Brittany Lemmon, Andrea Gil, Aviva A Musicus, Marissa G Hall, Christina A Roberto, Jennifer Falbe
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The main experiment used a 3 × 2 × 2 × 2 factorial design to test label type (icon-plus-text versus boxed icon-only versus icon-only label), color (red versus black), size (150% vs 100% of menu text height), and placement (right versus left side of item name). Participants viewed fast-food and full-service restaurant menus displaying the assigned label next to high-added-sugar items (containing >50% of the daily recommended limit).</p><p><strong>Main outcome measures: </strong>Noticing a high-added-sugar label and recognizing one's assigned label among other labels were assessed and analyzed in 2024. Menu-ordering behaviors were also examined.</p><p><strong>Results: </strong>Compared with icon-only labels, icon-plus-text labels increased the probability of noticing and recognizing high-added-sugar labels by 508% (7% vs 44%) and 263% (23% vs 82%) (ps<0.001), respectively. Red color increased noticing by 16% (p=0.020) and recognition by 20% (p<0.001) compared with black color. Larger height increased recognition by 13% (p=0.001). For icon-only labels, right placement increased noticing by 59% (p=0.020). Icon-plus-text labels reduced the probability of ordering a high-added-sugar item by 11% and the amount of added sugar ordered by 10.5 g (ps<0.001) compared with icon-only labels.</p><p><strong>Conclusions: </strong>Icon-plus-text labels were substantially more noticeable as high-added-sugar labels, recognizable, and efficacious at reducing the amount of added sugar ordered than icon-only labels. To a lesser extent, red color, larger labels, and right placement additionally improved performance, especially for icon-only designs, although they did not improve efficacy to a level similar to that of icon-plus-text labels.</p><p><strong>Trial registration: </strong>This trial is registered at AsPredicted.org (Number 156625) and ClinicalTrials.gov (NCT0620491).</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108038"},"PeriodicalIF":4.5000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Optimal Design of an Added-Sugar Menu Warning Label: A Randomized Experiment.\",\"authors\":\"Brittany Lemmon, Andrea Gil, Aviva A Musicus, Marissa G Hall, Christina A Roberto, Jennifer Falbe\",\"doi\":\"10.1016/j.amepre.2025.108038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Restaurant menu added-sugar warning labels have the potential to reduce added-sugar consumption. 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引用次数: 0
摘要
餐厅菜单上添加糖的警告标签有可能减少添加糖的消费。标签的有效性取决于其显著性。本研究旨在评估哪些设计元素提高了标签的可注意性和可识别性，并评估了对标签的行为反应。研究设计：采用在线随机实验。背景/参与者：招募了全国成年人样本（N= 4083），以近似美国性别、年龄、种族、民族和教育程度的分布。干预：主实验中，标签图标采用预测确定的三角形形状。主要实验使用3 × 2 × 2因子设计来测试标签类型（图标加文本vs盒装图标vs纯图标标签）、颜色（红色vs黑色）、大小（菜单文本高度的150% vs 100%）和位置（项目名称的右侧vs左侧）。参与者观看快餐和全方位服务餐厅的菜单，在高添加糖食品（含每日推荐限量的50%）旁边显示指定标签。主要结果指标：在2024年对注意到高添加糖标签和在其他标签中识别指定标签进行了评估和分析。他们还研究了点菜单的行为。结果：与纯图标标签相比，图标加文字标签的注意和识别高添加糖标签的概率分别提高了508%（7%对44%）和263%（23%对82%）。结论：与纯图标标签相比，图标加文字标签在高添加糖标签上更加引人注目、可识别，并且在减少订购的添加糖量方面更有效。在较小的程度上，红色、较大的标签和正确的位置也可以提高性能，特别是对于只有图标的设计，尽管它们没有将效果提高到与图标加文本标签相似的水平。试验注册：本试验在AsPredicted.org（编号156625）和ClinicalTrials.gov（编号NCT0620491）上注册。
Optimal Design of an Added-Sugar Menu Warning Label: A Randomized Experiment.
Introduction: Restaurant menu added-sugar warning labels have the potential to reduce added-sugar consumption. Label efficacy depends on noticeability. This study aimed to assess which design elements improve noticeability and recognizability and also assessed behavioral response to the labels.
Study design: An online randomized experiment was used.
Setting/participants: A national sample of adults (N=4,083) was recruited to approximate U.S. distributions of sex, age, race, ethnicity, and education.
Intervention: A pretest-determined triangle shape was used for the label icon in the main experiment. The main experiment used a 3 × 2 × 2 × 2 factorial design to test label type (icon-plus-text versus boxed icon-only versus icon-only label), color (red versus black), size (150% vs 100% of menu text height), and placement (right versus left side of item name). Participants viewed fast-food and full-service restaurant menus displaying the assigned label next to high-added-sugar items (containing >50% of the daily recommended limit).
Main outcome measures: Noticing a high-added-sugar label and recognizing one's assigned label among other labels were assessed and analyzed in 2024. Menu-ordering behaviors were also examined.
Results: Compared with icon-only labels, icon-plus-text labels increased the probability of noticing and recognizing high-added-sugar labels by 508% (7% vs 44%) and 263% (23% vs 82%) (ps<0.001), respectively. Red color increased noticing by 16% (p=0.020) and recognition by 20% (p<0.001) compared with black color. Larger height increased recognition by 13% (p=0.001). For icon-only labels, right placement increased noticing by 59% (p=0.020). Icon-plus-text labels reduced the probability of ordering a high-added-sugar item by 11% and the amount of added sugar ordered by 10.5 g (ps<0.001) compared with icon-only labels.
Conclusions: Icon-plus-text labels were substantially more noticeable as high-added-sugar labels, recognizable, and efficacious at reducing the amount of added sugar ordered than icon-only labels. To a lesser extent, red color, larger labels, and right placement additionally improved performance, especially for icon-only designs, although they did not improve efficacy to a level similar to that of icon-plus-text labels.
Trial registration: This trial is registered at AsPredicted.org (Number 156625) and ClinicalTrials.gov (NCT0620491).
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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