Clinical trial NCT06678178: Climate Impact Label Design and Fast-Food Meal Selection
Official title: Testing Climate Impact Menu Labels Influence on Nutrition Quality of Fast-Food Selections: A Pilot Study
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Food Selection
Keywords: food labeling
climate labeling
choice behavior
Lead sponsor: Johns Hopkins Bloomberg School of Public Health
Sponsor class: OTHER
Collaborators: name: National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
name: University of California, Davis
name: Harvard School of Public Health (HSPH)
name: University of Pennsylvania
First posted: 2024-11-07
Enrollment: 6221
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Participants will be randomized to view a fast-food menu with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a high climate impact warning label on high impact items; (3) traffic light labeling on all items by level of impact; (4) climate grade labels on all items by level of impact; and (5) numeric labels on all items. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for greenhouse gas emissions set a priori in kilograms of CO2 equivalent per kilogram of food. Participants will be instructed to select a hypothetical lunch meal order. The investigators will record participant meal selections and, using publicly available nutritional information for each item selected, calculate a score of overall meal healthfulness.
Primary purpose: PREVENTION

Brief summary: The primary objective of this study is to test the relative effects of climate-impact menu label designs on the healthfulness of consumers' fast-food meal choices. Participants will complete a hypothetical online meal ordering task using a survey which emulates the online menu of a burger restaurant chain. Participants will be randomized for exposure to menus featuring one of five labeling conditions. Secondary objectives include examining total greenhouse gas emissions per meal order and, through a post-order survey, perception of labels between the conditions.

Detailed description: This online randomized trial will test the relative effects of climate impact menu label designs on the healthfulness of consumers' fast-food meal choices and perceptions of menu items. The survey research firm CloudResearch will recruit a sample of 6,250 adults aged 18 years and older who speak English and reside in the United States.

Participants will complete a between-subjects online experiment in which the participants will be randomized to view a fast-food online ordering menu with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a high climate impact warning label on high impact items; (3) traffic light labels on all items by level of impact; (4) climate grade labels on all items by level of impact; and (5) numeric carbon footprint labels on all items. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for greenhouse gas emissions set a priori in kilograms of carbon dioxide (CO2) equivalent per kilogram of food. Participants will be instructed to select up to 4 menu items for a hypothetical meal order. After completing the meal ordering task, participants will be prompted to answer questions about the perception of the labeling condition which the participants were randomized to view, perception of the relative effectiveness of all labels in this experiment, and personal values, dietary patterns, and other demographic information.

The primary outcome will be the healthfulness of meal orders selected from the online menu, indicated by a modified Nutrient Profile Index meal score for all food items ordered. Secondary outcomes will be total greenhouse gas emissions per meal ordered, total calories ordered, whether a sugar-sweetened beverage was ordered, and perceived message effectiveness of the climate-impact labels.

Eligibility criteria: Inclusion Criteria:

* 18 years of age or older
* Member of the CloudResearch panel
* Residing in the United States

Exclusion Criteria:

* Under 18 years of age
* Not residing in the United States
* Completed the survey implausibly quick based on the distribution of the time to complete the survey among all participants
* Failed the built-in Qualtrics survey fraud detection measures

Primary outcomes:
measure: Modified Nutrient Profile Index score
timeFrame: approximately 1 minute
Secondary outcomes:
measure: Total greenhouse gas emissions as assessed by Cumulative total kilograms of carbon equivalent (kgCO2e) per kilogram
timeFrame: approximately 1 minute
measure: Perceived message effectiveness (PME) as assessed by the University of North Carolina (UNC) PME scale
timeFrame: approximately 1 minute
measure: Total energy (calories) selected
timeFrame: approximately 1 minute
measure: Sugar-sweetened beverage selection
timeFrame: approximately 1 minute
Other outcomes:
Locations:
city: Baltimore
country: United States
facility: Johns Hopkins Bloomberg School of Public Health
state: Maryland
Study officials:
affiliation: Johns Hopkins Bloomberg School of Public Health
name: Julia Wolfson, PHD MPP
role: PRINCIPAL_INVESTIGATOR
References: