Added-Sugars Warning Label PSAs

Noticing, recall, and understanding of the added sugar menu label

Noticing, recall, and understanding (hereafter, "noticing") of an added-sugars nutrient label where participants will be asked if they noticed any menu labels. If "Yes", participants would be asked what the warning label told them about (e.g., added sugars), and if answered "added sugars", what about added sugars (e.g., high amount of added sugars). If the three answers were "Yes", "Added sugars", and "high amount of added sugars", the dichotomous variable would be correct. Otherwise, the variable would be classified as incorrect. This outcome will be compared between the experimental PSA arm and the control PSA arm and between each of the three PSA intervention themes. Analysis will use Poisson regression with robust standard errors. Adapted from doi: 10.1016/j.amepre.2025.108038.

Grams of added sugar ordered

After the intervention, participants will place hypothetical meal orders from 2 realistic menus, shown in random order, that display an added-sugars warning label next to items containing ≥100% of the Daily Value for added sugars and a disclosure statement explaining the label's meaning. Added-sugars data will be estimated using restaurant website nutritional information. Analyses will use linear regression. Adapted from doi: 10.1016/j.amepre.2025.108038.

Noticing, recall, and understanding the PSAs

Noticing, recall, and understanding (hereafter, "noticing") of added-sugars PSAs where participants will be asked if they noticed any PSAs with response options "yes", "no", or "not sure". Then, participants will be asked what the previously viewed PSAs told them about. Response options include safe driving, covid-19 testing, labels for added sugars, calories labels, fruits and vegetables, exercise, how to filter water, labels indicating healthy food, "none of these options", or "I do not recall seeing a public service announcement (PSA)". If answers are "yes" and "labels for added sugars", respectively, the variable would be coded as correct and otherwise, incorrect. Analysis will use Poisson regression with robust standard errors. Adapted from doi: 10.1016/j.amepre.2025.108038.

Reported use of added-sugars label when selecting food items

If participants answer "yes" to the label noticing measure and correctly recall the nutrition label, they will be asked, "Did you use the label when deciding which food to select?" Response options will be "yes" or "no". The dichotomous outcome of reported use will be analyzed using Poisson regression with robust standard errors. Adapted from doi: 10.1016/S2468-2667(26)00027-7.

Selection of a food item high in added sugars for themselves

In a hypothetical menu ordering task, participants will select a food they would purchase for themselves. A dichotomous outcome (ordered high added-sugars item vs. did not order high added-sugars item) will be used. Analysis will use Poisson regression with robust standard errors. Adapted from doi: 10.1016/S2468-2667(26)00027-7.

Perceived message effectiveness of label

Adapted 1-item UNC PME scale specifically regarding the added-sugars warning label (i.e., discourage) with a 5-point scale from 1= not at all to 5= a great deal \[the higher the score, the higher the perceived effectiveness\]. Responses will be treated as a continuous outcome in linear regression. Adapted from doi: 10.1093/abm/kay080.