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| Name | Class |
|---|---|
| Stanford University | OTHER |
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The goal of this study is to determine whether eco-labels denoting more sustainable menu items improve the healthfulness of participants' entrée and appetizer selections from a restaurant menu. US adults will complete a restaurant ordering task in which they will select menu items to order from a mock restaurant menu modeled after a popular US sit-down restaurant. Participants will be randomized to a restaurant menu with or without eco-labels denoting more sustainable menu items. The investigators will record participants' selections from the menu. Participants will also answer survey questions.
The goal of this study is to determine whether eco-labels denoting more sustainable menu items improve the healthfulness of participants' entrée and appetizer selections. The survey research company Cloud Research will recruit a sample of approximately 3,100 US adults ages 18+ who read and speak English.
Participants will complete a between-subjects online randomized experiment. They will perform a restaurant ordering task in which they will select menu items to order from a mock restaurant menu modeled after a popular US sit-down restaurant. They will be randomized to 1 of 2 conditions: 1) eco-labels or 2) control. In the eco-labels condition, participants will order from a restaurant menu with eco-labels next to more sustainable menu items. In the control condition, participants will order from a restaurant menu without eco-labels. The investigators will record participants' selections from the menu. After completing the ordering task, participants will complete an online survey.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Eco-labels | Experimental | Participants will view a mock restaurant menu based on a popular US sit-down restaurant. They will be instructed to select the item or items they would like to order from the restaurant. The menu will display eco-labels next to more sustainable menu appetizers and entrees (i.e., appetizers and entrees that are in the bottom half of carbon footprints [i.e., greenhouse gas emissions in CO2-equivalents associated with production of the item] among appetizers and entrees). |
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| Control | No Intervention | Participants will view a mock restaurant menu based on a popular US sit-down restaurant. They will be instructed to select the item or items they would like to order from the restaurant. The menus will not display eco-labels. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Eco-Labels | Behavioral | Eco-labels will be displayed next to more sustainable restaurant menu items. The labels will display an earth icon and the words "ENVIRONMENTALLY FRIENDLY." |
| Measure | Description | Time Frame |
|---|---|---|
| Healthfulness of participants' entrée and appetizer selections | The study will assess the healthfulness of participants' entrée and appetizer selections as the average Ofcom Nutrient Profiling Model score of the entrees and appetizers the participants select in the restaurant ordering task. Ofcom Nutrient Profiling Model scores will be calculated for each item participants select. Items receive higher Ofcom scores when they contain lower calorie, saturated fat, sodium, and sugar density, higher protein and fiber density, and more fruits, vegetables, legumes, and nuts. The investigators will calculate the average score across participants' entrée and appetizer selections. The Ofcom Nutrient Profiling Model score ranges from 0 to 100, where higher scores indicate healthier products. | Through study completion, an average of 15 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Healthfulness of participants' restaurant selections | The study will assess the healthfulness of participants' restaurant selections as the average Ofcom Nutrient Profiling Model score of the menu items the participants select in the restaurant ordering task. Ofcom Nutrient Profiling Model scores will be calculated for each item participants select. Items receive higher Ofcom scores when they contain lower calorie, saturated fat, sodium, and sugar density, higher protein and fiber density, and more fruits, vegetables, legumes, and nuts. The investigators will calculate the average score across participants' selections. The Ofcom Nutrient Profiling Model score ranges from 0 to 100, where higher scores indicate healthier products. |
| Measure | Description | Time Frame |
|---|---|---|
| Liking of the eco-label | The study will assess the extent to which participants like the eco-label with 1 item: "I like this label." Response options will range from "Strongly disagree" (coded as 1) to "Strongly agree" (coded as 5). The investigators will dichotomize responses into agree (4 or 5, indicating participants like the ecolabel) vs. disagree or neutral (1-3, indicating participants do not like the ecolabel). |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Joshua Petimar, ScD | Harvard Pilgrim Health Care Institute | Principal Investigator |
| Anna Grummon, PhD | Stanford University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Harvard Pilgrim Health Care Institute | Boston | Massachusetts | 02215-3325 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40758354 | Derived | Grummon AH, Zeitlin AB, Lee CJY, Collis C, Cleveland LP, Musicus AA, Petimar J. Ecolabels and the Healthfulness and Carbon Footprint of Restaurant Meal Selections: A Randomized Clinical Trial. JAMA Netw Open. 2025 Aug 1;8(8):e2524773. doi: 10.1001/jamanetworkopen.2025.24773. |
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Investigators will post de-identified individual participant data in a public repository.
Investigators will post IDP within 6 months of publication of manuscripts associated with the data generated in this study.
Data and code will be made publicly available.
