Using FoodFlip© to Improve Food Choices Among Post-secondary Students

NCT06033911 | Completed

• 2 other identifiers: 508519CIHR UD1-170157
• Study Type: interventional
• Target: 133
• Locations: 1 country
• Sites: 1

Brief Summary

Canada passed mandatory front-of-package labelling (FOPL) regulations where pre-packaged food and beverage products that are high in sugar, saturated fat, and/or sodium are required to display a 'high-in' front-of-pack nutrition symbol (NS). FOPL is an effective tool to inform consumers about products that can harm health and help guide their purchasing decisions. However, as the regulations are limited to the pre-packaged food supply and do not apply to restaurants and other food services, little is known about the potential impact of the NS in such settings. Therefore, the objective of the present study is to investigate the impact of the Canadian FOPL (i.e. the 'high-in' NS) as delivered through a mobile health (mHealth) app in a setting currently not subject to regulations. The study will take place on a post-secondary campus (University of Toronto) hosting students, a population vulnerable to poor dietary choices, nutritional knowledge, and associated weight gain. A 2-week long, randomized controlled trial with a 3-parallel arm study design will be conducted to explore the effect of the 'high-in' NS on students' purchasing behaviours and nutritional knowledge. Eligible participants will be randomly allocated into one of 3 intervention groups: no App control; App control with no NS; App with NS. Questionnaires will be used to assess nutritional knowledge, and receipts will be used to analyze purchasing behaviour.

Conditions

Healthy Diet

Keywords

front-of-package labeling; post-secondary foods; university foods; universities; mobile applications; mobile health; smartphone

Outcome Measures

Primary Outcomes (2)

• Purchasing Behaviors

  Purchasing behaviours will be assessed using receipts and/or records provided by participants over the 2-week study period. Nutritional quality of purchased menu items will be determined using a nutrient profiling model based on the thresholds for Canada's FOPL regulations. Menu items will be assigned a "Menu item score" on a scale of 0 (minimum) to 3 (maximum), with 0 indicating no 'high-in' nutrients and 3 being 'high-in' all 3 nutrients-of-concern. Scores of each menu item purchased will be summed and divided by the total number of purchases to derive the final score for each participant; higher scores mean lower nutritional quality (i.e. worse outcome) and lower scores mean higher nutritional quality (i.e. better outcome). The final scores will then be compared between intervention groups, and change in nutritional quality will be compared within intervention groups at 2 time points: early intervention (end of Week 1) and late intervention (end of study period).

  2 weeks

• Nutritional Knowledge

  Nutritional knowledge will be assessed using an online questionnaire developed and validated by the L'Abbe Lab. Questionnaire will be completed by participants at 1) baseline and 2) end-of-study. This short (10-15 min) survey of 30 short questions will include questions assessing health literacy and nutritional knowledge that have been adapted from validated questionnaires. Correct answers will be coded as "1" while incorrect answers will be coded as "0", with a maximum of 30 points. Higher scores indicate higher nutritional knowledge (i.e. better outcome), and lower scores indicate lower nutritional knowledge (i.e. worse outcome). Between intervention groups differences in nutritional knowledge will be assessed using ANOVA, while changes in nutritional knowledge from baseline to end-of-study will be compared within intervention groups using Mann-Whitney U-tests.

  2 weeks

Study Arms (3)

No App

NO INTERVENTION

No intervention. Participants will be given access to a web-based submission portal.

FoodFlip© App with no nutrition symbol

PLACEBO COMPARATOR

Intervention control: participants will have access to food information in the shape of a Nutrition Facts table through FoodFlip©. Participants will have access to a submission portal linked to their study ID through the app.

Device: FoodFlip© App with no nutrition symbol

FoodFlip© App with 'high-in' nutrition symbol

ACTIVE COMPARATOR

Intervention: Participants will have access to food information through FoodFlip© with Health Canada's 'high-in' nutrition symbol. ©. Participants will have access to a submission portal linked to their study ID through the app.

Device: FoodFlip© App with 'high-in' nutrition symbol

Interventions

FoodFlip© App with no nutrition symbol DEVICE

Intervention control: participants will have access to food information such as calories or the Nutrition Facts table through FoodFlip©

FoodFlip© App with no nutrition symbol

FoodFlip© App with 'high-in' nutrition symbol DEVICE

Intervention: Participants will have access to food information through FoodFlip© with Canada's 'high-in' NS

FoodFlip© App with 'high-in' nutrition symbol

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ≥18 years of age
• enrolled at UofT
• have regular access to either iPhone or Android
• purchases at least one meal a day on campus
• able to speak and read English
• not currently pregnant or in lactation

You may not qualify if:

• \<18 years of age
• not enrolled at UofT
• does not have access to a smartphone
• does not purchase at least one meal a day on campus
• unable to speak and read English
• currently pregnant or in lactation

Sponsors & Collaborators

• University of Toronto: lead

Study Sites (1)

Department of Nutritional Sciences, University of Toronto

Toronto, Ontario, M5S 1A8, Canada

Location

Related Publications (20)

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  BACKGROUND

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  BACKGROUND

Study Officials

• Mary R L'Abbe, PhD

  University of Toronto

  PRINCIPAL INVESTIGATOR

• Hayun Jeong, HBSc

  University of Toronto

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Participants will be allocated into one of 3 groups: (i) no App control; (ii) App without 'high-in' nutrition symbol; (iii) App with Canada's 'high-in' nutrition symbol
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor Emeritus, CM, PhD

Model Details: 2-week long, single-blinded randomized controlled trial with a 3-parallel arm.

Study Record Dates

• First Submitted: September 5, 2023
• First Posted: September 13, 2023
• Study Start: January 29, 2024
• Primary Completion: April 22, 2024
• Study Completion: May 1, 2024
• Last Updated: March 30, 2025

Record last verified: 2025-03

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)