About this trial
This pilot study will evaluate communication strategies that may improve public understanding of alcohol-related cancer risks and influence behavioral intentions. The study will compare graphic alcohol cancer warning labels with the current U.S. Surgeon General text-only warning label across two stages. The first stage is an in-person, lab-based eye-tracking experiment that will examine differences in visual attention, communication outcomes, harm perception, and behavioral intentions following exposure to graphic versus text-only warning labels. The second stage is a discrete choice experiment that will examine how warning label type, warning label size, and alcohol type (beer, wine, or liquor) influence participants' intentions to reduce or stop alcohol consumption and purchase alcohol. The study will recruit 50 adults aged 21 years or older who report regular alcohol consumption.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Age ≥ 21 years
Regular alcohol consumers (≥ 2 drinks per week)
US residence
Able to read and understand English
Disqualifiers
Are not regular alcohol consumers (< 2 drinks per week)
Are unable to complete study procedures due to cognitive or physical limitations
Decline or withdraw informed consent
Pregnant women, prisoners, persons not residing in the US, and non-alcohol users
Trial design
Single group
Treatments tested in this trial
Alcohol Cancer Warning Labels
BehavioralParticipants will be exposed to alcohol-cancer warning labels during two sequential study states. Stage 1 consists of Eye-Tracking Experiment in which participants will be exposed to six alcohol warning-label stimuli, including graphic alcohol cancer warning labels and Surgeon General text-only warning labels displayed on beer, wine, and liquor containers. Each participant will view all six warning-label stimuli for 15 seconds each in a randomized, counterbalanced order while visual attention is measured using eye-tracking technology. Stage 2 consist of the Discrete Choice Experiment in which participants will choose between 18 randomly presented choice sets. Choice sets will vary by warning label type, warning label size, and alcohol type (beer, wine, or liquor). Participants' responses will be used to assess preferences and behavioral reactions to different alcohol warning-label characteristics.
Treatment groups
Trial outcomes
Primary outcomes
Visual Attention Metrics
Visual attention to predefined areas of interest (AOIs) containing graphic and text-only alcohol warning labels on alcohol beverage container stimuli will be assessed using eye-tracking. Outcome measures include: (1) time to first fixation (milliseconds), defined as the elapsed time from stimulus presentation to the participant's first fixation on an AOI; (2) visit count, defined as the number of visits to an AOI; and (3) dwell time (milliseconds), defined as the cumulative duration of fixations within an AOI. Higher visit counts and dwell times indicate greater visual attention to the warning label.
Intention to Reduce Alcohol Consumption in the Next 30 Days
Participants will select between warning label alternatives that vary by warning label type, warning label size, and alcohol type. The outcome will be measured as the frequency or probability of selecting warning label alternatives perceived as most likely to increase intentions to reduce alcohol consumption within the next 30 days.
Secondary outcomes
Emotional Reactions to Alcohol Warning Labels
Emotional reactions following exposure to the warning labels will include believability, avoidance, cognitive elaboration, and negative affective responses. Believability will be assessed on a scale from 1 (strongly disagree) to 5 (strongly agree). Avoidance will be assessed as yes/no. Cognitive elaboration will be assessed using three items on a scale from 1 (not at all) to 5 (very much), with higher scores indicating greater cognitive processing of the warning label message.. Negative affect will be assessed using five items on a scale from 1 (not at all) to 5 (very much),with higher scores indicating greater negative emotional response.
Change in Harm Perception
Change in harm perception will be assessed with one item asking how worried the participant is that alcohol drinking puts them at risk of cancer in the future, on a scale from 1 (not worried) to 5 (very worried).
Change in Behavioral Intentions Toward Alcohol Consumption
Change in behavioral intentions will be assessed with three items asking to what extent participants are determined to (i) reduce, (ii) completely stop, and (iii) commit to limiting their alcohol intake in the next 30 days, on a scale from 0 to 5, with higher scores indicating stronger intentions to modify alcohol consumption
Intention to Stop Alcohol Consumption in the Next 30 Days
Participants will select the warning label option most likely to increase their intention to stop alcohol consumption in the next 30 days. Warning label alternatives vary by warning label type, warning label size, and alcohol type. The outcome will be measured as the frequency of selecting warning label alternatives perceived as most likely to increase intentions to stop alcohol consumption within the next 30 days.
Sponsors and contacts
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