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| SAP | No | Yes | No | Statistical Analysis Plan | Jun 4, 2023 | Sep 10, 2024 | SAP_000.pdf |
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| ID | Term |
|---|---|
| D005518 | Food Preferences |
| D005247 | Feeding Behavior |
| ID | Term |
|---|---|
| D001519 | Behavior |
| D001522 | Behavior, Animal |
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| Through study completion, an average of 15 minutes |
| Calories selected from all items | The study will assess the number of calories participants select in the restaurant ordering task, calculated as the total number of calories selected across all menu items the participant selected in the restaurant ordering task. Higher values indicate higher calories selected. | Through study completion, an average of 15 minutes |
| Calories selected from entrees and appetizers | The study will assess the number of calories participants select from entrees and appetizers in the restaurant ordering task, calculated as the total number of calories selected across entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate higher calories selected. | Through study completion, an average of 15 minutes |
| Sodium selected from all items | The study will assess the amount of sodium participants select in the restaurant ordering task, calculated as the total sodium (in milligrams) selected across all menu items the participant selected in the restaurant ordering task. Higher values indicate higher sodium selected. | Through study completion, an average of 15 minutes |
| Sodium selected from entrees and appetizers | The study will assess the amount of sodium participants select from entrees and appetizers in the restaurant ordering task, calculated as the total sodium (in milligrams) selected across entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate higher sodium selected. | Through study completion, an average of 15 minutes |
| Saturated fat selected from all items | The study will assess the amount of saturated fat participants select in the restaurant ordering task, calculated as the total saturated fat (in grams) selected across all menu items the participant selected in the restaurant ordering task. Higher values indicate higher saturated fat selected. | Through study completion, an average of 15 minutes |
| Saturated fat selected from entrees and appetizers | The study will assess the amount of saturated fat participants select from entrees and appetizers in the restaurant ordering task, calculated as the total saturated fat (in grams) selected across entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate higher saturated fat selected. | Through study completion, an average of 15 minutes |
| Sugar selected from all items | The study will assess the amount of sugar participants select in the restaurant ordering task, calculated as the total sugar (in grams) selected across all menu items the participant selected in the restaurant ordering task. Higher values indicate higher sugar selected. | Through study completion, an average of 15 minutes |
| Sugar selected from entrees and appetizers | The study will assess the amount of sugar participants select from entrees and appetizers in the restaurant ordering task, calculated as the total sugar (in grams) selected across entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate higher sugar selected. | Through study completion, an average of 15 minutes |
| Fiber selected from all items | The study will assess the amount of fiber participants select in the restaurant ordering task, calculated as the total fiber (in grams) selected across all menu items the participant selected in the restaurant ordering task. Higher values indicate higher fiber selected. | Through study completion, an average of 15 minutes |
| Fiber selected from entrees and appetizers | The study will assess the amount of fiber participants select from entrees and appetizers in the restaurant ordering task, calculated as the total fiber (in grams) selected across entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate higher fiber selected. | Through study completion, an average of 15 minutes |
| Protein selected from all items | The study will assess the amount of protein participants select in the restaurant ordering task, calculated as the total protein (in grams) selected across all menu items the participant selected in the restaurant ordering task. Higher values indicate higher protein selected. | Through study completion, an average of 15 minutes |
| Protein selected from entrees and appetizers | The study will assess the amount of protein participants select from entrees and appetizers in the restaurant ordering task, calculated as the total protein (in grams) selected across entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate higher protein selected. | Through study completion, an average of 15 minutes |
| Carbon footprint of all items selected | The study will assess the carbon footprint of all items that participants select in the restaurant ordering task, calculated as the total carbon footprint (in CO2-equivalents) selected across all items the participant selected in the restaurant ordering task. Higher values indicate a larger carbon footprint of selected items. | Through study completion, an average of 15 minutes |
| Carbon footprint of entrees and appetizers selected | The study will assess the carbon footprint of all entrees and appetizers that participants select in the restaurant ordering task, calculated as the total carbon footprint (in CO2-equivalents) selected across all entrees and appetizers the participant selected in the restaurant ordering task. Higher values indicate a larger carbon footprint of selected items. | Through study completion, an average of 15 minutes |
| Noticing of eco-labels | The study will assess noticing of the eco-labels with 1 item: "When you were selecting items to order, did you notice any other labels next to menu items?" Response options will be "yes" (coded as 1) and "no" (coded as 0). | Through study completion, an average of 15 minutes |
| Thinking about the environmental effects of food | The study will assess thinking about the environmental effects of food while ordering with 1 item: "When you chose what to order from the menu, how much did you think about each of the following characteristics? Environmental sustainability." Response options will range from "Not at all" (coded as 1) to "A great deal" (coded as 5). Higher scores indicate more thinking about the environmental effects of food while ordering. | Through study completion, an average of 15 minutes |
