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| ID | Type | Description | Link |
|---|---|---|---|
| 7R03CA273391-02 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| Oakland University | OTHER |
| National Cancer Institute (NCI) | NIH |
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The goal of this study is to determine the effectiveness of pictorial warning labels (PWLs) featuring narrative (vs. non-narrative) content in communicating the cancer risk of alcohol. Participants will be randomized to view either three narrative or non-narrative PWLs. Key outcome variables include visual attention, message reactance, risk perceptions, and intentions to reduce and stop drinking.
The goal of this study is to determine the effectiveness of pictorial warning labels (PWLs) featuring narrative (vs. non-narrative) content in communicating the cancer risk of alcohol. Participants will be recruited from online panels. Participants will first be invited to participate in an online screening survey. Eligible participants will be invited to participate in the main experiment. In the main experiment, participants will first answer questions concerning baseline alcohol consumption and other background information. Then they will engage with a webcam-based eye-tracking task through Sticky by Tobii. Participants will first read instructions and tips related to completing the eye-tracking task. They will complete a brief calibration procedure and be presented with either three narrative PWLs or three non-narrative PWLs. Sticky by Tobii will record participants' gaze, thereby measuring visual attention to each PWL. After viewing each PWL, participants will answer a few questions. After viewing all three PWLs, they will answer questions based on all images combined. Upon study completion, participants will be compensated. A follow-up survey will be sent to participants after two weeks, which includes questions about their drinking behaviors, information seeking behaviors, and social interactions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Narrative Pictorial Warning Labels | Experimental | Participants in this arm will be presented with three narrative pictorial warning labels for alcoholic beverages. |
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| Non-Narrative Pictorial Warning Labels | Experimental | Participants in this arm will be presented with three non-narrative pictorial warning labels for alcoholic beverages. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Narrative pictorial warning labels for alcoholic beverages | Behavioral | Pictorial warning labels consisting of text and narrative imagery (e.g., photos of cancer patients) conveying the risk of alcohol for oral cancer, esophageal cancer, and larynx cancer. |
| Measure | Description | Time Frame |
|---|---|---|
| Dwell Time | Dwell time measures the total duration of attention to an area of interest (AOI). Each warning label consisted of two AOIs: image AOI and text AOI. Dwell time for each AOI was averaged across three PWLs within each arm. | Assessed during the one-time 15-minute online survey experiment. |
| Visit Count | Visit count measures the total number of times participants viewed an area of interest (AOI). Each warning label consisted of two AOIs: image AOI and text AOI. Visit count for each AOI was averaged across three PWLs within each arm. | Assessed during the one-time 15-minute online survey experiment. |
| Reactance | Reactance were measured after exposure to each PWL (i.e., three times in total). It was assessed using the brief Reactance to Health Warnings Scale (Hall et al., 2017). Participants were asked to indicate how much each warning tried to manipulate them, annoyed them, and was overblown (1 = not at all, 5 = a great deal). Reactance for each PWL was averaged across three PWLs within each arm. | Assessed during the one-time 15-minute online survey experiment. |
| Affective Risk Perceptions | Affective risk perceptions were assessed once after participants viewed all three PWLs. Participants were asked to indicate how worried they are about getting a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1 = Not at all worried, 2=Slightly worried, 3=Moderately worried, 4=Very worried, 5=Extremely worried). | Assessed during the one-time 15-minute online survey experiment. |
| Experiential Risk Perceptions | Experiential risk perceptions were assessed once after participants viewed all three PWLs. Participants were asked to indicate how vulnerable they feel about getting a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1 = Not at all vulnerable, 2=Slightly vulnerable, 3=Moderately vulnerable, 4=Very vulnerable, 5=Extremely vulnerable). |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Zexin Ma, Ph.D. | University of Connecticut | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Online Survey-Experiment | Storrs | Connecticut | 06269 | United States |
The de-identified dataset, study protocol, sample informed consent, and data dictionary will be made available to the research community free of charge through ICPSR (https://www.openicpsr.org/).
Datasets will be shared upon the publication of the manuscripts and will be available to the research community in perpetuity.
All de-identified study data use will be made available as public use data to the research community through ICPSR. Users of the public use data must register with ICPSR and agree to the Terms of Use, which are designed to protect study participants by limiting data use to scientific research and aggregate statistical reporting, prohibiting attempts to identify study participants, and requiring immediate reporting of any disclosure of study participant identity. Data users also agree not to share or redistribute any data downloads.
