Trial Outcomes & Findings for Food Swaps to Improve the Healthfulness and Reduce the Carbon Footprint of Grocery Purchases (NCT NCT06648226)
NCT ID: NCT06648226
Last Updated: 2026-06-24
Results Overview
The study will asses healthfulness of participants' selections as the average Ofcom Nutrient Profiling Model score of the products the participants select in the shopping task. The score ranges from 0 to 100, where higher scores are healthier. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
1201 participants
Primary outcome timeframe
1-week follow-up (visit 2), and 2-week follow-up (visit 3)
Results posted on
2026-06-24
Participant Flow
Participant milestones
| Measure |
Health Swaps
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
Control
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
|---|---|---|---|---|
|
Overall Study
STARTED
|
300
|
301
|
300
|
300
|
|
Overall Study
Visit 2
|
275
|
280
|
261
|
277
|
|
Overall Study
Visit 3
|
260
|
261
|
248
|
262
|
|
Overall Study
COMPLETED
|
279
|
284
|
266
|
279
|
|
Overall Study
NOT COMPLETED
|
21
|
17
|
34
|
21
|
Reasons for withdrawal
Withdrawal data not reported
Baseline Characteristics
Food Swaps to Improve the Healthfulness and Reduce the Carbon Footprint of Grocery Purchases
Baseline characteristics by cohort
| Measure |
Health Swaps
n=300 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=301 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=300 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
Control
n=300 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Total
n=1201 Participants
Total of all reporting groups
|
|---|---|---|---|---|---|
|
Age, Categorical
<=18 years
|
0 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
0 Participants
n=40 Participants
|
0 Participants
n=6 Participants
|
0 Participants
n=7 Participants
|
|
Age, Categorical
Between 18 and 65 years
|
291 Participants
n=20 Participants
|
298 Participants
n=20 Participants
|
292 Participants
n=40 Participants
|
295 Participants
n=6 Participants
|
1176 Participants
n=7 Participants
|
|
Age, Categorical
>=65 years
|
9 Participants
n=20 Participants
|
3 Participants
n=20 Participants
|
8 Participants
n=40 Participants
|
5 Participants
n=6 Participants
|
25 Participants
n=7 Participants
|
|
Age, Continuous
|
32.5 years
STANDARD_DEVIATION 12.9 • n=20 Participants
|
31.5 years
STANDARD_DEVIATION 11.3 • n=20 Participants
|
31.1 years
STANDARD_DEVIATION 12.4 • n=40 Participants
|
30.8 years
STANDARD_DEVIATION 12.0 • n=6 Participants
|
31.5 years
STANDARD_DEVIATION 12.2 • n=7 Participants
|
|
Sex/Gender, Customized
Woman
|
164 Participants
n=20 Participants
|
157 Participants
n=20 Participants
|
157 Participants
n=40 Participants
|
160 Participants
n=6 Participants
|
638 Participants
n=7 Participants
|
|
Sex/Gender, Customized
Man
|
132 Participants
n=20 Participants
|
138 Participants
n=20 Participants
|
141 Participants
n=40 Participants
|
134 Participants
n=6 Participants
|
545 Participants
n=7 Participants
|
|
Sex/Gender, Customized
Unknown or other
|
4 Participants
n=20 Participants
|
6 Participants
n=20 Participants
|
2 Participants
n=40 Participants
|
6 Participants
n=6 Participants
|
18 Participants
n=7 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
1 Participants
n=20 Participants
|
2 Participants
n=20 Participants
|
2 Participants
n=40 Participants
|
2 Participants
n=6 Participants
|
7 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Asian
|
13 Participants
n=20 Participants
|
11 Participants
n=20 Participants
|
11 Participants
n=40 Participants
|
19 Participants
n=6 Participants
|
54 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
0 Participants
n=40 Participants
|
2 Participants
n=6 Participants
|
2 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Black or African American
|
92 Participants
n=20 Participants
|
89 Participants
n=20 Participants
|
96 Participants
n=40 Participants
|
100 Participants
n=6 Participants
|
377 Participants
n=7 Participants
|
|
Race (NIH/OMB)
White
|
180 Participants
n=20 Participants
|
187 Participants
n=20 Participants
|
181 Participants
n=40 Participants
|
165 Participants
n=6 Participants
|
713 Participants
n=7 Participants
|
|
Race (NIH/OMB)
More than one race
|
10 Participants
n=20 Participants
|
4 Participants
n=20 Participants
|
7 Participants
n=40 Participants
|
8 Participants
n=6 Participants
|
29 Participants
n=7 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
4 Participants
n=20 Participants
|
8 Participants
n=20 Participants
|
3 Participants
n=40 Participants
|
4 Participants
n=6 Participants
|
19 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
27 Participants
n=20 Participants
|
24 Participants
n=20 Participants
|
21 Participants
n=40 Participants
|
23 Participants
n=6 Participants
|
95 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
273 Participants
n=20 Participants
|
277 Participants
n=20 Participants
|
279 Participants
n=40 Participants
|
277 Participants
n=6 Participants
|
1106 Participants
n=7 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=20 Participants
|
0 Participants
n=20 Participants
|
0 Participants
n=40 Participants
|
0 Participants
n=6 Participants
|
0 Participants
n=7 Participants
|
|
Region of Enrollment
United States
|
300 Participants
