Impact of Front-of-package Warning Labels on Perceived Weight Stigmatization

NCT ID: NCT06179043

Last Updated: 2024-02-13

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

2522 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-18

Study Completion Date

2024-01-26

Brief Summary

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The goal of this experiment is to examine the effects of three different types of front-of-package warning labels for sugar-sweetened beverages on perceived weight stigmatization, as well as the effect of making such labels more weight-neutral. The main questions this experiment aims to answer are:

* Are certain types of front-of-package warning labels perceived as more stigmatizing than others?
* Are more weight-neutral versions of front-of-package warning labels perceived as less stigmatizing than their regular versions?
* Is there a trade-off between label effectiveness in discouraging product consumption and perceived weight stigmatization?

Additionally, this experiment also aims to answer the following questions:

* Does exposure to certain types of front-of-package warning labels lead to changes in participants' weight bias?
* Are changes in participants' weight bias as a result of label exposure mediated by attribution of personal responsibility for body weight, pathogen disgust, or perceived social consensus?

Detailed Description

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Participants will be randomly assigned to see one of four types of labels: control labels, nutrient warning labels, text-only health warning labels, or graphic health warning labels. Participants will then see an image depicting different types of fictional sugar-sweetened beverages carrying the label type that they were assigned to. Participants will see this image twice, in random order, each time differing in whether the label is weight-neutral or not (i.e., whether the label references calories/obesity or not). Each time, participants will answer survey questions about the label. Last, participants will answer survey questions measuring their weight bias and potential mediating variables.

Conditions

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Weight Stigma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Between-subjects intervention: label type (4 arms); Within-subjects intervention: regular or weight-neutral version of label (2 versions).
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Control labels

Individuals in this trial arm will see neutral control labels on sugar-sweetened beverages.

Group Type SHAM_COMPARATOR

Control labels

Intervention Type BEHAVIORAL

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* A neutral bar code label
* A neutral quick response (QR) code label (not scannable)

Nutrient warning labels

Individuals in this trial arm will see nutrient warning labels on sugar-sweetened beverages.

Group Type EXPERIMENTAL

Nutrient warning labels

Intervention Type BEHAVIORAL

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* Labels that read "high in sugars" and "high in calories"
* A label that reads "high in sugars"

Text-only health warning labels

Individuals in this trial arm will see text-only health warning labels on sugar-sweetened beverages.

Group Type EXPERIMENTAL

Text-only health warning labels

Intervention Type BEHAVIORAL

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay"
* A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay"

Graphic warning labels

Individuals in this trial arm will see graphic health warning labels on sugar-sweetened beverages.

Group Type EXPERIMENTAL

Graphic health warning labels

Intervention Type BEHAVIORAL

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay" and contains graphics illustrating obesity, type 2 diabetes, and tooth decay
* A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay" and contains graphics illustrating type 2 diabetes and tooth decay

Interventions

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Nutrient warning labels

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* Labels that read "high in sugars" and "high in calories"
* A label that reads "high in sugars"

Intervention Type BEHAVIORAL

Text-only health warning labels

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay"
* A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay"

Intervention Type BEHAVIORAL

Graphic health warning labels

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* A label that reads "Drinking beverages with added sugars contributes to obesity, type 2 diabetes and tooth decay" and contains graphics illustrating obesity, type 2 diabetes, and tooth decay
* A label that reads "Drinking beverages with added sugars contributes type 2 diabetes and tooth decay" and contains graphics illustrating type 2 diabetes and tooth decay

Intervention Type BEHAVIORAL

Control labels

In random order, participants in this arm will see an image of fictional sugar-sweetened beverages carrying:

* A neutral bar code label
* A neutral quick response (QR) code label (not scannable)

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* At least 21 years of age.
* Residing in the US.

Exclusion Criteria

-Involved in any pre-testing.
Minimum Eligible Age

21 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Stanford University

OTHER

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aline D'Angelo Campos, MPP

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Locations

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University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status

Countries

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United States

References

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Grummon AH, Gibson LA, Musicus AA, Stephens-Shields AJ, Hua SV, Roberto CA. Effects of 4 Interpretive Front-of-Package Labeling Systems on Hypothetical Beverage and Snack Selections: A Randomized Clinical Trial. JAMA Netw Open. 2023 Sep 5;6(9):e2333515. doi: 10.1001/jamanetworkopen.2023.33515.

Reference Type BACKGROUND
PMID: 37703015 (View on PubMed)

Hayward LE, Vartanian LR. Potential unintended consequences of graphic warning labels on sugary drinks: do they promote obesity stigma? Obes Sci Pract. 2019 Aug 2;5(4):333-341. doi: 10.1002/osp4.353. eCollection 2019 Aug.

Reference Type BACKGROUND
PMID: 31452918 (View on PubMed)

D'Angelo Campos A, Grummon AH, Ng SW, Puhl RM, Golden SD, Hall MG. Front-of-Package Food Labels and Perceived Weight Stigmatization: A Randomized Clinical Trial. JAMA Netw Open. 2025 Jun 2;8(6):e2516821. doi: 10.1001/jamanetworkopen.2025.16821.

Reference Type DERIVED
PMID: 40540266 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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23-3069

Identifier Type: -

Identifier Source: org_study_id

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