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| ID | Title | Description |
|---|---|---|
| FG000 | Narrative Pictorial Warning Labels | Participants in this arm were presented with three narrative pictorial warning labels (PWLs) for alcoholic beverages. Narrative PWLs included a photo showing the lived experiences of individuals affected by alcohol-related cancer (e.g., a headshot of a man with a misshapen jaw) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. |
| FG001 | Non-Narrative Pictorial Warning Labels | Participants in this arm will be presented with three non-narrative pictorial warning labels (PWLs) for alcoholic beverages. Non-narrative PWLs contained graphic images of diseased organs (e.g., a closeup image of a mouth with rotten teeth and oral thrush) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Narrative Pictorial Warning Labels | Participants in this arm were presented with three narrative pictorial warning labels (PWLs) for alcoholic beverages. Narrative PWLs included a photo showing the lived experiences of individuals affected by alcohol-related cancer (e.g., a headshot of a man with a misshapen jaw) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Dwell Time | Dwell time measures the total duration of attention to an area of interest (AOI). Each warning label consisted of two AOIs: image AOI and text AOI. Dwell time for each AOI was averaged across three PWLs within each arm. | Sticky's internal algorithms determined cases where the eye tracking data is less than "perfect" and only returns "usable" data. Thus, only usable eye tracking data were analyzed. | Posted | Mean | Standard Error | seconds | Assessed during the one-time 15-minute online survey experiment. |
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Adverse Events were not monitored/assessed for this online survey experiment.
Deaths and/or adverse events were not monitored/assessed as this was an online study where participants completed the survey on their own computer at a location of their choice.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Narrative Pictorial Warning Labels | Participants in this arm were presented with three narrative pictorial warning labels (PWLs) for alcoholic beverages. Narrative PWLs included a photo showing the lived experiences of individuals affected by alcohol-related cancer (e.g., a headshot of a man with a misshapen jaw) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Zexin Ma, Ph.D. | University of Connecticut | (860) 486-6871 | zexin.ma@uconn.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 26, 2024 | Sep 17, 2025 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D009062 | Mouth Neoplasms |
| D004938 | Esophageal Neoplasms |
| D007822 | Laryngeal Neoplasms |
| D000428 | Alcohol Drinking |
| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D009059 | Mouth Diseases |
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| ID | Term |
|---|---|
| D000434 | Alcoholic Beverages |
| ID | Term |
|---|---|
| D001628 | Beverages |
| D000066888 | Diet, Food, and Nutrition |
| D010829 | Physiological Phenomena |
| D019602 | Food and Beverages |
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| Non-narrative pictorial warning labels for alcoholic beverages | Behavioral | Pictorial warning labels consisting of text and non-narrative imagery (e.g., images of diseased organs) conveying the risk of alcohol for oral cancer, esophageal cancer, and larynx cancer. |
|
| Assessed during the one-time 15-minute online survey experiment. |
| Perceived Susceptibility | Perceived susceptibility were assessed once after participants viewed all three PWLs. Participants were asked to indicate how likely it is that they will get a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1 = Not at all likely, 2=A little likely, 3=Somewhat likely, 4=Very likely, 5=Extremely likely). | Assessed during the one-time 15-minute online survey experiment. |
| Comparative Risk | Comparative risk were assessed once after participants viewed all three PWLs. Participants were asked to indicate compared to an average person their age, race, and sex, how likely do they think they will get a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1=Much less likely, 2=Less likely, 3=About as likely, 4=More likely, 5=Much more likely). | Assessed during the one-time 15-minute online survey experiment. |
| Perceived Severity of Harm | Perceived severity of harm were assessed once after participants viewed all three PWLs. Participants were asked to indicate how much getting a specific type of cancer because of drinking would affect their life. Participants responded on a five-point scale (1=Not at all, 2=Very little, 3=Somewhat, 4=Quite a bit, 5=A great deal). | Assessed during the one-time 15-minute online survey experiment. |
| Intentions to Reduce Drinking | Intentions to reduce drinking were assessed once after participants viewed all three PWLs. Participants were asked to answer questions such as "How interested are you in reducing drinking in the next 6 months?" Participants responded to these questions on an appropriately labeled 5-point scale (e.g., 1 = Not at all interested, 2=Slightly interested, 3=Moderately interested, 4=Very interested, 5=Extremely interested). | Assessed during the one-time 15-minute online survey experiment. |
| Intentions to Stop Drinking | Intentions to stop drinking were assessed once after participants viewed all three PWLs. Participants were asked to answer three questions such as "How interested are you in stopping drinking in the next 6 months?" Participants responded to these questions on an appropriately labeled 5-point scale (e.g., 1 = Not at all interested, 2=Slightly interested, 3=Moderately interested, 4=Very interested, 5=Extremely interested). | Assessed during the one-time 15-minute online survey experiment. |
| BG001 | Non-Narrative Pictorial Warning Labels | Participants in this arm will be presented with three non-narrative pictorial warning labels (PWLs) for alcoholic beverages. Non-narrative PWLs contained graphic images of diseased organs (e.g., a closeup image of a mouth with rotten teeth and oral thrush) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. |