n=20 Participants
|
301 Participants
n=20 Participants
|
300 Participants
n=40 Participants
|
300 Participants
n=6 Participants
|
1201 Participants
n=7 Participants
|
|
Household Income
$0 to $49,999
|
77 Participants
n=20 Participants
|
95 Participants
n=20 Participants
|
85 Participants
n=40 Participants
|
78 Participants
n=6 Participants
|
335 Participants
n=7 Participants
|
|
Household Income
$50,000 to $99,999
|
121 Participants
n=20 Participants
|
108 Participants
n=20 Participants
|
118 Participants
n=40 Participants
|
128 Participants
n=6 Participants
|
475 Participants
n=7 Participants
|
|
Household Income
$100,000 to $149,999
|
62 Participants
n=20 Participants
|
57 Participants
n=20 Participants
|
64 Participants
n=40 Participants
|
63 Participants
n=6 Participants
|
246 Participants
n=7 Participants
|
|
Household Income
$150,000 or more
|
40 Participants
n=20 Participants
|
41 Participants
n=20 Participants
|
33 Participants
n=40 Participants
|
31 Participants
n=6 Participants
|
145 Participants
n=7 Participants
|
PRIMARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at either visit 2 or visit 3.
The study will asses healthfulness of participants' selections as the average Ofcom Nutrient Profiling Model score of the products the participants select in the shopping task. The score ranges from 0 to 100, where higher scores are healthier. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Healthfulness of Product Selection
|
57.9 score on a scale
Standard Deviation 6.5
|
64 score on a scale
Standard Deviation 7.4
|
60.1 score on a scale
Standard Deviation 6.3
|
62.6 score on a scale
Standard Deviation 8.1
|
PRIMARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at either visit 2 or visit 3.
The study will assess the carbon footprint of participants' selections, operationalized as the average carbon footprint (in CO2-equivalents) of the products the participants select in the shopping task. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, the non-missing value was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Carbon Footprint of Participants' Grocery Store Selections
|
9.6 kg CO2-eq per kg
Standard Deviation 7
|
8.1 kg CO2-eq per kg
Standard Deviation 6.6
|
5.5 kg CO2-eq per kg
Standard Deviation 5.2
|
5.9 kg CO2-eq per kg
Standard Deviation 5.2
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the average calorie density of participants' grocery selections, calculated as the average kcal per 100g of the selected products. Higher values will indicate higher calorie density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Calorie Density of Participants' Grocery Selections
|
200.5 kcal per 100g
Standard Deviation 68.4
|
166.8 kcal per 100g
Standard Deviation 68.4
|
182.2 kcal per 100g
Standard Deviation 65.5
|
175.7 kcal per 100g
Standard Deviation 75.8
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the average sugar density of participants' grocery selections, calculated as the average grams of sugar per 100g of the selected products. Higher values will indicate higher sugar density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Sugar Density of Participants' Grocery Selections
|
8 g per 100g
Standard Deviation 5.8
|
6.4 g per 100g
Standard Deviation 5.8
|
6.9 g per 100g
Standard Deviation 5.3
|
6.4 g per 100g
Standard Deviation 5.3
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the average sodium density of participants' grocery selections, calculated as the average milligrams of sodium per 100g of the selected products. Higher values will indicate higher sodium density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Sodium Density of Participants' Grocery Selections
|
317.3 mg per 100g
Standard Deviation 175.4
|
264.1 mg per 100g
Standard Deviation 163
|
314.4 mg per 100g
Standard Deviation 188.4
|
284.7 mg per 100g
Standard Deviation 158.1
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the average saturated fat density of participants' grocery selections, calculated as the average grams of saturated fat per 100g of the selected products. Higher values will indicate higher saturated fat density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Saturated Fat Density of Participants' Grocery Selections
|
3.4 g per 100g
Standard Deviation 1.7
|
2.3 g per 100g
Standard Deviation 1.4
|
2.7 g per 100g
Standard Deviation 1.8
|
2.4 g per 100g
Standard Deviation 2
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the average fiber density of participants' grocery selections, calculated as the average grams of fiber per 100g of the selected products. Higher values will indicate higher fiber density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Fiber Density of Participants' Grocery Selections
|
1.1 g per 100g
Standard Deviation 0.7
|
1.3 g per 100g
Standard Deviation 1.1
|
1.1 g per 100g
Standard Deviation 0.8
|
1.3 g per 100g
Standard Deviation 0.9
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the average protein density of participants' grocery selections, calculated as the average grams of protein per 100g of the selected products. Higher values will indicate higher protein density. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Protein Density of Participants' Grocery Selections
|
7.2 g per 100g
Standard Deviation 2.9
