FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods

Diet, Food, and Nutrition Clinical Trial

Official title:

FoodFLIP: Testing the Effectiveness of a Food Information App to Promote the Selection of Healthier Foods

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02814604
• Other study ID #: 499174
• Status: Completed
• Phase: N/A
• Start date: November 1, 2018
• Est. completion date: January 30, 2020

Study information

• Verified date: November 2020
• Source: University of Toronto
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

There is a lot of confusion when it comes to understanding nutrition information on food packages, thus making it difficult for consumers to choose healthy products. In today's busy and fast-paced shopping environment, mobile digital technology (for example, Smartphone applications) can help consumers make 'healthier' food choices when they are shopping. This study aims to test the effectiveness of a traffic light front-of-pack system, the Health Star Rating System (HSR or Star System), and the proposed sodium, saturated fat and sugar warning labels proposed by Health Canada. The study will also experimentally test the use of a Smartphone application (app), FoodFlip, to help educate consumers on these systems on food packages to explore the impact of a learning effect on the efficacy of the labelling systems.

Description:

The rising rate of obesity and diet-related chronic diseases illustrate that Canadians' eating habits need to change. Equipping Canadians with information and tools to enable healthy food choices that decrease risk for disease is imperative. While the Nutrition Facts table (NFt) is the most standardized and complete form of nutrition labelling, studies have shown that consumers are confused about serving size, nutrient quantities, and the interpretation of the % Daily Value. Thus, expert groups have proposed the introduction of interpretive front-of-pack (FOP) nutrition rating systems (e.g. traffic light labelling or star ratings) that also help consumers understand the significance of the levels of nutrients in relation to the "healthiness" of a food. One of the main barriers to the introduction of such a system is the absence of high quality studies that objectively measure the impact of nutrition information on actual food purchases. This is a consequence of both the practical challenges associated with designing and conducting such studies in 'real-world' settings, and the lack of food industry support to quantitatively examine or publish the potential for enhanced nutrition labels to modify consumer food choices. With the growing burden of diet-related disease, there is an urgent need for robust evidence to evaluate the potential for additional interpretive nutrition labelling systems to modify and improve food purchasing patterns. Given the relative ubiquity of mobile digital technologies, our Canadian Smartphone application (FoodFLIP) provides us with an unprecedented opportunity to examine and improve consumers' diets.

This study will investigate whether a traffic light, a health star rating or a high-in warning label FOP system can help consumers identify and purchase healthier foods.

Objective 1: To evaluate the effects of three FOP systems in helping consumers characterize healthfulness and nutritional content of food items.

Objective 2: To determine which of the three FOP systems support healthier food choices and are preferred by Canadian consumers.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2008
• Est. completion date: January 30, 2020
• Est. primary completion date: December 23, 2019
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Shop at a supermarket owned by one of the largest four national retailers at least twice a month. This includes Loblaws, Sobeys, Metro or Safeway

• Own a smartphone (iPhone version 3 or later or android)

• Are 18 years or over and provide informed consent to participate

• Reside in Canada, excluding Northern Territories

Related Conditions & MeSH terms

• Consumer Behavior
• Diet, Food, and Nutrition

Intervention

Other:
• Nutrition Rating Systems
Behavioural: Nutrition Rating Systems (shown on a mobile app) provide consumers with an interpretation of the healthfulness of a food or beverage product.

Locations

Country	Name	City	State
Canada	University of Toronto	Toronto	Ontario

Sponsors (3)

Lead Sponsor	Collaborator
University of Toronto	Dietitians of Canada, Heart and Stroke Foundation of Canada

Country where clinical trial is conducted

Canada, 

References & Publications (4)

Committee on Examination of Front-of-Package Nutrition Rating Systems and Symbols (Phase II), Institute of Medicine. Front-of-Package Nutrition Rating Systems and Symbols: Promoting Healthier Choices. 2011 October 20.

Emrich TE, Qi Y, Mendoza JE, Lou W, Cohen JE, L'abbé MR. Consumer perceptions of the Nutrition Facts table and front-of-pack nutrition rating systems. Appl Physiol Nutr Metab. 2014 Apr;39(4):417-24. doi: 10.1139/apnm-2013-0304. Epub 2013 Oct 24. — View Citation

Key TJ, Schatzkin A, Willett WC, Allen NE, Spencer EA, Travis RC. Diet, nutrition and the prevention of cancer. Public Health Nutr. 2004 Feb;7(1A):187-200. Review. — View Citation

The Standing Committee on Health. Healthy Weights for Healthy Kids. 2007

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The accurate characterization of healthfulness and nutritional content of foods as indicated by each intervention group will be compared.	In the first series of experimental tasks, participants will be exposed to an image of a food package with the assigned FOP nutrition information and NFt. Participants will be asked to rate the products on how likely they would be to purchase the product, overall healthiness, and the relative amount of specific nutrients in the product (e.g., if the product contains a little or a lot of sodium) using a Likert scale. In the second series of tasks, participants will be shown 5 similar products side by side (5 breakfast cereals, 5 yogurts and 5 pasta dinners). Participants will be asked to rank the products from MOST HEALTHY to LEAST HEALTHY, and which product they would select if they were trying to consume a low sodium, low energy or high fibre diet.	6 weeks
Secondary	A qualitative assessment of the functionality and usability of the smartphone app (FoodFLIP) will be assessed through questionnaires on a 5-point Likert Scale (the percentage of users finding the app easy to use/easy to understand etc).	The functionality and usability of the smartphone app is assessed through questionnaires (e.g easy to use, easy to understand etc). Responses on these questionnaires are scaled using a five-point Likert-scale and scores for each question are recorded separately to assess the usability of the smartphone app (e.g 1 least liked to 5 most liked).	6 weeks
Secondary	The health claims with or without additional labelling elements influence perceptions of healthiness and purchasing intentions will be compared between each FOP system.	Participants will be randomized to see products with symbolic and textual health and/or nutrition claims. Participants will first be shown an image with or without claims for 10 seconds (this is slightly longer than the average time an individual spends viewing a product in a food store when making a purchasing decision). The image will then be removed from the screen, and participants will be asked to recall the presence and content of the claim. The image will then be returned to the screen and participants will be asked to rate how healthy the product is and to rate how likely they would be to purchase the product.	6 weeks