| BG002 | Total | Total of all reporting groups |
| years |
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| Sex/Gender, Customized | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| OG001 | Non-Narrative Pictorial Warning Labels | Participants in this arm will be presented with three non-narrative pictorial warning labels (PWLs) for alcoholic beverages. Non-narrative PWLs contained graphic images of diseased organs (e.g., a closeup image of a mouth with rotten teeth and oral thrush) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. |
|
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| Primary | Visit Count | Visit count measures the total number of times participants viewed an area of interest (AOI). Each warning label consisted of two AOIs: image AOI and text AOI. Visit count for each AOI was averaged across three PWLs within each arm. | Sticky's internal algorithms determined cases where the eye tracking data is less than "perfect" and only returns "usable" data. Thus, only usable eye tracking data were analyzed. | Posted | Mean | Standard Error | visit | Assessed during the one-time 15-minute online survey experiment. |
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|
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| Primary | Reactance | Reactance were measured after exposure to each PWL (i.e., three times in total). It was assessed using the brief Reactance to Health Warnings Scale (Hall et al., 2017). Participants were asked to indicate how much each warning tried to manipulate them, annoyed them, and was overblown (1 = not at all, 5 = a great deal). Reactance for each PWL was averaged across three PWLs within each arm. | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
|
| Primary | Affective Risk Perceptions | Affective risk perceptions were assessed once after participants viewed all three PWLs. Participants were asked to indicate how worried they are about getting a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1 = Not at all worried, 2=Slightly worried, 3=Moderately worried, 4=Very worried, 5=Extremely worried). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
|
| Primary | Experiential Risk Perceptions | Experiential risk perceptions were assessed once after participants viewed all three PWLs. Participants were asked to indicate how vulnerable they feel about getting a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1 = Not at all vulnerable, 2=Slightly vulnerable, 3=Moderately vulnerable, 4=Very vulnerable, 5=Extremely vulnerable). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
|
| Primary | Perceived Susceptibility | Perceived susceptibility were assessed once after participants viewed all three PWLs. Participants were asked to indicate how likely it is that they will get a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1 = Not at all likely, 2=A little likely, 3=Somewhat likely, 4=Very likely, 5=Extremely likely). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
|
| Primary | Comparative Risk | Comparative risk were assessed once after participants viewed all three PWLs. Participants were asked to indicate compared to an average person their age, race, and sex, how likely do they think they will get a specific type of cancer if they keep drinking the amount of alcohol like they do now. Participants responded on a five-point scale (1=Much less likely, 2=Less likely, 3=About as likely, 4=More likely, 5=Much more likely). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
|
| Primary | Perceived Severity of Harm | Perceived severity of harm were assessed once after participants viewed all three PWLs. Participants were asked to indicate how much getting a specific type of cancer because of drinking would affect their life. Participants responded on a five-point scale (1=Not at all, 2=Very little, 3=Somewhat, 4=Quite a bit, 5=A great deal). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
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| Primary | Intentions to Reduce Drinking | Intentions to reduce drinking were assessed once after participants viewed all three PWLs. Participants were asked to answer questions such as "How interested are you in reducing drinking in the next 6 months?" Participants responded to these questions on an appropriately labeled 5-point scale (e.g., 1 = Not at all interested, 2=Slightly interested, 3=Moderately interested, 4=Very interested, 5=Extremely interested). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
|
|
|
| Primary | Intentions to Stop Drinking | Intentions to stop drinking were assessed once after participants viewed all three PWLs. Participants were asked to answer three questions such as "How interested are you in stopping drinking in the next 6 months?" Participants responded to these questions on an appropriately labeled 5-point scale (e.g., 1 = Not at all interested, 2=Slightly interested, 3=Moderately interested, 4=Very interested, 5=Extremely interested). | Posted | Mean | Standard Error | score on a scale | Assessed during the one-time 15-minute online survey experiment. |
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|
| 0 |
| 0 |
| 0 |
| 0 |
| 0 |
| 0 |
| EG001 | Non-Narrative Pictorial Warning Labels | Participants in this arm will be presented with three non-narrative pictorial warning labels (PWLs) for alcoholic beverages. Non-narrative PWLs contained graphic images of diseased organs (e.g., a closeup image of a mouth with rotten teeth and oral thrush) and a text warning statement (e.g., WARNING: Drinking alcohol can cause oral cancer). The warnings focused on oral, esophageal, and laryngeal cancers, respectively. | 0 | 0 | 0 | 0 | 0 | 0 |
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| D009057 |
| Stomatognathic Diseases |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D004066 | Digestive System Diseases |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
| D010039 | Otorhinolaryngologic Neoplasms |
| D007818 | Laryngeal Diseases |
| D012140 | Respiratory Tract Diseases |
| D012142 | Respiratory Tract Neoplasms |
| D010038 | Otorhinolaryngologic Diseases |
| D004327 | Drinking Behavior |
| D001519 | Behavior |