|
7.1 g per 100g
Standard Deviation 2.8
|
6.6 g per 100g
Standard Deviation 2.8
|
7.1 g per 100g
Standard Deviation 3.1
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess the total amount participants spent on their grocery selections in United States dollars. Higher values will indicate greater spending. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Total Spending on Participants' Grocery Selections
|
45.8 US Dollars
Standard Deviation 6.4
|
44.9 US Dollars
Standard Deviation 7.5
|
44.4 US Dollars
Standard Deviation 7.2
|
44.2 US Dollars
Standard Deviation 7.8
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess thinking about health using 1 item: "We are interested in how you selected products while you were grocery shopping. When you selected foods, how much did you think about each of the following characteristics? ... health." Response options range from "Not at all" (1) to "A great deal" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Thinking About Health
|
3.7 score on a scale
Standard Deviation 1.1
|
3.9 score on a scale
Standard Deviation 1
|
3.9 score on a scale
Standard Deviation 1
|
4 score on a scale
Standard Deviation 1
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess thinking about climate impact using 1 item: "We are interested in how you selected products while you were grocery shopping. When you selected foods, how much did you think about each of the following characteristics? ... climate impact." Response options range from "Not at all" (1) to "A great deal" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Thinking About Climate Impact
|
2.6 score on a scale
Standard Deviation 1.3
|
2.6 score on a scale
Standard Deviation 1.3
|
3.5 score on a scale
Standard Deviation 1.3
|
3.3 score on a scale
Standard Deviation 1.2
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess thinking about taste using 1 item: "We are interested in how you selected products while you were grocery shopping. When you selected foods, how much did you think about each of the following characteristics? ... taste." Response options range from "Not at all" (1) to "A great deal" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Thinking About Taste
|
4.4 score on a scale
Standard Deviation 0.6
|
4.4 score on a scale
Standard Deviation 0.7
|
4.4 score on a scale
Standard Deviation 0.7
|
4.4 score on a scale
Standard Deviation 0.6
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess negative emotional reactions using 3 items: "While you were shopping, how much did you feel…" "worried", "guilty," "ashamed"? Response options range from "Not at all" (1) to "Extremely" (5). The investigators will average the 3 items; higher average scores indicate stronger negative emotional reactions. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Negative Emotional Reactions While Shopping
|
1.3 score on a scale
Standard Deviation 0.5
|
1.4 score on a scale
Standard Deviation 0.5
|
1.3 score on a scale
Standard Deviation 0.5
|
1.4 score on a scale
Standard Deviation 0.6
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess positive emotional reactions using 3 items: "While you were shopping, how much did you feel…" "inspired", "proud," "reassured"? Response options range from "Not at all" (1) to "Extremely" (5). The investigators will average the 3 items; higher average scores indicate stronger positive emotional reactions. Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Positive Emotional Reactions While Shopping
|
3.2 score on a scale
Standard Deviation 1.1
|
3.2 score on a scale
Standard Deviation 1.2
|
3.2 score on a scale
Standard Deviation 1.2
|
3.2 score on a scale
Standard Deviation 1.2
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess injunctive norms to buy healthy foods with 1 item: "People who are important to me think I should buy healthy foods." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Injunctive Norms to Buy Healthy Foods
|
4.3 score on a scale
Standard Deviation 0.8
|
4.3 score on a scale
Standard Deviation 0.8
|
4.3 score on a scale
Standard Deviation 0.7
|
4.3 score on a scale
Standard Deviation 0.7
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess descriptive norms to buy healthy foods with 1 item: "Most shoppers buy healthy foods when they are shopping for groceries." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Descriptive Norms to Buy Healthy Foods
|
3.4 score on a scale
Standard Deviation 1.0
|
3.4 score on a scale
Standard Deviation 1.1
|
3.4 score on a scale
Standard Deviation 1.0
|
3.4 score on a scale
Standard Deviation 1.1
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess injunctive norms to buy foods with low climate impact with 1 item: "People who are important to me think I should buy foods with low climate impact." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Injunctive Norms to Buy Foods With Low Climate Impact
|
3.2 score on a scale
Standard Deviation 1.1
|
3.4 score on a scale
Standard Deviation 1.2
|
3.4 score on a scale
Standard Deviation 1.1
|
3.4 score on a scale
Standard Deviation 1.1
|
SECONDARY outcome
Timeframe: 1-week follow-up (visit 2), and 2-week follow-up (visit 3)Population: Analysis population included participants with nonmissing outcome data at visit 2 or visit 3.
