NCT02814604

Brief Summary

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.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,008

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Nov 2018

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 24, 2016

Completed
1 month until next milestone

First Posted

Study publicly available on registry

June 28, 2016

Completed
2.3 years until next milestone

Study Start

First participant enrolled

November 1, 2018

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 23, 2019

Completed
1 month until next milestone

Study Completion

Last participant's last visit for all outcomes

January 30, 2020

Completed
Last Updated

November 9, 2020

Status Verified

November 1, 2020

Enrollment Period

1.1 years

First QC Date

May 24, 2016

Last Update Submit

November 4, 2020

Conditions

Consumer BehaviorDiet, Food, and Nutrition

Keywords

Front-of-Pack LabellingStar rating systemTraffic light rating systemConsumer BehaviorHealth LiteracyMobile AppsNutrition LabelingHealthy food choicesHigh-in Warning Labels

Outcome Measures

Primary Outcomes (1)

  • The accurate characterization of healthfulness and nutritional content of foods as indicated by each intervention group will be compared.

    In the first series of experimental tasks, participants will be exposed to an image of a food package with the assigned FOP nutrition information and NFt. Participants will be asked to rate the products on how likely they would be to purchase the product, overall healthiness, and the relative amount of specific nutrients in the product (e.g., if the product contains a little or a lot of sodium) using a Likert scale. In the second series of tasks, participants will be shown 5 similar products side by side (5 breakfast cereals, 5 yogurts and 5 pasta dinners). Participants will be asked to rank the products from MOST HEALTHY to LEAST HEALTHY, and which product they would select if they were trying to consume a low sodium, low energy or high fibre diet.

    6 weeks

Secondary Outcomes (2)

  • A qualitative assessment of the functionality and usability of the smartphone app (FoodFLIP) will be assessed through questionnaires on a 5-point Likert Scale (the percentage of users finding the app easy to use/easy to understand etc).

    6 weeks

  • The health claims with or without additional labelling elements influence perceptions of healthiness and purchasing intentions will be compared between each FOP system.

    6 weeks

Study Arms (4)

Traffic Light

EXPERIMENTAL

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

Other: Nutrition Rating Systems

Health Star Rating System

EXPERIMENTAL

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

Other: Nutrition Rating Systems

Control

NO INTERVENTION

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.

High-in Warning Label

EXPERIMENTAL

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

Other: Nutrition Rating Systems

Interventions

Nutrition Rating SystemsOTHER

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

Also known as: Device: Smartphone
Health Star Rating SystemHigh-in Warning LabelTraffic Light

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Toronto

Toronto, Ontario, M5S3E2, Canada

Location

Related Publications (4)

  • 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.

    PMID: 14972060BACKGROUND

  • 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.

    PMID: 24669982BACKGROUND

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

    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.

    PMID: 22585907BACKGROUND

MeSH Terms

Conditions

Consumer Behavior

Condition Hierarchy (Ancestors)

Behavior

Study Officials

  • Mary R L'Abbe, Ph.D.

    University of Toronto

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
OTHER
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Earle W. McHenry Professor and Chair

Study Record Dates

First Submitted

May 24, 2016

First Posted

June 28, 2016

Study Start

November 1, 2018

Primary Completion

December 23, 2019

Study Completion

January 30, 2020

Last Updated

November 9, 2020

Record last verified: 2020-11

Data Sharing

IPD Sharing
Will not share

Locations

CA(1)