Perceptions of and Reactions to Ultra-Processed Menu Label Designs

NCT ID: NCT07214805

Last Updated: 2025-11-10

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

RECRUITING

Clinical Phase

NA

Total Enrollment

12400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-09

Study Completion Date

2025-11-30

Brief Summary

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The primary objective of this study is to explore perceptions and understanding of different menu label designs related to ultra-processed foods (UPF). Participants will be randomized to view a fast-food online menu excerpt featuring one of sixteen labeling conditions and then will answer questions about the participant's reactions to and interpretations of the label, perceived label effectiveness, the intention to purchase a menu item with the label, as well as the participant's perceptions of fast-food menu items with and without the label.

Detailed Description

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This survey will explore the perceptions and understanding of different hypothetical UPF menu label designs. The survey research firm CloudResearch will recruit a sample of \~12,400 adults aged 18 years and older who reside in the United States.

This exploratory study will use a factorial experiment to assess different UPF label designs. Participants will be randomized to view a fast-food menu excerpt with one of sixteen labeling schemes, varying by message ("Ultra-Processed" vs. "Contains Food Additives" vs. "Warning: Ultra-Processed" vs. "Warning: UPF"), background and text color (red background with white text vs. yellow background with black text), and type (icon-plus-text vs. text-only). All menus will consist of a selection of food and beverage items, and select items will have the UPF label.

Participants will be shown the menu and the label in isolation and will then be asked about the participant's interpretations of the label, reactions to the label, perceived message effectiveness (PME) of the label, how helpful the participant finds the label to be, and the participant's intention to purchase a menu item with the label. The participants will also be shown two different individual fast-food items with the label to which the participant was randomized in random order and asked about the perceived appeal and healthfulness of the menu items.

The primary outcome will be intention to purchase a hypothetical menu item with the label. Secondary outcomes include label interpretation, perceived label understandability, perceived label believability, perception that the label grabbed attention, perceived message effectiveness (PME) of the label, perceived helpfulness of the label. Other outcomes include perceived level of appeal of menu items, and perceived level of healthfulness of menu items.

Conditions

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Food Choices

Keywords

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food labeling ultra-processed foods

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomized to view a fast-food online ordering menu with one of sixteen labeling schemes, varying by message ("Ultra-Processed" vs. "Contains Food Additives" vs. "Warning: Ultra-Processed" vs. "Warning: UPF"), background and text color (red with white text vs. yellow with black text), and type (icon-plus-text vs. text-only). Participants will be asked about a hypothetical intention to purchase a menu item with the label to which the participants were randomized.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Warning UPF, Yellow, Text-only Labels

A yellow text-only label that reads "WARNING: UPF" in black text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Warning UPF, Yellow, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Ultra-Processed, Red, Icon-plus-text Labels

A red icon-plus-text label that reads "ULTRA-PROCESSED" in white text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Ultra-Processed, Red, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Contains Food Additives, Red, Icon-plus-text Labels

A red icon-plus-text label that reads "CONTAINS FOOD ADDITIVES" in white text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Contains Food Additives, Red, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning Ultra-Processed, Red, Icon-plus-text Labels

A red icon-plus-text label that reads "WARNING: ULTRA-PROCESSED" in white text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Warning Ultra-Processed, Red, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning UPF, Red, Icon-plus-text Labels

A red icon-plus-text label that reads "WARNING: UPF" in white text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Warning UPF, Red, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Ultra-Processed, Yellow, Icon-plus-text Labels

A yellow icon-plus-text label that reads "ULTRA-PROCESSED" in black text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Ultra-Processed, Yellow, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Contains Food Additives, Yellow, Icon-plus-text Labels

A yellow icon-plus-text label that reads "CONTAINS FOOD ADDITIVES" in black text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Contains Food Additives, Yellow, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning Ultra-Processed, Yellow, Icon-plus-text Labels

A yellow icon-plus-text label that reads "WARNING: ULTRA-PROCESSED" in black text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Warning Ultra-Processed, Yellow, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning UPF, Yellow, Icon-plus-text Labels

A yellow icon-plus-text label that reads "WARNING: UPF" in black text will be placed beneath ultra-processed menu items. Labels will include a triangle icon with an exclamation point directly preceding the label text.

Group Type EXPERIMENTAL

Warning UPF, Yellow, Icon-plus-text Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Ultra-Processed, Red, Text-only Labels

A red text-only label that reads "ULTRA-PROCESSED" in white text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Ultra-Processed, Red, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Contains Food Additives, Red, Text-only Labels

A red text-only label that reads "CONTAINS FOOD ADDITIVES" in white text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Contains Food Additives, Red, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning Ultra-Processed, Red, Text-only Labels

A red text-only label that reads "WARNING: ULTRA-PROCESSED" in white text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Warning Ultra-Processed, Red, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning UPF, Red, Text-only Labels

A red text-only label that reads "WARNING: UPF" in white text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Warning UPF, Red, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Ultra-Processed, Yellow, Text-only Labels

A yellow text-only label that reads "ULTRA-PROCESSED" in black text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Ultra-Processed, Yellow, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Contains Food Additives, Yellow, Text-only Labels

A yellow text-only label that reads "CONTAINS FOOD ADDITIVES" in black text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Contains Food Additives, Yellow, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Warning Ultra-Processed, Yellow, Text-only Labels

A red text-only label that reads "WARNING: ULTRA-PROCESSED" in black text will be placed beneath ultra-processed menu items.

Group Type EXPERIMENTAL

Warning Ultra-Processed, Yellow, Text-only Labels

Intervention Type BEHAVIORAL

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Interventions

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Ultra-Processed, Red, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Contains Food Additives, Red, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning Ultra-Processed, Red, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning UPF, Red, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Red, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Ultra-Processed, Yellow, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Contains Food Additives, Yellow, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning Ultra-Processed, Yellow, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning UPF, Yellow, Icon-plus-text Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Yellow, Icon-plus-text labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Ultra-Processed, Red, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Contains Food Additives, Red, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning Ultra-Processed, Red, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning UPF, Red, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Red, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Ultra-Processed, Yellow, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Ultra-Processed, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Contains Food Additives, Yellow, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Contains Food Additives, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning Ultra-Processed, Yellow, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning Ultra-Processed, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Warning UPF, Yellow, Text-only Labels

Participants will view a fast-food restaurant menu excerpt. Each menu item will be displayed with an image of the item, name, price, and total calories. The Warning UPF, Yellow, Text-only labels will be displayed next to items that are ultra-processed. Participants will view the menu and then the label in isolation and then be asked about a hypothetical intention to purchase a menu item with the label.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* \- 18 years of age or older
* Member of the CloudResearch panel
* Residing in the United States

Exclusion Criteria

* \<18 years of age
* Not residing in the United States
* Completed the survey implausibly quickly based on the distribution of the time to complete the survey among all participants
* Failed the built-in Qualtrics survey fraud detection measures
* Failed attention check question included in the survey
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Johns Hopkins Bloomberg School of Public Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Julia Wolfson, PhD, MPP

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Bloomberg School of Public Health

Locations

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Johns Hopkins Bloomberg School of Public Health

Baltimore, Maryland, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Nina Carr, MPH, MBA

Role: CONTACT

Phone: 240-405-2823

Email: [email protected]

Other Identifiers

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5R01DK139327-02

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00034378-2

Identifier Type: -

Identifier Source: org_study_id