The study will assess descriptive norms to buy foods with lower climate impact with 1 item: "Most shoppers buy foods with low climate impact when they are shopping for groceries." Response options range from "Strongly disagree" (1) to "Strongly agree" (5). Outcome values were calculated as each participant's mean across visits 2 and 3. If participants had missing data at one of these visits, data from the non-missing visit was used.
Outcome measures
| Measure |
Control
n=279 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=279 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=284 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=266 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Descriptive Norms to Buy Foods With Low Climate Impact
|
2.7 score on a scale
Standard Deviation 1.2
|
2.8 score on a scale
Standard Deviation 1.2
|
2.9 score on a scale
Standard Deviation 1.1
|
2.8 score on a scale
Standard Deviation 1.1
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess perceived helpfulness of nutrition labels with 1 item: "These labels would help me choose healthier foods." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Perceived Helpfulness of Nutrition Labels
|
4.1 score on a scale
Standard Deviation 1.0
|
4.1 score on a scale
Standard Deviation 1.0
|
4.0 score on a scale
Standard Deviation 1.1
|
4.1 score on a scale
Standard Deviation 1.1
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess perceived helpfulness of climate labels with 1 item: "These labels would help me choose foods with lower climate impact." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Perceived Helpfulness of Climate Labels
|
3.8 score on a scale
Standard Deviation 1.1
|
3.8 score on a scale
Standard Deviation 1.2
|
4.0 score on a scale
Standard Deviation 1.2
|
3.9 score on a scale
Standard Deviation 1.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess perceived helpfulness of health swap recommendations with 1 item: "This type of recommendation would help me choose healthier foods." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Perceived Helpfulness of Health Swap Recommendations
|
4.1 score on a scale
Standard Deviation 1.1
|
4.2 score on a scale
Standard Deviation 1.0
|
4.0 score on a scale
Standard Deviation 1.2
|
4.1 score on a scale
Standard Deviation 1.1
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess perceived helpfulness of climate swap recommendations with 1 item: "This type of recommendation would help me choose more foods with lower climate impact." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Perceived Helpfulness of Climate Swap Recommendations
|
3.9 score on a scale
Standard Deviation 1.1
|
3.8 score on a scale
Standard Deviation 1.3
|
3.9 score on a scale
Standard Deviation 1.2
|
3.9 score on a scale
Standard Deviation 1.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess liking of nutrition labels with 1 item: "I like these labels." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Liking of Nutrition Labels
|
3.9 score on a scale
Standard Deviation 1.0
|
4.1 score on a scale
Standard Deviation 1.1
|
3.9 score on a scale
Standard Deviation 1.2
|
4.0 score on a scale
Standard Deviation 1.1
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess liking of climate labels with 1 item: "I like these labels." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Liking of Climate Labels
|
3.7 score on a scale
Standard Deviation 1.1
|
3.7 score on a scale
Standard Deviation 1.3
|
3.8 score on a scale
Standard Deviation 1.3
|
3.8 score on a scale
Standard Deviation 1.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess liking health swap recommendations with 1 item: "I like these recommendations." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Liking of Health Swap Recommendations
|
4.0 score on a scale
Standard Deviation 1.1
|
4.0 score on a scale
Standard Deviation 1.2
|
4.0 score on a scale
Standard Deviation 1.2
|
3.9 score on a scale
Standard Deviation 1.2
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess liking climate swap recommendations with 1 item: "I like these recommendations." Response options range from "Not at all" (1) to "A great deal" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Liking of Climate Swap Recommendations
|
3.8 score on a scale
Standard Deviation 1.2
|
3.7 score on a scale
Standard Deviation 1.4
|
3.7 score on a scale
Standard Deviation 1.3
|
3.8 score on a scale
Standard Deviation 1.3
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess acceptability of the nutrition labels with 1 item: "How much would you approve or disapprove of these labels being displayed on foods sold in grocery stores?" Response options range from "Strongly disapprove" (1) to "Strongly approve" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Acceptability of Nutrition Labels
|
4.3 score on a scale
Standard Deviation 0.8
|
4.4 score on a scale
Standard Deviation 0.9
|
4.3 score on a scale
Standard Deviation 0.9
|
4.3 score on a scale
Standard Deviation 0.8
