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This randomized controlled online experiment will test whether adding an ultra-processed food (UPF) warning label to the FDA's proposed Nutrition Information Box (NIB) changes consumer perceptions of UPFs among a nationally representative sample of U.S. adults.
Participants will be randomized to one of four label conditions and will evaluate four UPF yogurt products with different nutritional profiles on the NIB. The primary outcome is purchase intent and the secondary outcomes are perceived healthfulness, perceived usefulness and correct identification of UPF products.
This experiment aims to answer the following questions:
Do UPF warning labels reduce purchase intentions compared to the NIB alone? Do UPF warning labels reduce perceived healthfulness compared to the NIB alone? Do UPF warning labels help more consumers correctly identify products as ultra-processed compared to the NIB alone? Do different UPF warning label color designs differ in effectiveness at reducing purchase intentions, lowering perceived healthfulness, and improving correct identification of UPFs?
Researchers will compare outcomes across the four randomized arms to estimate the independent effect of adding UPF warnings beyond nutrient disclosure in the NIB alone.
Four-arm parallel randomized controlled trial (RCT) in a nationally representative online survey. Participants (n≈7,000) will view identical product images with different UPFWL: NIB only Control, NIB + UPF label Yellow, NIB + UPF label Red, NIB + UPF label Black.
Between-subjects design. Each participant will see one label condition across four products (presented in a random order). Outcomes will be measured via Likert scales and binary classification. Randomization implemented in Qualtrics with simple equal allocation. After viewing each product participants will answer questions about the intention to purchase the product, how healthy the participant thinks the product is, and whether or not the product is a UPF. After presentation of the 4 products, the label will be displayed again and participants will answer questions about how useful the participant thinks the label is for making decisions about how well a food fits into a healthy diet.
The investigators hypothesize that all UPF warning labels (UPFWL) will be more effective than the Nutrition Information Box (NIB) alone, with the red UPF warning label being the most effective, followed by the yellow label, and the black label being the least effective at reducing purchase intention, lowering perceived healthfulness, increasing perceived usefulness, and improving correct identification of ultra-processed products.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | Active Comparator | NIB only |
|
| NIB + UPFWL 1 | Experimental | NIB + UPF Warning Label Yellow |
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| NIB + UPFWL 2 | Experimental | NIB + UPF Warning Label Red |
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| NIB + UPFWL 3 | Experimental | NIB + UPF Warning Label Black |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Label exposure in mock-up UPF products | Behavioral | This intervention consists of exposure to ultra-processed warning label (UPFWL) conditions embedded within the FDA Nutrition Information Box (NIB). Participants view mock-ups of ultra-processed yogurt products displaying either the NIB alone or the NIB combined with a UPFWL (yellow, red, or black). This intervention experimentally isolates the incremental effect of adding a processing-based warning across products with varying nutritional profiles, providing evidence on how UPFWL, independent of nutrient content, can alter purchase intent, identification of UPFs and perceived healthfulness. |
| Measure | Description | Time Frame |
|---|---|---|
| Purchase Intent | Likelihood of purchasing each product measured on a 5-point Likert scale from 1 = "Very unlikely" to 5 = "Very likely" indicating how likely the participant would be to buy the product in the next week if it were available in a store. Higher scores indicate greater purchase intent. | Immediately after label exposure |
| Measure | Description | Time Frame |
|---|---|---|
| Correct Identification of UPF | Binary variable (1 = correctly identifies product as ultra-processed; 0 = incorrect). Participants indicate whether the participant thinks the product is ultra-processed | Immediately after label exposure |
| Perceived Healthfulness |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Julia Wolfson, PhD | Johns Hopkins University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins Bloomberg School of Public Health | Baltimore | Maryland | 21205 | United States |
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| ID | Term |
|---|---|
| D003258 | Consumer Behavior |
| ID | Term |
|---|---|
| D001519 | Behavior |
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Participants will view four UPF yogurt products of different nutritional profiles (presented in random order). Participants will be randomized to view the yogurt products with one of four labeling schemes applied: (1) NIB only Control, (2) NIB + UPF label Yellow, (3) NIB + UPF label Red, (4) NIB + UPF label Black. After viewing each product, participants will answer survey questions to assess the intention to purchase the product and the perceived healthfulness of the product, and correct identification of UPF products. Then, the participant will view the assigned label again and answer an additional question about how useful the label is.
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Participants rate each product on a 5-point Likert scale from 1 = "Very unhealthy" to 5 = "Very healthy" indicating how good or bad for health, the participant believes it would be to consume the product every day. Higher scores indicate greater perceived healthfulness. |
| Immediately after label exposure |
| Perceived Usefulness | Participants rate each label on a 5-point Likert scale from 1 = "Not at all confident" to 5 = "Extremely confident" indicating how confident the participant is that the label could be used to help make decisions about how well the food fits into a healthy diet. Higher scores indicate greater perceived usefulness of the label. | Immediately after label exposure |