionally, they will live in the United States and identify as non-Hispanic black, non-Hispanic white, or Hispanic. The panel research company Kantar will recruit individuals from its pool of potential individuals.

Procedures (methods): The investigators will randomize participants to one of 12 versions of a virtual convenience store (iShoppe) and then the participants will complete two shopping tasks in the store. They will select two beverages (task 1) for their child 1-5 who had their birthday most recently, and they will select a snack (task 2) for that same child. After completing the shopping tasks, the participant will complete a survey in Qualtrics. The survey will ask a series of questions about the beverages and snacks (e.g., perceived healthfulness, perceived appeal, intentions to consume products). Questions will also include standard demographic and health related variables.

Detailed description: There are major racial-ethnic disparities in the US childhood obesity epidemic. Among children age 1-5 years, Black children are twice as likely to be obese and Latino children are three times as likely to be obese compared to White children. Sugar-sweetened beverage (SSB) and processed food consumption are major drivers of the childhood obesity epidemic, and an important driver of racial-ethnic obesity disparities. Policies to reduce marketing and require warning labels are important strategies for improving health outcomes among US parents and children at risk for obesity. Understanding the impact of nutrition claims on fruit drink purchases among Black and Latino parents is especially important given pre-existing disparities in early childhood SSB consumption and obesity. However, little is known about the relationship between nutrition claims and SSB purchases among racial-ethnic minorities. Thus, it is important to understand the effect of nutrition claims on racial-ethnic minority parents' purchases of fruit drinks. Another key research gap relates to the impact of warning labels for processed food among this population. Thus, in this study the investigators also aim to test warning labels on food/snack products as part of this study.

Setting: The trial will take place in a virtual convenience store setting created for researchers to examine how store and product characteristics influence consumer purchases in a controlled but realistic environment.

Recruitment: Participants will be recruited online through Kantar's currently available panel participants. Interested potential participants will complete a screener online, and if they are eligible, they will be redirected to the consent form.

Informed consent: Participants will view an online consent form prior to participating in the study, They will acknowledge their consent by proceeding onto the study.

Randomization: After acknowledging consent, participants will be randomized to one of 12 versions of the store(see trial arms). Participants will have an equal chance to be randomized to one of the arms of the store.

Assessment: Participants will enter the virtual convenience store and be given a shopping task to select 2 beverages (task 1) for their child age 1-5 who celebrated their birthday most recently. The participant will have to select between 100% grape juice and a grape-flavored fruit drink, and they will have to select between water and an apple-flavored fruit drink. After selecting two beverages, the participant will then be directed to complete a snack shopping task (task 2). After completing the two shopping tasks, the participant will be redirected to an online survey to complete. Participation in the study will last approximately 15-18 minutes.

Trial arms: All participants will complete two shopping tasks where they have to (1) choose between a grape fruit drink and a 100% grape juice, and choose between an apple fruit drink and water, and (2) choose between a snack with a nutrient warning label or a snack with no warning label. There will be 4 versions of the fruit drinks that participants will be randomized to. They will see either a fruit drink with no claim (control) or a fruit drink with 1 of 3 claims ("No artificial sweeteners," "100% vitamin c daily value," "100% all natural"). For the snack with the nutrient warning label, participants will see either a control label (barcode) or a nutrient warning label (text or graphic).

Eligibility criteria: Inclusion Criteria:

* Be 18 years or older
* Currently reside in the US
* Be a Kantar panel member
* have at least one child aged 1-5
* Child 1-5 with the most recent birthday must have consumed at least one fruit drink in the previous week (7 days)
* Self-identify as non-Hispanic white, non-Hispanic black, or Hispanic any race

Exclusion Criteria:

-

Primary outcomes:
measure: Percent of Participants Who Selected the Grape-Flavored Fruit Drink (Fruit Drink Experimental Task 1)
timeFrame: During virtual shopping task which will last ~5 minutes
measure: Percent of Participants Who Selected the Lower Sugar Granola Snack (Snack Experimental Task 2)
timeFrame: During virtual shopping task which will last ~5 minutes
Secondary outcomes:
measure: Percent of Participants Who Misperceive That the Fruit Drink Does Not Have Added Sugar (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Percent of Participants Who Misperceive That the Fruit Drink is 100% Fruit Juice (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Number of Teaspoons of Added Sugar Participants Think the Fruit Drink Contains (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Mean Percent of Fruit Juice That Participants Believe the Fruit Drink Contains (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Perceived Misleadingness of Fruit Drink (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Perceived Product Healthfulness of Fruit Drink for Child's Daily Consumption (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Interest in Giving the Fruit Drink to One's Child (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Percent of Participants Who Selected Apple-flavored Fruit Drink (Fruit Drink Experimental Task 1)
timeFrame: During virtual shopping task which will last ~5 minutes
measure: Perceived Appeal of Fruit Drink (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Interest in Consuming the Fruit Drink (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Relative Harm of the Fruit Drink Compared to Soda (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Relative Harm of the Fruit Drink Compared to 100% Fruit Juice (Fruit Drink Experimental Task 1)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Perceived Product Healthfulness of Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Product Appeal of Snack for One's Child (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Participant Intentions to Give Snack to One's Child (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Intentions to Purchase the Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Intentions to Consume the Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Percent of Participants Able to Identify the Healthier Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Percent of Participants Able to Identify the Snack With Higher Amount of Added Sugar (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Percent of Participants Who Intend to Purchase the Snack With Higher Added Sugar (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Perceived Message Effectiveness of Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Social Reactions to Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Percent of Participants Who Learned Something New About the Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Snack Grabbed the Participant's Attention (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Label on Snack Makes Participant Feel Scared (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
measure: Thinking About the Health Effects of the Snack (Snack Experimental Task 2)
timeFrame: 13-15 minutes post-test computer survey following the ~5 minute virtual shopping task.
Other outcomes:
Locations:
city: Chapel Hill
country: United States
facility: UNC Carolina Population Center
state: North Carolina
Study officials:
affiliation: University of North Carolina
name: Marissa G Hall, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Taillie LS, Higgins ICA, Lazard AJ, Miles DR, Blitstein JL, Hall MG. Do sugar warning labels influence parents' selection of a labeled snack for their children? A randomized trial in a virtual convenience store. Appetite. 2022 Aug 1;175:106059. doi: 10.1016/j.appet.2022.106059. Epub 2022 May 5.
citation: Hall MG, Lazard AJ, Higgins ICA, Blitstein JL, Duffy EW, Greenthal E, Sorscher S, Taillie LS. Nutrition-related claims lead parents to choose less healthy drinks for young children: a randomized trial in a virtual convenience store. Am J Clin Nutr. 2022 Apr 1;115(4):1144-1154. doi: 10.1093/ajcn/nqac008.