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess acceptability of the climate labels with 1 item: "How much would you approve or disapprove of these labels being displayed on foods sold in grocery stores?" Response options range from "Strongly disapprove" (1) to "Strongly approve" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Acceptability of Climate Labels
|
4.2 score on a scale
Standard Deviation 0.9
|
4.1 score on a scale
Standard Deviation 1.1
|
4.2 score on a scale
Standard Deviation 1.0
|
4.2 score on a scale
Standard Deviation 0.9
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess acceptability of the health swap recommendations with 1 item: "How much would you approve or disapprove of these recommendations being offered by grocery stores?" Response options range from "Strongly disapprove" (1) to "Strongly approve" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Acceptability of Health Swap Recommendations
|
4.3 score on a scale
Standard Deviation 0.9
|
4.4 score on a scale
Standard Deviation 0.8
|
4.3 score on a scale
Standard Deviation 1.0
|
4.3 score on a scale
Standard Deviation 0.9
|
OTHER_PRE_SPECIFIED outcome
Timeframe: Assessed at 2-week follow-up (visit 3)Population: Participants with nonmissing visit 3 outcome data only; these outcomes were assessed at visit 3 only.
The study will assess acceptability of the climate swap recommendations 1 item: "How much would you approve or disapprove of these recommendations being offered by grocery stores?" Response options range from "Strongly disapprove" (1) to "Strongly approve" (5).
Outcome measures
| Measure |
Control
n=262 Participants
No labels or swaps.
Control: Participants will not view any extra labels or be offered any swaps in the online grocery store.
|
Health Swaps
n=260 Participants
Labels will be "nutrition grades" for products and replacement swap suggestions will be for items with a better nutrition grade.
Health swaps: Participants will view "health grade" labels on all products in the online grocery store indicating their healthfulness as estimated by United Kingdom Ofcom Nutrient Profiling Model scores. The health score labels will mimic Nutri-Score labels, a labeling system used in some European countries, showing a color-coded grade of "A" (green) through "F" (red) on each product. Products with "A" and "B" labels will meet the United Kingdom's cutoff for products that can be marketed to children and "C", "D" and "F" labels products are less healthy than this cutoff (based on tertiles of Ofcom scores within each food group). When participants attempt to add a less healthy product to their cart (e.g., "C," "D" or "F" health label), the store will automatically suggest a healthier product from the same category (e.g., with a "A" or "B" health label).
|
Climate Swaps
n=260 Participants
Labels will be "climate grades" for products and replacement swap suggestions will be for items with a better climate grade.
Climate swaps: Participants will view "climate grade" labels on all products indicating their climate impact. The climate impact is calculated as the greenhouse gas emissions associated with producing the product in carbon dioxide equivalents (CO2-eq) per 100g (i.e., "carbon footprint"). Labels will be applied based on quintiles of carbon footprints in each food group. When participants attempt to add a high-climate-impact product to their cart (e.g., with a "C," "D," or "F" climate label), the store will automatically offer them swaps to more climate-friendly products (e.g., with a "A" or "B" climate label).
|
Combined Health and Climate Swaps
n=248 Participants
Labels will be "nutrition grades" and "climate grades" for products and replacement swap suggestions will be for items that are better than originally selected products on at least one dimension (nutrition grade or climate grade) and not worse than originally selected products on either dimension.
Combined health and climate swaps: Participants will view both the health and climate grade labels on all products in the online grocery store. When participants attempt to select a product with a "C," "D," or "F" label on either dimension to their cart, the store will automatically offer them swaps to products that offer improvement over the original food on at least 1 dimension (health or climate-friendliness) and were at least as good or better on the other dimension, with the additional guardrail that the store never suggests products with a "C," "D" or "F" label on either dimension.
|
|---|---|---|---|---|
|
Acceptability of Climate Swap Recommendations
|
4.1 score on a scale
Standard Deviation 1.0
|
4.0 score on a scale
Standard Deviation 1.1
|
4.1 score on a scale
Standard Deviation 1.1
|
4.1 score on a scale
Standard Deviation 1.0
|
Adverse Events
Health Swaps - Visits 2 and 3
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Climate Swaps - Visits 2 and 3
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Combined Health and Climate Swaps - Visits 2 and 3
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Control - Visits 2 and 3
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
No Interventions - Visit 1
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place