Studying the Impact of Product Packaging in a Virtual Store Environment

University of North Carolina (UNC)

Status: Completed

Conditions: Obesity, Childhood

Treatments: Behavioral: Control snack: barcode label; Behavioral: Control Drink: No nutrition claim; Behavioral: Experimental snack: Graphic warning; Behavioral: Experimental Drink: Nutrition claim on fruit drinks; Behavioral: Experimental snack: Text warning

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT04381481

K01HL147713 (U.S. NIH Grant/Contract)

19-3227

Details and patient eligibility

About

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.

Full 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).

Enrollment: 2,374 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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2,374 participants in 12 patient groups

Control beverage, text snack

Experimental group

Description:

The participant will see fruit drinks with no nutrition claims (task 1). They will see a snack with a text warning "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Control Drink: No nutrition claim

Behavioral: Experimental snack: Text warning

Control beverage, control snack

Experimental group

Description:

The participant will see fruit drinks with no nutrition claims (task 1). They will see a snack with a barcode label (control label) (task 2).

Treatment:

Behavioral: Control Drink: No nutrition claim

Behavioral: Control snack: barcode label

Control beverage, graphic snack

Experimental group

Description:

The participant will see fruit drinks with no nutrition claims (task 1). They will see a snack with a graphic label (image of sugar cubes in a cup) along with the text "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Control Drink: No nutrition claim

Behavioral: Experimental snack: Graphic warning

Claim 1 beverage, text snack

Experimental group

Description:

The participant will see fruit drinks with the nutrition claim "No Artificial Sweeteners" (task 1). They will see a snack with a text warning "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Experimental snack: Text warning

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 1 beverage, control snack

Experimental group

Description:

The participant will see fruit drinks with the nutrition claim "No Artificial Sweeteners" (task 1). They will see a snack with a barcode label (control label) (task 2).

Treatment:

Behavioral: Control snack: barcode label

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 1 beverage, graphic snack

Experimental group

Description:

The participant will see fruit drinks with the nutrition claim "No Artificial Sweeteners" (task 1). They will see a snack with a graphic label (image of sugar cubes in a cup) along with the text "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Experimental snack: Graphic warning

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 2 beverage, text snack

Experimental group

Description:

The participants will see fruit drinks with the nutrition claim "100% Vitamin C daily value" (task 1). They will see a snack with a text warning "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Experimental snack: Text warning

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 2 beverage, control snack

Experimental group

Description:

The participants will see fruit drinks with the nutrition claim "100% Vitamin C daily value" (task 1). They will see a snack with a barcode label (control label) (task 2).

Treatment:

Behavioral: Control snack: barcode label

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 2 beverage, graphic snack

Experimental group

Description:

The participants will see fruit drinks with the nutrition claim "100% Vitamin C daily value" (task 1). They will see a snack with a graphic label (image of sugar cubes in a cup) along with the text "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Experimental snack: Graphic warning

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 3 beverage, text snack

Experimental group

Description:

The participants will see fruit drinks with the nutrition claim "100% All Natural" (task 1). They will see a snack with a text warning "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Experimental snack: Text warning

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 3 beverage, control snack

Experimental group

Description:

The participants will see fruit drinks with the nutrition claim "100% All Natural" (task 1). They will see a snack with a barcode label (control label) (task 2).

Treatment:

Behavioral: Control snack: barcode label

Behavioral: Experimental Drink: Nutrition claim on fruit drinks

Claim 3 beverage, graphic snack

Experimental group

Description:

The participants will see fruit drinks with the nutrition claim "100% All Natural" (task 1). They will see a snack with a graphic label (image of sugar cubes in a cup) along with the text "WARNING: High in added sugar" (task 2).

Treatment:

Behavioral: Experimental snack: Graphic warning

Behavioral: Experimental Drink: Nutrition claim on fruit drinks