| Thinking about the healthfulness of food | The study will assess thinking about the healthfulness of food while ordering with 1 item: "When you chose what to order from the menu, how much did you think about each of the following characteristics? Healthfulness." Response options will range from "Not at all" (coded as 1) to "A great deal" (coded as 5). Higher scores indicate more thinking about the healthfulness of food while ordering. | Through study completion, an average of 15 minutes |
| Thinking about the taste of food | The study will assess thinking about the taste of food while ordering with 1 item: "When you chose what to order from the menu, how much did you think about each of the following characteristics? Taste." Response options will range from "Not at all" (coded as 1) to "A great deal" (coded as 5). Higher scores indicate more thinking about the taste food while ordering. | Through study completion, an average of 15 minutes |
| Perceived sustainability of sustainable menu items | The study will assess perceived sustainability of sustainable menu items with 1 item: "How environmentally sustainable do you think this item is?" For this question, participants will be randomized to view an image of 1 of 13 more sustainable menu items. For participants in the ecolabels arm, the item will display an ecolabel. Response options will range from "Not at all" (coded as 1) to "Extremely" (coded as 5). Higher scores indicate higher perceived sustainability. | Through study completion, an average of 15 minutes |
| Perceived healthfulness of sustainable menu items | The study will assess perceived healthfulness of sustainable menu items with 1 item: "How healthy do you think this item is?" For this question, participants will be randomized to view an image of 1 of 13 more sustainable menu items. For participants in the ecolabels arm, the item will display an ecolabel. Response options will range from "Not at all" (coded as 1) to "Extremely" (coded as 5). Higher scores indicate higher perceived healthfulness. | Through study completion, an average of 15 minutes |
| Perceived tastiness of sustainable menu items | The study will assess perceived tastiness of sustainable menu items with 1 item: "How tasty do you think this item is?" For this question, participants will be randomized to view an image of 1 of 13 more sustainable menu items. For participants in the ecolabels arm, the item will display an ecolabel. Response options will range from "Not at all" (coded as 1) to "Extremely" (coded as 5). Higher scores indicate higher perceived tastiness. | Through study completion, an average of 15 minutes |
| Perceived sustainability of unsustainable menu items | The study will assess perceived sustainability of unsustainable menu items with 1 item: "How environmentally sustainable do you think this item is?" For this question, participants will be randomized to view an image of 1 of 13 less sustainable menu items. Response options will range from "Not at all" (coded as 1) to "Extremely" (coded as 5). Higher scores indicate higher perceived sustainability. | Through study completion, an average of 15 minutes |
| Perceived healthfulness of unsustainable menu items | The study will assess perceived healthfulness of unsustainable menu items with 1 item: "How healthy do you think this item is?" For this question, participants will be randomized to view an image of 1 of 13 less sustainable menu items. Response options will range from "Not at all" (coded as 1) to "Extremely" (coded as 5). Higher scores indicate higher perceived healthfulness. | Through study completion, an average of 15 minutes |
| Perceived tastiness of unsustainable menu items | The study will assess perceived tastiness of unsustainable menu items with 1 item: "How tasty do you think this item is?" For this question, participants will be randomized to view an image of 1 of 13 less sustainable menu items. Response options will range from "Not at all" (coded as 1) to "Extremely" (coded as 5). Higher scores indicate higher perceived tastiness. | Through study completion, an average of 15 minutes |
| Through study completion, an average of 15 minutes |
| Wanting to see the eco-label on restaurant menus | The study will assess the extent to which participants want to see the eco-label on restaurant menus with 1 item: "I want to see this label on menus next to foods that are more environmentally sustainable." Response options will range from "Strongly disagree" (coded as 1) to "Strongly agree" (coded as 5). The investigators will dichotomize responses into agree (4 or 5, indicating participants want to see the label on restaurant menus) vs. disagree or neutral (1-3, indicating participants do not want to see the label on restaurant menus). | Through study completion, an average of 15 minutes |
| Label helpfulness in choosing more environmentally sustainable foods | The study will assess the extent to which participants think the ecolabel helps them choose more sustainable foods with 1 item: "This label would help me choose more environmentally sustainable foods." Response options will range from "Strongly disagree" (coded as 1) to "Strongly agree" (coded as 5). The investigators will dichotomize responses into agree (4 or 5, indicating participants think the ecolabel helps them choose more sustainable foods) vs. disagree or neutral (1-3, indicating participants do not think the ecolabel helps them choose more sustainable foods). | Through study completion, an average of 15 minutes |
| Perceptions of control over making sustainable eating decisions | The study will assess the extent to which participants perceive that the ecolabel makes them feel more in control of making sustainable eating decisions with 1 item: "This label makes me feel more in control of making sustainable eating decisions." Response options will range from "Strongly disagree" (coded as 1) to "Strongly agree" (coded as 5). The investigators will dichotomize responses into agree (4 or 5, indicating participants perceive the ecolabel increases control over making sustainable eating decisions) vs. disagree or neutral (1-3, indicating participants do not perceive that the ecolabel increases control). | Through study completion, an average of 15 minutes |