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

NCT06179043 | Completed

• 1 other identifier: 23-3069
• Study Type: interventional
• Target: 2,522
• Locations: 1 country
• Sites: 1

Brief Summary

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?

Conditions

Weight Stigma

Outcome Measures

Primary Outcomes (1)

• Perceived weight stigmatization, mean score

  Stigmatization of people with obesity will be measured by survey through a three-item scale. Items will inquire about how much participants perceive the label to (1) stigmatize people with obesity, (2) promote negative stereotypes about people with obesity, and (3) portray people with obesity in a disrespectful manner. Response options will be on a 1 to 5 scale, with higher scores representing a higher perceived weight stigmatization by the study labels. Each participant's responses to each item will be combined to obtain their final score on the outcome.

  Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.

Secondary Outcomes (2)

• Perceived message effectiveness, mean score

  Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.

• Weight bias, mean score

  Immediately after exposure to intervention (i.e., study stimuli), assessed during one-time online study survey.

Study Arms (4)

Control labels

SHAM COMPARATOR

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

Behavioral: Control labels

Nutrient warning labels

EXPERIMENTAL

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

Behavioral: Nutrient warning labels

Text-only health warning labels

EXPERIMENTAL

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

Behavioral: Text-only health warning labels

Graphic warning labels

EXPERIMENTAL

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

Behavioral: Graphic health warning labels

Interventions

Nutrient warning labels 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"

Nutrient warning labels

Text-only health warning labels 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"

Text-only health warning labels

Graphic health warning labels 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

Graphic warning labels

Control labels 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)

Control labels

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

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

You may not qualify if:

• Involved in any pre-testing.

Sponsors & Collaborators

• University of North Carolina, Chapel Hill: lead
• Stanford University: collaborator

Study Sites (1)

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, 27516, United States

Location

Related Publications (3)

• 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.

  PMID: 37703015 BACKGROUND

• 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.

  PMID: 31452918 BACKGROUND

• 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.

  PMID: 40540266 DERIVED

MeSH Terms

Conditions

Weight Prejudice

Condition Hierarchy (Ancestors)

Prejudice; Social Behavior; Behavior

Study Officials

• Aline D'Angelo Campos, MPP

  University of North Carolina, Chapel Hill

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

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

Study Record Dates

• First Submitted: December 11, 2023
• First Posted: December 21, 2023
• Study Start: January 18, 2024
• Primary Completion: January 26, 2024
• Study Completion: January 26, 2024
• Last Updated: February 13, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ANALYTIC CODE
• Time Frame: Upon publication of the study.
• Access Criteria: No access criteria. The dataset and analytic code will be made publicly available at Open Science Framework.

Locations

US (1)