Trial Outcomes & Findings for Impact of Sugar-Sweetened Beverage Health Warnings (NCT NCT03511937)

Impact of Sugar-Sweetened Beverage Health Warnings

The primary outcome is calories of sugar-sweetened beverages purchased during the shopping task. Calories from sugar-sweetened beverage purchases is defined as the total number of calories from sugar-sweetened beverages in the participant's basket when they complete the shopping task, calculated as the sum of calories/container for all SSB containers. Purchases will be recorded by the experimenter immediately after the participant completes the \~10-minute shopping task.

Total calories purchased from all foods and beverages is defined as the total number of calories from all products (including sugar-sweetened beverages, non-sugar-sweetened beverages, and all foods) in the participant's basket when they complete the shopping task. Total calories purchased will be calculated as the sum of calories/container for all products. Purchases will be recorded by the experimenter immediately after the participant completes the \~10 minute shopping task.

Purchase of a sugar-sweetened beverage is defined as the participant having one or more sugar-sweetened beverage in their basket when they complete the shopping task. Purchases will be recorded by the experimenter immediately after the participant completes the \~10-minute shopping task.

Number of sugar-sweetened beverages purchased is defined as the number of sugar-sweetened beverages in the participants' basket when they complete the shopping task. Purchases will be recorded by the experimenter immediately after the participant completes the \~10-minute shopping task.

Intentions to limit consumption of beverages with added sugar will be measured at post-test using 3 items adapted from Klein, Zajax \& Monin (2009). The items ask participants to rate the extent to which they want to, plan to, and are likely to, drink less than 1 beverage with added sugar in the next week. Responses to these three items will be averaged to create a mean intentions score. Response options are on a 1 to 7 scale, thus, mean scores can range from 1-7, with higher scores indicating higher intentions to limit consumption of beverages with added sugar.

Intentions to limit consumption of specific beverage categories (i.e., soda, fruit drinks, sport drinks/flavored waters, sweetened coffee/tea, and energy drinks) will be measured at post-test using measures adapted from Klein, Zajax, \& Monin (2009). For each of the five beverage categories, participants will rate the extent to which they are likely to drink less than 1 serving of the beverage in the next week. Responses will be averaged to a create a mean intentions score. Response options are on a 1 to 7 scale. Thus, mean scores can range from 1-7, with higher scores indicating higher intentions to limit consumption of these beverages.

Noticing of the trial labels will be measured at post-test using 1 item adapted from Roberto et al. (2016). The item asks participants to indicate whether they noticed the trial labels. Response options are 0 (no) and 1 (yes).

Attention to the trial labels will be measured at post-test using 2 items adapted from Nonnemaker et al. (2010). The items ask participants to rate their agreement with statements about whether the label grabbed their attention and whether they read and looked closely at the label. Responses will be averaged to create a mean attention score. Responses are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating higher attention to the labels.

Emotional reactions to the trial labels will be measured at post-test using 6 items adapted from Brewer et al. (2018). The items ask participants to indicate the extent to which trial labels elicited particular emotional reactions (e.g., fear, guilt, disgust). Responses will be averaged to create a mean emotional reactions score. Response options are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating stronger emotional reactions.

Cognitive elaboration will be measured at post-test using 2 items adapted from Moodie, MacKintosh \& Hammond (2010) and Fathelrahman et al. (2010). Items ask participants to rate the amount they thought about the information conveyed by the trial label and about the health consequences of consuming beverages with added sugar. Responses will be averaged to create a mean cognitive elaboration score. Response options range from 1 to 5. Thus, mean scores can range from 1-5, with higher scores indicating more elaboration.

Social interactions of the labels will be measured at post-test with a single item adapted from Brewer et al. (2018). Participants will rate the extent to which they are likely to have social interactions about the trial label. Response options are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating a higher likelihood of having social interactions.

