Recruiting

Environmental Harm Labels

Sponsor:

Johns Hopkins Bloomberg School of Public Health

Code:

NCT07910617

Conditions

Food Choices

Eligibility Criteria

Sex: All

Age: 18 - 64

Healthy Volunteers: Accepted

Interventions

Control (QR Code) Menu Labels

Traffic-Light Style Environmental Harm Menu Labels

Study Details

Brief summary:

The primary objective of this study is to evaluate whether repeated exposure to environmental harm menu labels on fast-food restaurant menus changes overall dietary quality. Participants will be randomized to view either a control (QR code) label or traffic-light style environmental harm labels on two alternating fast-food restaurant menus, and will order one lunch per week for seven weeks through a study ordering website, with each meal delivered to the participant the following day. The outcome is the change in overall dietary quality from baseline to endline, assessed with 24-hour dietary recalls before and after the seven-week ordering period.

Conditions

Food Choices

Study ID

NCT07910617

Start date

Nov 2, 2026

Status verified date

Nov, 2026

Completion date

Apr 1, 2029

Anticipated

Primary completion date

Apr 1, 2029

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 64

Healthy Volunteers: Accepted

Inclusion Criteria:

  • Aged 18 to 64 years
  • Consumes fast food two or more times per month
  • Willing to eat meat
  • Lives or works within the greater Washington, D.C./Baltimore metropolitan area, defined as the counties and county equivalents within the Baltimore-Columbia-Towson, MD and Washington-Arlington-Alexandria, DC-VA-MD-WV Core Based Statistical Areas (excluding Jefferson County, West Virginia)
  • Has access to the internet during the daytime
  • Has access to an internet-capable device (smartphone, tablet, or computer)
  • Able to send and receive phone calls and text messages at a unique primary phone number (number if not affiliated with a separate prospective or enrolled participant record)
  • Available to receive a weekly lunch delivery one day per week (Tuesday-Friday, 11:00 am - 3:00 pm) for seven weeks at a consistent address within the sample frame (this includes screening for potentially disruptive travel plans during ordering period)
  • Within the delivery zone for both restaurants in the study
  • Willing to complete training on lunch ordering procedures
  • Willing and able to complete dietary recalls and surveys

Exclusion Criteria:

  • Under 18 years of age
  • Over 64 years of age
  • Consumes fast food fewer than two times per month
  • Pescatarian, vegetarian, or vegan (due to menu content)
  • Lives and works outside of the greater Washington, D.C./Baltimore metropolitan area
  • Lacks access to the internet during the daytime
  • Lacks access to an internet-capable device
  • Unable to send and receive phone calls and text messages at a unique primary phone number (phone number is affiliated with a separate prospective or enrolled participant record)
  • Lives or works outside the delivery zone for either or both study restaurants
  • Unavailable to receive seven weeks of consecutive lunch deliveries on a selected day Tuesday through Friday between 11:00 am and 3:00 pm at a consistent address within the sample frame
  • Unwilling to complete training on lunch ordering procedures
  • Unwilling or unable to complete dietary recalls and surveys
  • Fails verification via Cloudfare Turnstile check when accessing REDCap Interest Survey
  • Answers the hidden bot-detection question embedded in the Interest Survey

Study Design

Enrollment

450 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Prevention

Interventions and Outcome Measures

Arms

placebo comparator: Control Label

Participants order one lunch per week for seven weeks from two alternating fast-food restaurant menus. The Week 1 menu is unlabeled. In Weeks 2-7, a control label consisting of a QR code is applied to all main items on the restaurant menus. Participants in this arm are randomized in equal numbers to begin with the burger restaurant menu or the sandwich restaurant menu in Week 1; the two restaurants then alternate weekly, so that each participant sees their first restaurant in Weeks 1, 3, 5 and 7 and the other restaurant in Weeks 2, 4 and 6.

experimental: Environmental Harm Labels

Participants order one lunch per week for seven weeks from two alternating fast-food restaurant menus. The Week 1 menu is unlabeled. In Weeks 2-7, traffic-light style environmental harm labels are applied to all main items on the restaurant menus. Participants in this arm are randomized in equal numbers to begin with the burger restaurant menu or the sandwich restaurant menu in Week 1; the two restaurants then alternate weekly, so that each participant sees their first restaurant in Weeks 1, 3, 5 and 7 and the other restaurant in Weeks 2, 4 and 6.

Interventions

Control (QR Code) Menu Labels

A control label consisting of a QR code is applied to the main items on both restaurant menus in Weeks 2-7. The label carries no environmental information.

Traffic-Light Style Environmental Harm Menu Labels

Traffic-light style environmental harm labels are applied to the main items on both restaurant menus in Weeks 2-7. Each label conveys the environmental harm of the item, defined for participants as how much water and land are required to produce it. Harm levels are assigned from ingredient-level land use and water use factors applied to the ingredients of each menu item.

Primary outcome measure

  • Change in overall dietary quality (Healthy Eating Index-2020) [ Time Frame: Baseline (Week 0, prior to the ordering period) and endline (Week 8, after the seven-week ordering period) ]

Central Contacts and Locations

Central contacts

Nina Carr, MPH, MBA

240-405-2823ncarr6@jhu.edu

Julia Wolfson, PhD, MPP

213-359-2915jwolfso7@jhu.edu

Locations

Johns Hopkins Bloomberg School of Public Health

Recruiting

Baltimore, Maryland, United States, 21205

Contacts

Nina Carr, MPH, MBA

240-405-2823ncarr6@jhu.edu

Principal Investigator:

Julia Wolfson, PhD, MPP

More Information

Sponsor

Johns Hopkins Bloomberg School of Public Health

Last update posted

Nov 4, 2026

Last verified

Nov, 2026

Keywords

  • Food labeling
  • Menu labeling
  • Sustainability
  • Environmental impact
  • Fast food
  • Diet quality
  • Healthy eating index

Trial information was received from ClinicalTrials.gov and was last updated on 2026-11-05. This information was provided to ClinicalTrials.gov by Johns Hopkins Bloomberg School of Public Health on 2026-11-04. Recruitment status is synced daily from ClinicalTrials.gov and may not reflect the sponsor's current status. Confirm during your call.