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FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods

NCT ID: NCT02814604

Last Updated: 2020-11-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2008 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-11-01

Study Completion Date

2020-01-30

Brief Summary

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There is a lot of confusion when it comes to understanding nutrition information on food packages, thus making it difficult for consumers to choose healthy products. In today's busy and fast-paced shopping environment, mobile digital technology (for example, Smartphone applications) can help consumers make 'healthier' food choices when they are shopping. This study aims to test the effectiveness of a traffic light front-of-pack system, the Health Star Rating System (HSR or Star System), and the proposed sodium, saturated fat and sugar warning labels proposed by Health Canada. The study will also experimentally test the use of a Smartphone application (app), FoodFlip, to help educate consumers on these systems on food packages to explore the impact of a learning effect on the efficacy of the labelling systems.

Detailed Description

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The rising rate of obesity and diet-related chronic diseases illustrate that Canadians' eating habits need to change. Equipping Canadians with information and tools to enable healthy food choices that decrease risk for disease is imperative. While the Nutrition Facts table (NFt) is the most standardized and complete form of nutrition labelling, studies have shown that consumers are confused about serving size, nutrient quantities, and the interpretation of the % Daily Value. Thus, expert groups have proposed the introduction of interpretive front-of-pack (FOP) nutrition rating systems (e.g. traffic light labelling or star ratings) that also help consumers understand the significance of the levels of nutrients in relation to the "healthiness" of a food. One of the main barriers to the introduction of such a system is the absence of high quality studies that objectively measure the impact of nutrition information on actual food purchases. This is a consequence of both the practical challenges associated with designing and conducting such studies in 'real-world' settings, and the lack of food industry support to quantitatively examine or publish the potential for enhanced nutrition labels to modify consumer food choices. With the growing burden of diet-related disease, there is an urgent need for robust evidence to evaluate the potential for additional interpretive nutrition labelling systems to modify and improve food purchasing patterns. Given the relative ubiquity of mobile digital technologies, our Canadian Smartphone application (FoodFLIP) provides us with an unprecedented opportunity to examine and improve consumers' diets.

This study will investigate whether a traffic light, a health star rating or a high-in warning label FOP system can help consumers identify and purchase healthier foods.

Objective 1: To evaluate the effects of three FOP systems in helping consumers characterize healthfulness and nutritional content of food items.

Objective 2: To determine which of the three FOP systems support healthier food choices and are preferred by Canadian consumers.

Conditions

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Consumer Behavior Diet, Food, and Nutrition

Keywords

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Front-of-Pack Labelling Star rating system Traffic light rating system Consumer Behavior Health Literacy Mobile Apps Nutrition Labeling Healthy food choices High-in Warning Labels

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Traffic Light

Participants in this group will download an app which features the nutrition information of the selected product in a multiple coloured traffic light format (i.e. the traffic light system shows a coloured round indicator for each of saturated fat, sugar, and sodium; shaded red (high), amber (medium) or green (low), according to thresholds set for each nutrient). In addition, a list of healthier similar products will appear on screen to facilitate comparisons.

Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems

Group Type EXPERIMENTAL

Nutrition Rating Systems

Intervention Type OTHER

Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.

Health Star Rating System

Participants in this group will download an app which features the nutrition information of the selected product in a form of 0-5 stars to provide an overall "healthy" rating. The Health Star Rating provides a rating for all products and products not meeting the criteria still carry the symbol (with no colored stars). In addition, a list of healthier similar products will appear on screen to facilitate comparisons.

Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems

Group Type EXPERIMENTAL

Nutrition Rating Systems

Intervention Type OTHER

Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.

Control

Participants in this group will only see the Nutrition Facts Table (as it appears on the product's package) when the product is scanned in the app.

Group Type NO_INTERVENTION

No interventions assigned to this group

High-in Warning Label

Participants in this group will download an app which features the nutrition information of the selected product in a 'high-in' warning label format (i.e. stop signs for each of saturated fat, sugar, and sodium; according to thresholds set for each nutrient). In addition, a list of healthier similar products will appear on screen to facilitate comparisons.

Intervention: Device:Smartphone, Behavioural: Nutrition Rating Systems

Group Type EXPERIMENTAL

Nutrition Rating Systems

Intervention Type OTHER

Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.

Interventions

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Nutrition Rating Systems

Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.

Intervention Type OTHER

Other Intervention Names

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Device: Smartphone

Eligibility Criteria

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Inclusion Criteria

* Shop at a supermarket owned by one of the largest four national retailers at least twice a month. This includes Loblaws, Sobeys, Metro or Safeway
* Own a smartphone (iPhone version 3 or later or android)
* Are 18 years or over and provide informed consent to participate
* Reside in Canada, excluding Northern Territories
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Heart and Stroke Foundation of Canada

OTHER

Sponsor Role collaborator

Dietitians of Canada

UNKNOWN

Sponsor Role collaborator

University of Toronto

OTHER

Sponsor Role lead

Responsible Party

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Mary L'Abbe

Earle W. McHenry Professor and Chair

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mary R L'Abbe, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Toronto

Locations

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University of Toronto

Toronto, Ontario, Canada

Site Status

Countries

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Canada

References

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Key TJ, Schatzkin A, Willett WC, Allen NE, Spencer EA, Travis RC. Diet, nutrition and the prevention of cancer. Public Health Nutr. 2004 Feb;7(1A):187-200. doi: 10.1079/phn2003588.

Reference Type BACKGROUND
PMID: 14972060 (View on PubMed)

Emrich TE, Qi Y, Mendoza JE, Lou W, Cohen JE, L'abbe MR. Consumer perceptions of the Nutrition Facts table and front-of-pack nutrition rating systems. Appl Physiol Nutr Metab. 2014 Apr;39(4):417-24. doi: 10.1139/apnm-2013-0304. Epub 2013 Oct 24.

Reference Type BACKGROUND
PMID: 24669982 (View on PubMed)

The Standing Committee on Health. Healthy Weights for Healthy Kids. 2007

Reference Type BACKGROUND

McGuire S. Institute of Medicine. 2012. Front-of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. Washington, DC: The National Academies Press. Adv Nutr. 2012 May 1;3(3):332-3. doi: 10.3945/an.112.001933. No abstract available.

Reference Type BACKGROUND
PMID: 22585907 (View on PubMed)

Other Identifiers

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499174

Identifier Type: -

Identifier Source: org_study_id