Johns Hopkins Bloomberg School of Public Health
The primary objective of this study is to evaluate whether repeated exposure to environmental harm menu labels on fast-food restaurant menus changes overall dietary quality. Participants will be randomized to view either a control (QR code) label or traffic-light style environmental harm labels on two alternating fast-food restaurant menus, and will order one lunch per week for seven weeks through a study ordering website, with each meal delivered to the participant the following day. The outcome is the change in overall dietary quality from baseline to endline, assessed with 24-hour dietary recalls before and after the seven-week ordering period.
Fast-food restaurants, where over one-third of Americans eat on a typical day, are an important setting for dietary interventions aimed at reducing nutrition-related chronic diseases. Prior research on eco-labels, including this team's preliminary studies, has tested labels in online randomized experiments in which food choices are hypothetical. This trial assesses the change in overall dietary intake after seven weeks of repeated exposure to environmental harm labels on fast-food menus, in a real-world setting in which participants receive the foods chosen foods. A total of 450 adults aged 1…
Inclusion Criteria: * Aged 18 to 64 years * Consumes fast food two or more times per month * Willing to eat meat * Lives or works within the greater Washington, D.C./Baltimore metropolitan area, defined as the counties and county equivalents within the Baltimore-Columbia-Towson, MD and Washington-Arlington-Alexandria, DC-VA-MD-WV Core Based Statistical Areas (excluding Jefferson County, West Virginia) * Has access to the internet during the daytime * Has access to an internet-capable device (smartphone, tablet, or computer) * Able to send and receive phone calls and text messages at a unique…
A control label consisting of a QR code is applied to the main items on both restaurant menus in Weeks 2-7. The label carries no environmental information.
Traffic-light style environmental harm labels are applied to the main items on both restaurant menus in Weeks 2-7. Each label conveys the environmental harm of the item, defined for participants as how much water and land are required to produce it. Harm levels are assigned from ingredient-level land use and water use factors applied to the ingredients of each menu item.
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