Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina; Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.
Carolina Population Center, University of North Carolina Chapel Hill, Chapel Hill, North Carolina; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina.
Am J Prev Med. 2019 Nov;57(5):601-610. doi: 10.1016/j.amepre.2019.06.019. Epub 2019 Oct 2.
Five U.S. states have proposed policies to require health warnings on sugar-sweetened beverages, but warnings' effects on actual purchase behavior remain uncertain. This study evaluated the impact of sugar-sweetened beverage health warnings on sugar-sweetened beverage purchases.
Participants completed one study visit to a life-sized replica of a convenience store in North Carolina. Participants chose six items (two beverages, two foods, and two household products). One item was randomly selected for them to purchase and take home. Participants also completed a questionnaire. Researchers collected data in 2018 and conducted analyses in 2019.
SETTING/PARTICIPANTS: Participants were a demographically diverse convenience sample of 400 adult sugar-sweetened beverage consumers (usual consumption ≥12 ounces/week).
Research staff randomly assigned participants to a health warning arm (sugar-sweetened beverages in the store displayed a front-of-package health warning) or a control arm (sugar-sweetened beverages displayed a control label).
The primary trial outcome was sugar-sweetened beverage calories purchased. Secondary outcomes included reactions to trial labels (e.g., negative emotions) and sugar-sweetened beverage perceptions and attitudes (e.g., healthfulness).
All 400 participants completed the trial and were included in analyses. Health warning arm participants were less likely to be Hispanic and to have overweight/obesity than control arm participants. In intent-to-treat analyses adjusting for Hispanic ethnicity and overweight/obesity, health warnings led to lower sugar-sweetened beverage purchases (adjusted difference, -31.4 calories; 95% CI= -57.9, -5.0). Unadjusted analyses yielded similar results (difference, -32.9 calories; 95% CI= -58.9, -7.0). Compared with the control label, sugar-sweetened beverage health warnings also led to higher intentions to limit sugar-sweetened beverage consumption and elicited more attention, negative emotions, thinking about the harms of sugar-sweetened beverage consumption, and anticipated social interactions. Trial arms did not differ on perceptions of sugar-sweetened beverages' added sugar content, healthfulness, appeal/coolness, or disease risk.
Brief exposure to health warnings reduced sugar-sweetened beverage purchases in this naturalistic RCT. Sugar-sweetened beverage health warning policies could discourage sugar-sweetened beverage consumption.
This study is registered at www.clinicaltrials.gov NCT03511937.
美国有五个州提出了在含糖饮料上添加健康警示标签的政策，但这些警示标签对实际购买行为的影响仍不确定。本研究评估了含糖饮料健康警示标签对含糖饮料购买的影响。
参与者在北卡罗来纳州的一家便利店的真人大小复制品中完成了一次研究访问。参与者选择了六件商品（两种饮料、两种食品和两种家用产品）。其中一件商品被随机选中让他们购买并带回家。参与者还完成了一份问卷。研究人员于 2018 年收集数据，并于 2019 年进行分析。
地点/参与者：这是一项便利抽样的、具有代表性的 400 名成年含糖饮料消费者（通常每周饮用≥12 盎司）的横断面研究。
研究人员将参与者随机分配到健康警示组（店内的含糖饮料显示包装正面的健康警示标签）或对照组（含糖饮料显示控制标签）。
主要试验结果是购买的含糖饮料卡路里。次要结果包括对试验标签的反应（如负面情绪）以及对含糖饮料的看法和态度（如健康度）。
所有 400 名参与者都完成了试验并纳入分析。健康警示组参与者的西班牙裔比例和超重/肥胖比例均低于对照组参与者。在调整西班牙裔种族和超重/肥胖的意向治疗分析中，健康警示标签导致含糖饮料购买量减少（调整差异，-31.4 卡路里；95%CI=-57.9，-5.0）。未调整的分析结果相似（差异，-32.9 卡路里；95%CI=-58.9，-7.0）。与对照组标签相比，含糖饮料健康警示标签还导致更多的人打算限制含糖饮料的摄入量，并引起更多的关注、负面情绪、思考含糖饮料消费的危害以及预期的社交互动。试验组在对含糖饮料添加糖含量、健康度、吸引力/酷感和疾病风险的看法上没有差异。
在这项自然随机对照试验中，短暂接触健康警示标签减少了含糖饮料的购买。含糖饮料健康警示标签政策可能会抑制含糖饮料的消费。
本研究在 www.clinicaltrials.gov 注册，编号为 NCT03511937。
