Interpretive Nutrition Labels, Parent-Child Interactions, and Food Choices in Indonesia

Last registered on August 14, 2024

Pre-Trial

Trial Information

General Information

Title
Interpretive Nutrition Labels, Parent-Child Interactions, and Food Choices in Indonesia
RCT ID
AEARCTR-0014163
Initial registration date
August 10, 2024

Initial registration date is when the trial was registered.

It corresponds to when the registration was submitted to the Registry to be reviewed for publication.

First published
August 14, 2024, 2:40 PM EDT

First published corresponds to when the trial was first made public on the Registry after being reviewed.

Locations

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Primary Investigator

Affiliation
Erasmus School of Economics

Other Primary Investigator(s)

PI Affiliation
Erasmus School of Health Policy & Management, Erasmus University Rotterdam
PI Affiliation
National Research and Innovation Agency (BRIN), Indonesia

Additional Trial Information

Status
In development
Start date
2024-08-13
End date
2025-06-01
Secondary IDs
Prior work
This trial does not extend or rely on any prior RCTs.
Abstract
Diets in many countries in the Global South are moving towards more processed, unhealthy foods. A good example is Indonesia – the fourth most populous country in the world. While the country has traditionally grappled with undernutrition, food consumption patterns are shifting rapidly. Food expenditures on unhealthy (processed) foods are rising fast especially in urban areas. Unhealthy food consumption raises the risk of overweight, diabetes and ultimately cardiovascular diseases in later life, leading to substantial economic costs and reduced productivity in the future.
One popular policy response to tackle the growing consumption of unhealthy food in the Global North has been the introduction of interpretive nutrition labels. The aim of this project is to explore potentially scalable interventions to improve the food choices of parents and children in Indonesia in a series of lab-in-the-field experiments. The project will test one concrete policy nudge in the form of “traffic lights” labels and further our understanding of how parents (mothers or primary caregivers) can influence children’s food choices. The research will rely on quantitative experimental methods and will be implemented by an interdisciplinary team of international and local researchers.
External Link(s)

Registration Citation

Citation
de Vries Mecheva, Margarita, Puguh Prasetyoputra and Matthias Rieger. 2024. "Interpretive Nutrition Labels, Parent-Child Interactions, and Food Choices in Indonesia." AEA RCT Registry. August 14. https://doi.org/10.1257/rct.14163-1.0
Experimental Details

Interventions

Intervention(s)
The aim of this project is to investigate if interpretive nutrition labels may potentially food consumption of parents and children and that, in turn, may potentially inform current nutrition policies in Indonesia. First, we apply a “traffic lights” food labelling approach in the Indonesian context to examine its potential effect on the nutritional content of the grocery basket for family consumption. Second, we build on previous research studying the effect of “emoji” labels on children’s snack choices by extending the analysis from the lab experiment to a close-to-the-real-life food environment. Third, we assess the spillover effects of “traffic lights” labelling on parental ability and willingness to “correct” children’s choices. Fourth, we explore the nutrition knowledge and motivations behind children’s and parents’ decisions and choices related to food consumption.
Intervention Start Date
2024-08-13
Intervention End Date
2024-09-30

Primary Outcomes

Primary Outcomes (end points)
1. Number, value and proportion of healthy classified products purchased by parents in treatment (“traffic lights” labels) and control groups.
2. Number, value and proportion of healthy classified snacks chosen by children in treatment (“traffic lights labels) and control groups.
3. Parental approval of children snack choices across four parent-child experimental conditions (binary variable where 1=approval).
4. Acceptance of parental (dis)approval by children (binary variable where 1=acceptance) across four parent-child experimental conditions.
Primary Outcomes (explanation)

Secondary Outcomes

Secondary Outcomes (end points)
1. Parental and children’s attitudes towards the “traffic lights” labels (attention, understanding, perception) among parents and children exposed to the “traffic lights” labels.
2. Children’s motivations of choosing the snack (perceived tastiness and healthiness of various snacks).
Secondary Outcomes (explanation)

Experimental Design

Experimental Design
The study uses a randomized control design at the individual level based on the parents of 7-10 years old children from public primary schools. Subjects of our study are the parents and their children that agreed to participate in the laboratory experiment. The schools are sampled at random from the list of public primary schools in the area.

The parents are invited to a room where they are briefed about the procedure, task, the lottery with a chance to win a weekly supply of food for family consumption, and informed about a post-experimental survey. Participants are told that they are given 15 minutes and a fixed (virtual) budget to buy food and drink items in an online supermarket using their mobile phones. The online experimental supermarket offers a range of fresh fruits and vegetables, processed and non-processed foods, and healthy and sugary drinks. Following the completion of the experimental task, the participants fill out a post-experimental survey questionnaire. At the end of the session, the parents are invited to another room to pick up their children.

We invite children to participate in a quiz and bring them one-by-one to a separate room making a stop on the way to pick up a snack. In that room the children are waiting for their parents, fill a quiz, and their height and weight are measured. The parents are invited to pick up their children and every parent is asked to tell the child whether he or she is allowed to consume the snack.
Experimental Design Details
Not available
Randomization Method
Randomization of parents and children is done by a computer
Randomization Unit
Individual
Was the treatment clustered?
No

Experiment Characteristics

Sample size: planned number of clusters
20 schools (we plan to add more schools if participation in the randomly selected 20 schools is lower than expected)
Sample size: planned number of observations
800 parents and 800 children
Sample size (or number of clusters) by treatment arms
800 dyads parent-child
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
The minimum required sample size of 800 observations (parent-child dyads) is calculated assuming 80 percent power and a 5 percent level of significance. We expect the minimum detectable treatment effect of 9.7 percentage points. The value share of processed/prepared foods accounts for 36 percent of per capita monthly food expenditures in urban Indonesia (National Statistics Bureau of Indonesia). If the share of unhealthy foods (labeled “red” in treatment “Traffic lights”) in the experimental shopping basket of adults at a baseline will be 40 (rounded) percent, we are powered to detect a positive treatment effect (“traffic lights”) decreasing the share to 30 percent within our setting given that we look at repeat exposure to labels in the online supermarket.
IRB

Institutional Review Boards (IRBs)

IRB Name
Erasmus School of Economics IRB-E
IRB Approval Date
2024-05-21
IRB Approval Number
ETH2324-0810
IRB Name
The Ethics Committee on Social Studies and Humanities (NRIA), National Research and Innovation Agency, Indonesia
IRB Approval Date
2024-07-17
IRB Approval Number
28062024000004
Analysis Plan

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