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Updated: Sep 16, 2025
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A Method for Manipulating Blood Glucose and Measuring Resulting Changes in Cognitive Accessibility of Target Stimuli
Published on: August 12, 2016
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Online RCT of Added-Sugar Warning Labels and Spanish-English Label Education.
Ethan C Wolf1, Marissa G Hall2, Dean Schillinger3
1Human Development and Family Studies Program, Department of Human Ecology, University of California, Davis, Davis, California; Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California.
American Journal of Preventive Medicine
|July 5, 2025
Summary
Combining multilingual educational messages with front-of-package added-sugar warning labels significantly reduced sugar-sweetened beverage selection among Hispanic adults. This combined approach proved most effective in improving dietary choices for diverse populations.
Area of Science:
- Public Health Nutrition
- Health Communication
- Behavioral Science
Background:
- Front-of-package added-sugar warning labels can improve U.S. dietary patterns.
- Effectiveness may be limited by English proficiency; multilingual campaigns can enhance reach.
- Previous research has not fully explored the combined impact of labels and multilingual messages.
Purpose of the Study:
- To determine if a combined added-sugar warning label and Spanish/English educational message reduces sugar-sweetened beverage (SSB) selection intention.
- To compare the efficacy of the combined intervention against a warning label alone or an educational message alone.
- To assess effectiveness among U.S. Hispanic adults with varying acculturation levels.
Main Methods:
- Online randomized controlled trial (RCT) involving 2,000 U.S. Hispanic adults.
- Participants randomized into four groups: control, language-matched message, warning label, or message plus warning.
- Main outcome: intention to select SSBs measured via hypothetical online shopping task.
Main Results:
- The message-plus-warning condition (27% SSB selection) significantly reduced selection compared to control (58%), message only (43%), and warning label only (38%).
- Combined intervention showed greater efficacy than either component alone (p<0.001).
- Intervention effects varied by acculturation, language of study navigation, and income.
Conclusions:
- Multilingual educational messages accompanying added-sugar warning labels can enhance public health outcomes.
- This combined strategy is particularly beneficial for populations with diverse acculturation and language proficiencies.
- Findings support the integration of culturally and linguistically tailored communication with front-of-package labeling policies.
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