2. Materials and Methods
FOP
EVENTS
Participants in this randomized controlled trial were 175 pairs of one parent/caregiver and one 5–10-year-old child who were recruited as part of a larger study that also examined parenting style. Children ranged in age from 5 to 10 years (Adult participants were excluded from participating if they did not speak English or Spanish and did not have a child aged 5 to 10 years old. Participants were recruited through (i) flyers in schools, community clinics, hospitals, physicians’ offices, and other local facilities, (ii) letters to area families with school-aged children, (iii) informational sessions at community events and churches, (iv) newspaper, radio, and public service announcements, (v) e-mails to school and other community listservs with parents of school-aged children; and (vi) a community health promotion organization that primarily serves low-income and Hispanic families. Materials invited families to participate in two studies to better understand parent and child impressions of product advertisements and parent–child interactions while grocery shopping. Participants came to an on-campus laboratory to complete Study 1 (video rating) and moved to a separate lab in a nearby building on campus for Study 2 (food selection task in mock grocery/convenience store aisle). Both studies are described in detail below:Study 1: Video Rating. After obtaining parent consent and child assent, parents and children participated in what was described as a marketing study. Parents and children viewed a series of 7 advertisements. Dyads in the FOP Only condition and the Control group viewed a series of 7 unfamiliar product ads (taken from other English-speaking countries). All ads were appropriate for children and included Spanish subtitles. Dyads in the FOP + Video condition (i.e., those participants randomly assigned to see both FOP labels during the shopping task and an explanatory video) viewed the same ads, but also viewed an FOP-label public service announcement (PSA)-style educational video created by the study team. This educational advertisement explained the purpose of the relevant “Healthy Stars” FOP labels and explained how to use these labels to evaluate the healthfulness of foods. This education was modeled after a PSA/commercial advertisement and was 30 s long. After viewing each ad, participants were asked two questions requiring them to evaluate the quality of the ad as well as the main message of the ad: (1) “Can you tell me how much you disliked vs. liked the commercial you just saw?” from “liked a lot” to “disliked a lot” (the children’s version of the questionnaire also had corresponding emoji-style face images showing a very happy face to a very unhappy face), and (2) the open-ended question “Please describe what this commercial was about.”Study 2: Food Selection. In a different laboratory in a nearby university building, two mock grocery aisles were set up on opposite walls, stocked with 90 common foods and beverages including canned fruits, vegetables and legumes, pastas and pasta sauce, cookies, peanuts, crackers, soups, cereal bars, peanut butter, jelly, breakfast cereals, snack foods such as pretzels and potato chips, juice, soda, canned fish and meats, and dried fruit. The products on the shelves were in the same locations in each aisle, with the only difference being the presence of added 1–4-star FOP labels in the upper right-hand corner of all items included in one of the aisles (see After obtaining parent consent and child assent to participate in Study 2, participants were provided with a grocery basket and instructed that they could choose up to USD 20 worth of products from the grocery aisle to take home with them and they were further instructed that parents and children should work together to make their choices. The specific prompt provided was “We’ll give you a $20 budget and ask you to pick out foods like you were grocery shopping together, and you’ll get to take these foods home today. You can choose any foods you want, but you can’t go over the $20 budget, and you won’t get to keep any money left over if you spend less than $20.” No instructions were provided regarding the FOP labels. All prices were rounded to the nearest whole dollar amount to facilitate ease of calculating USD 20 worth of products for participants. Once participants had selected their preferred products, they notified the experimenter that they were finished. The experimenter then calculated the total price of the items in the grocery basket, and if the price exceeded USD 20, participants were asked to return something in order to get to USD 20 or less. At the conclusion of this task, the experimenter made note of which products were selected and the parent completed a brief food purchasing questionnaire asking how frequently they buy the foods that they selected in this Study 2 food selection task. Finally, parents completed questionnaires for approximately 30 min while children played with toys provided by the experimenter.To delay directing attention to the health/nutrition focus of the study, parents responded to health-related questions after completing the food selection task. Parents were permitted to skip any questions that they were not comfortable answering. The questionnaire assessed parent/child overall health (i.e., “Rate your [your child’s] overall health.”), parent perception of the importance of health and healthy eating (e.g., “How important is it to you to purchase healthy food?”), perceptions of what makes some products healthy (e.g., “How important is sodium in determining whether a food is healthy?”), and awareness of federal nutrition information programs and use of food labels (e.g., “How often do you read the nutrition information on food labels before purchasing foods or beverages?”); (questions were taken from the National Health and Nutrition Examination Survey.) Parents completed a brief battery of measures to assess potential control/confounding variables, including demographics (e.g., age, race, ethnicity, marital status, household income, and education), home environment (e.g., “There is very little commotion in our home”), family resources (e.g., “[We have] money to buy necessities”), family well-being (e.g., purchasing behavior/intention for a selected list of products (i.e., those categories of foods and beverages available in the study aisle—see After completing these procedures for Study 1 and Study 2, dyads were debriefed about the aims of the research and the link between the two studies. As they departed, dyads received the foods and beverages they selected from the grocery aisle, a USD 10 gift card for their participation in Study 1, and a USD 20 gift card for their participation in Study 2.