Testing Non-Nutrition Menu Labels on Food Selections

NCT07536126 | Not Yet Recruiting

• 1 other identifier: IRB00035394-1
• Study Type: interventional
• Target: 7,000
• Locations: 1 country
• Sites: 1

Brief Summary

The primary objective of this study is to test the relative effects of environmental harm menu label designs on the healthfulness of consumers' fast-food meal choices. Participants will complete hypothetical online meal ordering tasks using a survey which emulates the online menus of two types of fast-food chain restaurants: a burger restaurant and a sandwich restaurant. Participants will be randomized the view both menus, presented in random order, with one of five labeling conditions applied. Secondary objectives include energy and nutrient content of meals ordered, prices of meals ordered, and, through a post-order survey, noticeability of the labels and perceptions of labels between the conditions.

Conditions

Food Selection

Keywords

food labeling; ecolabeling; choice behavior

Outcome Measures

Primary Outcomes (1)

• Modified Nutrient Profile Index score

  The primary outcome measure will be the healthfulness of the fast-food meal selections, measured with a modified Nutrient Profile Index (NPI) score. NPI scores are based on the United Kingdom (UK) Ofcom Nutrient Profiling Model, which is used to score individual foods in the UK to determine which ones can be marketed to children. The NPI is a 0 to 100-point score for foods; a score of \>=64 is considered healthy. Higher score is better.

  Immediately upon viewing the menus

Secondary Outcomes (16)

• Nutrient Profile Index score

  Immediately upon viewing the menus

• Number of Participants who Notice labels (Attention to label)

  Immediately after viewing the menus

• Number of Participants who Recall Label Purpose

  Immediately after viewing the menus

• Number of Participants Who Use of label

  Immediately after viewing the menus

• Participant's Perceived label believability

  Immediately after viewing the menu excerpt and label image

Study Arms (5)

Control (QR) Labels

PLACEBO COMPARATOR

A black label featuring a QR code and white text that reads "SCAN HERE" will be placed beneath all main menu items on two restaurant menus. Explanatory text describing the label's meaning will be displayed at the top of the menu.

Behavioral: Control (QR) Labels

Low Environmental Harm Labels

EXPERIMENTAL

A green icon-plus-text label that reads "LOW ENVIRONMENTAL HARM" in white text against a green background will be placed on two restaurant menus beneath main menu items that are less harmful to the environment compared to unlabeled main menu items, based on use of cropland, pastureland, and water. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu.

Behavioral: Low Environmental Harm Labels

High Environmental Harm Labels

EXPERIMENTAL

A red icon-plus-text label that reads "HIGH ENVIRONMENTAL HARM" in white text against a red background will be placed on two restaurant menus beneath main menu items that are more harmful to the environment compared to unlabeled main menu items, based on use of cropland, pastureland, and water. Labels will include a white globe icon directly preceding the label text. Explanatory text describing the label's meaning will be displayed at the top of the menu.

Behavioral: High Environmental Harm Labels

Environmental Harm Traffic Light Labels

EXPERIMENTAL

Traffic Light labels will be placed on two restaurant menus beneath all main menu items. Using estimated cropland, pastureland, and water use, each item will be assigned one of three icon-plus-text labels within this scheme: low-, medium-, or high-impact label. Each will read, "HIGH ENVIRONMENTAL HARM" within a red label, "MED. ENVIRONMENTAL HARM" in a yellow label, and "LOW ENVIRONMENTAL HARM" in a green label. Text for all labels will be written in white, and a white globe icon will precede the text. Explanatory text describing the meaning of the labels will be displayed at the top of the menu.

Behavioral: Environmental Harm Traffic Light Labels

Environmental Grade Labels

EXPERIMENTAL

Environmental Grade labels will be placed on two restaurant menus beneath all main menu items, using estimated cropland, pastureland, and water use to assign one of five icon-plus-text labels which indicate a specific environmental grade (A, B, C, D, and F). All labels are solid black with a white globe icon followed by white text which reads "ENVIRONMENTAL GRADE". On the left side of each label, a grade is displayed, capitalized and in a white font within a solid-colored box. The color of the box corresponds with each letter grade: A = dark green, B = light green, C = yellow, D = orange, F = red. Beneath the letter grade, a gradient of all possible grades is displayed horizontally in smaller font, each grade atop a small solid box in the respective grade color. Explanatory text describing the meaning of the labels will be displayed at the top of the menu.

Behavioral: Environmental Grade Labels

Interventions

Control (QR) Labels BEHAVIORAL

Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Control (QR) labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).

Control (QR) Labels

Low Environmental Harm Labels BEHAVIORAL

Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Low Environmental Harm labels will be displayed beneath a subset of items. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).

Low Environmental Harm Labels

Environmental Harm Traffic Light Labels BEHAVIORAL

Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Harm Traffic Light labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).

Environmental Harm Traffic Light Labels

Environmental Grade Labels BEHAVIORAL

Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Grade labels will be displayed beneath each item. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).

Environmental Grade Labels

High Environmental Harm Labels BEHAVIORAL

Participants will view two fast-food restaurant menus presented in a random order. Each menu will include main, side, dessert, and drink items, and each menu item will be displayed with an image of the item, name, price, and total calories. For main items only, Environmental Harm labels will be displayed beneath select items. Participants will be instructed to select at least 1 and up to 4 menu items for a hypothetical meal order. Participants will be required to select a main item and, optionally, up to 3 additional items (drinks, sides, desserts).

High Environmental Harm Labels

Eligibility Criteria

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

You may qualify if:

• years of age or older
• Member of the Verasight Panel
• Residing in the United States

You may not qualify if:

• \<18 years of age
• Not residing in the United States
• Completed the survey in less than one-third of the median completion duration of all participants
• Respondents with high refusal rates (skipped or refused more than 50% of questions)
• Respondents who 'straight-line' all question grids with 6 or more items, where responses are not internally consistent

Sponsors & Collaborators

• Johns Hopkins Bloomberg School of Public Health: lead

Study Sites (1)

Johns Hopkins Bloomberg School of Public Health

Baltimore, Maryland, 21205, United States

Location

MeSH Terms

Conditions

Food Preferences

Interventions

Product Labeling

Condition Hierarchy (Ancestors)

Feeding Behavior; Behavior

Intervention Hierarchy (Ancestors)

Product Packaging; Industry; Technology, Industry, and Agriculture

Study Officials

• Julia Wolfson, PhD MPP

  Johns Hopkins Bloomberg School of Public Health

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Nina M Carr, MPH, MBA

CONTACT

2404052823; ncarr6@jhu.edu

Study Design

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

Model Details: Participants will be randomized to view two fast-food menus presented in random order with one of five labeling schemes applied: (1) a QR code on all items (control); (2) a low environmental harm label on all low harm items (3) a high environmental harm label on high harm items; (4) traffic light labels on all items by level of environmental harm; and (5) environmental grade labels on all items by level of environmental harm. All fast-food menus will include main items, sides, desserts, and drinks. Labels will only appear alongside main menu items and will be assigned using thresholds for environmental harm that factor estimated cropland, pastureland, and water used in the production of the item. Participants will be instructed to select a hypothetical lunch meal order from each menu. The investigators will record participant meal selections and, using publicly available nutritional information for each item selected, calculate a score of overall meal healthfulness.

Study Record Dates

• First Submitted: April 8, 2026
• First Posted: April 17, 2026
• Study Start: April 15, 2026
• Primary Completion (Estimated): May 14, 2026
• Study Completion (Estimated): May 14, 2026
• Last Updated: April 17, 2026

Record last verified: 2026-04

Locations

US (1)