Decoding the Interplay of Front-of-Pack Labels, Price, and Consumer Perceptions: Impact on Food Choices in Korea and Singapore

Duke University

Status: Not yet enrolling

Conditions: Consumer Behavior

Treatments: Behavioral: Graded FOP labels (no label vs. high rating (grade A) vs. low rating (grade D)) x Price (average vs. premium); Behavioral: Positively framed FOP labels (present versus absent) x Price (high versus low)

Study type: Interventional

Funder types: Other

Identifiers

NCT07186270

000273

Details and patient eligibility

About

The global epidemic of obesity and chronic diseases has led to widespread use of front-of-package (FOP) nutrition labels. While existing research has established a link between FOP labels and consumer choices, the interplay between product types, consumer perceptions, and label effectiveness is underexplored. This study examines: 1) whether consumers perceive healthier food item as more expensive when healthiness is less obvious; 2) how FOP labels mediate the relationship among product characteristics, price, and consumer's belief about food healthiness and price on choices; and 3) whether food choice changes given a price, with and without FOP labels, are more prominent for products where the perceived healthiness by consumers significantly differs from label indications. The investigators will conduct experiments with online panelists in Korea and Singapore in two settings: restaurant menus and grocery items. Results will inform more impactful nutritional information policies for healthier food choices and improved population health.

Full description

The investigators will conduct experiments in both Korea and Singapore, focusing on two settings with various food items: restaurant menu choices and grocery item selections. For each item, investigators will elicit consumers' prior belief about its healthiness. Our research builds upon the work of Haws et al. (2017), which demonstrated that US consumers tend to overgeneralize their belief about "expensive=healthy" to product categories where it is not true. This tendency potentially biases perceptions of healthy foods. The investigators aim to test this "expensive=healthy" intuition and its impact on food choice, with and without FOP labels, in Asian contexts. The investigators hypothesize that absent FOP labels, consumers will infer healthiness from price information (i.e., this product is expensive, so it must be healthy) and that providing FOP labels will reduce the reliance on this inference. The investigators also hypothesize that such effects of FOP labels are more prominent for products where the perceived healthiness by consumers significantly differs from the healthiness indicated by the labels. When the FOP labels show 'less healthy' for those expensive and perceived as 'healthy' products, consumers will update their prior belief about its healthiness and be more likely to drop the intuition 'expensive=healthiness' in decision-making and respond to a greater extent.

Enrollment: 1,000 estimated patients

Sex: All

Ages: Under 65 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria:

• Adults aged 18-65 years residing in Korea
• Adults aged 21-65 years residing in Singapore

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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1,000 participants in 2 patient groups

Study 1: Restaurant menu choice experiment

Experimental group

Description:

Participants will read a hypothetical scenario about ordering a meal for a coworker. Participants will be told that their coworker has no dietary restrictions and is trying to eat healthier. They will be presented with two similar restaurant meal options, one priced higher than the other, with randomized assignments. In the label condition, a nutritional label for healthy foods, called the Healthy Choice Symbol adopted in Singapore, will be provided with an explanation of the labelling system. For both label and non-label conditions, participants will be asked to assess the healthfulness of each option using a standard 5-point scale (1-least healthy to 5-healthiest). Participants will then be asked to indicate which option to order for their coworker. Participants will be randomly assigned to one in four experimental arms.

Treatment:

Behavioral: Positively framed FOP labels (present versus absent) x Price (high versus low)

Study 2: Grocery Food Item Choice Experiment

Experimental group

Description:

Participants will read a hypothetical cover story about a new brand of a grocery item with generic health claims and see pictures of different flavors of this brand. Participants will be randomly assigned to either an average or a premium price condition and informed about the average price of other brands of the same item. They will be asked to indicate their perceived relative healthiness of the product compared to the products in other brands on a 5-point scale (1- least healthy to 5- healthiest). After assessment, they will see a high-grade label (grade A), low-grade label (grade D), or no label. For those exposed to labels, they will be given an explanation of the label and asked to indicate their perceived relative healthiness of the product again. In the end, all participants will indicate their intention to purchase items on a 7-point scale (1: least likely - 7: most likely). Participants will be assigned to one in six experimental arms.

Treatment:

Behavioral: Graded FOP labels (no label vs. high rating (grade A) vs. low rating (grade D)) x Price (average vs. premium)