Perceptions of and Reactions to Sustainability Menu Label Designs

Johns Hopkins Bloomberg School of Public Health

Status: Completed

Conditions: Food Choices

Treatments: Behavioral: Environmental Harm Labels; Behavioral: Unsustainable Labels; Behavioral: Control (QR) Labels; Behavioral: Numeric Environmental Cost Labels; Behavioral: High Environmental Cost Labels; Behavioral: Low Sustainability Labels; Behavioral: High Environmental Harm Labels

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT07214792

5R01DK139327-02 (U.S. NIH Grant/Contract)

IRB00034378

Details and patient eligibility

About

The primary objective of this study is to explore perceptions and understanding of different menu label designs related to sustainability and environmental harm. Participants will be randomized to view a fast-food menu featuring one of seven labeling conditions and then will answer questions about the participant's reactions to and interpretations of the label, perceived label effectiveness, intention to purchase a menu item with the label, as well as perceptions of two fast-food menu items.

Full description

This survey will explore the perceptions and understanding of different hypothetical menu label designs related to sustainability and environmental harm compared to a control label The survey research firm CloudResearch will recruit a sample of ~12,400 adults aged 18 years and older who reside in the United States.

Participants will be randomized to view a fast-food online ordering menu with one of seven labeling schemes applied: (1) a QR code on all items (control); (2) Low Sustainability labels; (3) Unsustainable labels; (4) Environmental Harm labels; (5) High Environmental Harm labels; (6) High Environmental Cost labels; and (7) numeric Environmental Cost labels on all items. All fast-food menus will include a selection of main entrée items. The control QR code and numeric environmental cost labels will display labels on all menu items. All other label conditions will apply labels only to items with higher environmental impact as defined by ingredient-level environmental impact estimates based on the Cool Food Pledge Calculator.

Participants will be shown the menu and the label in isolation and will then be asked about interpretations of the label, reactions to the label, perceived message effectiveness (PME) of the label, how helpful the participants find the label to be, and the intention to purchase a menu item with the label. The participants will also be shown two different individual fast-food items with the label to which the participants were randomized (if applicable) in random order and asked about the perceived appeal, healthfulness, and environmental impact of the menu items.

The primary outcome in this exploratory study will be intention to purchase a hypothetical menu item with the label shown. Secondary outcomes include label interpretation, perceived label understandability, perceived label believability, perception that the label grabbed attention, perceived message effectiveness (PME) of the label, perceived helpfulness of the label, perceived level of appeal of menu items, perceived level of healthfulness of menu items, and perceived environmental impact of menu items.

Enrollment: 14,720 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

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

Exclusion criteria

• - <18 years of age
• Not residing in the United States
• Completed the survey implausibly quickly based on the distribution of the time to complete the survey among all participants
• Failed the built-in Qualtrics survey fraud detection measures
• Failed the attention check question included in the survey

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

14,720 participants in 7 patient groups, including a placebo group

Control (QR) labels

Placebo Comparator group

Description:

A black label featuring a QR code and white text that reads "SCAN HERE" will be placed beneath all main menu items.

Treatment:

Behavioral: Control (QR) Labels

Low Sustainability Labels

Experimental group

Description:

A red icon-plus-text label that reads "LOW SUSTAINABILITY" in white text will be placed beneath menu items with a high environmental impact, defined by ingredient-level environmental impact estimates from the Cool Food Pledge Calculator. Labels will include a white globe icon directly preceding the label text.

Treatment:

Behavioral: Low Sustainability Labels

Unsustainable Labels

Experimental group

Description:

A red icon-plus-text label that reads "UNSUSTAINABLE" in white text will be placed beneath menu items with a high environmental impact, defined by ingredient-level environmental impact estimates from the Cool Food Pledge Calculator. Labels will include a white globe icon directly preceding the label text.

Treatment:

Behavioral: Unsustainable Labels

Environmental Harm Labels

Experimental group

Description:

A red icon-plus-text label that reads "ENVIRONMENTAL HARM" in white text will be placed beneath menu items with a high environmental impact, defined by ingredient-level environmental impact estimates from the Cool Food Pledge Calculator. Labels will include a white globe icon directly preceding the label text.

Treatment:

Behavioral: Environmental Harm Labels

High Environmental Harm Labels

Experimental group

Description:

A red icon-plus-text label that reads "HIGH ENVIRONMENTAL HARM" in white text will be placed beneath menu items with a high environmental impact, defined by ingredient-level environmental impact estimates from the Cool Food Pledge Calculator. Labels will include a white globe icon directly preceding the label text.

Treatment:

Behavioral: High Environmental Harm Labels

High Environmental Cost Labels

Experimental group

Description:

A red icon-plus-text label that reads "HIGH ENVIRONMENTAL COST" in white text will be placed beneath menu items with a high environmental impact, defined by ingredient-level environmental impact estimates from the Cool Food Pledge Calculator. Labels will include a white triangle icon with a dollar sign directly preceding the label text.

Treatment:

Behavioral: High Environmental Cost Labels

Numeric Environmental Cost Labels

Experimental group

Description:

Numeric Environmental Cost labels will be placed beneath all menu items and display the estimated dollar value associated with the item's True Cost Accounting which calculates the additional cost of a commodity by accounting for environmental and social costs. The label will read "ENVIRONMENTAL COST" in white text followed by a dollar value (i.e., +$6.01). All labels have a solid red background and an icon-plus-text design. A white globe icon will precede the text.

Treatment:

Behavioral: Numeric Environmental Cost Labels