Perceptions of added sugar content in specific categories of sugar-sweetened beverages (i.e., soda, fruit drinks, sport drinks/flavored waters, sweetened coffee/tea, and energy drinks) will be measured at post-test using items adapted from Roberto et al. (2016). Items ask participants to rate the amount of added sugar they think is in 1 serving of the beverage. Responses will be averaged to create a mean perceptions of added sugar score. Response options are on a 1 to 4 scale. Thus, mean scores can range from 1-4, with higher scores indicating perceiving higher added sugar content.

Attitudes toward consuming specific sugar-sweetened beverages (i.e., soda, fruit drinks, sport drinks/flavored waters, sweetened coffee/tea, and energy drinks) will be measured at post-test using 5 items adapted from Bollard et al. (2016). Items ask participants to rate how healthy/unhealthy it is for them to consume each beverage category. Responses will be averaged to create an average attitudes score. Response options are on a 1 to 7 scale. Thus, mean scores can range from 1-7, with higher scores indicating more positive attitudes toward consuming these sugar-sweetened beverages.

Product attitudes toward specific sugar-sweetened beverages (i.e., soda, fruit drinks, sport drinks/flavored waters, sweetened coffee/tea, and energy drinks) will be measured at post-test using 10 items adapted from Bollard et al. (2016). Items ask participants to rate the appeal and the coolness of each beverage category. Responses will be averaged to create a mean product attitude score. Responses are on a 1 to 7 scale. Thus, mean scores can range from 1-7, with higher scores indicating more positive product attitudes toward these sugar-sweetened beverages.

Outcome expectations will be measured at post-test with items adapted from Roberto et al. (2016). Participants will rate the extent to which they expect that consuming beverages with added sugar would increase their risk of negative health outcomes (e.g., tooth decay). Responses will be averaged to a create a mean outcome expectations score. Responses are on a 1 to 7 scale. Thus, mean scores can range from 1-7, with higher scores indicating more negative outcome expectations.

Injunctive norms will be measured at post-test with items adapted from Zoellner et al. (2012). Items ask participants to rate the extent to which people who are important to them think they should drink less than 1 beverage with added sugar per week, would approve of them drinking less than 1 beverage with added sugar per week, and want them to drink less than 1 beverage with added sugar per week. Responses will be averaged to create a mean injunctive norms score. Responses are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating higher injunctive norms.

Perceived message effectiveness will be measured at post-test with 1-item adapted from Brewer et al. (2018). Participants will rate the extent to which the trial label would discourage them from drinking beverages with added sugar. Response options are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating higher perceived effectiveness.

Support for sugar-sweetened beverage health warning labels will be measured at post-test with 1 item adapted from Brewer et al. (2018). Participants rate their support for a policy that would require health warning labels on sugar-sweetened beverages. Responses are on a 1 to 4 scale. Thus, mean scores can range from 1-4, with higher scores indicating greater support.

Self-efficacy to limit consumption of beverages with added sugar will be measured at post-test with items adapted from Brewer et al. (2018). Items ask participants to rate the extent to which: it would be easy to drink less than 1 beverage with added sugar per week, they have the ability to drink less than 1 beverage with added sugar per week, and they are confident that they could drink less than 1 beverage with added sugar per week. Responses will be averaged to create a mean self-efficacy score. Responses are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating self-efficacy.

Response efficacy of limiting consumption of beverages with added sugar will be measured at post-test with items adapted from Brewer et al. (2018). Participants will indicate the extent to which drinking no beverages with added sugar would lower their chances of weight gain, diabetes, tooth decay, and heart disease, and the extent to which drinking no beverages with added sugar would improve their health. Responses are on a 1 to 5 scale. Thus, mean scores can range from 1-5, with higher scores indicating greater response efficacy.

Calories from food purchases is defined as the total number of calories from foods in the participant's basket when they complete the shopping task, calculated as the sum of calories/product for all food products. Purchases will be recorded by the experimenter immediately after the participant completes the \~10-minute shopping task.

Calories from non-sugar-sweetened beverage purchases is defined as the total number of calories from non-sugar-sweetened beverages in the participant's basket when they complete the shopping task, calculated as the sum of calories/container for all non-sugar-sweetened beverage containers. Purchases will be recorded by the experimenter immediately after the participant completes the \~10-minute shopping task.