Designing Front-of-Package Labels to Inform Consumers and Encourage Healthier Food Choices in Bangladesh: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Setting
2.2. Sample
2.3. Label Design
2.4. Procedure
2.5. Positionality
2.6. Analysis
3. Results
3.1. Descriptive Results
3.2. Perceptions of Healthfulness, Unhealthfulness, and Nutrients of Concern
“If a food contains all the necessary elements for our body, we can consider it a nutritious food. For example, if a biscuit contains flour, sugar, salt, milk, and some liquid glucose in appropriate quantities, then that biscuit will also be healthy for us.”
“By healthy food, we mean packaged foods. Flies and mosquitoes sit, and dust and dirt fall on the unpackaged foods, but the packaged food is safe from these.”
3.3. FOPL Evaluation
“Everyone will understand [the warning label]. It can be understood just by looking at a glance. Only one color is used here. For traffic, we have to understand the three colors on the road. But here, it’s all in one color. My problem there (color-coded GDA) would be figuring out what red, yellow, or green means. But here, it’s black. It means, “It cannot be eaten”. It’s harmful to me. The white letters on black are clearly visible.”
“When we go to buy packaged food, the details are on the label. But I don’t read those. Because I know that they may be correct or not. Because I don’t trust labels.”
3.4. Warning Label Design Elements
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A. Warning Label Design Elements
Appendix B. Full Translated Discussion Guide
- Section 1. Discussion about the healthfulness of foods and drinks
“First, we are going to talk about what you think about some nutrients, like sugar, and some food and drink products.”
- General Discussion
- “First, let’s talk about food in general. When you think of a food that is healthy, what are some of its characteristics? What makes it healthy? When you think of a food that is unhealthy, what are some of its characteristics? What makes it unhealthy?”
- “Now, we’ll talk about sugar.
- a.
- When you think about foods that are high in sugar, what are some examples? When you think of drinks that are high in sugar, what are some examples? I’d like you to focus your answers on products that you would buy at a store vs those that you or someone in your household might prepare at home.
- b.
- Now let’s consider some specific (packaged) foods and drinks that are high in sugar, like (XYZ; show images of a couple of foods and a couple of drinks). Do you think it is good or bad for your health to eat these foods that are high in sugar? Why?
- c.
- What are some of the health effects of eating too much sugar?”
- “Now, let’s talk about sodium or salt.
- a.
- When you think about foods that are high in salt, what are some examples? When you think of drinks that are high in sugar, what are some examples? I’d like you to focus your answers on products that you would buy at a store vs those that you or someone in your household might prepare at home.
- b.
- Now let’s consider some specific (packaged) foods and drinks that are high in salt, like (XYZ; show images of a couple of foods and a couple of drinks). Do you think it is good or bad for your health to eat these foods that are high in salt? Why?
- c.
- What are some of the health effects of eating too much salt?”
- “Now, let’s talk about saturated fat.
- a.
- What is saturated fat? Where does it come from? (Answer: saturated fat is a type of fat that has a different structure than unsaturated fat. Saturated fat mainly comes from animal-source foods, whereas most unsaturated fat comes from plants).
- b.
- When you think about foods that are high in saturated fat, what are some examples? When you think of drinks that are high in saturated fat, what are some examples? I’d like you to focus your answers on products that you would buy at a store vs those that you or someone in your household might prepare at home.
- c.
- Now let’s consider some specific (packaged) foods and drinks that are high in saturated fat, like (XYZ; show images of a couple of foods and a couple of drinks). Do you think it is good or bad for your health to eat these foods that are high in saturated fat? Why?
- d.
- What are some of the health effects of eating too much-saturated fat?”
- Section 2. FOPL Testing
“Now, I’m going to show you all some images of food packages and their labels, and then ask you some questions about them.”
- Section 2A. Main Label Testing:
- [Repeat this section for both labels that will be tested]. Then, proceed to show the main image for testing Label #1 (e.g., the 4 products with Label #1). Keep it up for 10 s or so until everyone seems to have seen it clearly. Then turn off the image.]
- Visibility/Memorability
- “Were the labels easily visible? Did it grab your attention? How visible was it? Was it immediately visible or not? Did it catch your eye?”
- “Were the labels memorable? Why or why not?”
- “Can you recall the label for me now? What exactly did it look like? What do you recall of its shape, color? Was there any text in it? What did it say?” [Without leading their answers, probe respondents’ memory of its shape, color, text, icon, etc.]“Now, I’m going to show you the labels again and ask you more questions about them.” [You can highlight the specific labels you are talking about.]
- Comprehensibility
- “What did you understand from the labels?
- Is there anything you did not understand about the label or that confused you about it?
- What did the labels tell you about the food and drinks they were on? (probe for if they thought the product was healthy or unhealthy)
- Who do you think these labels are for?
- Did you believe what the label said?
- Is there anything about this label that is culturally inappropriate? Is there anything about it that is likely to be difficult to understand/interpret for Bangladeshi food shoppers?”
- Potential Effectiveness
- “If you were at the store and saw these labels on a food or drink package, would they change your attitude toward the product? How?
- If you saw this label on food or drink packages in a store, would it affect your decision to buy that product or not? How would it affect your decision to buy it?”
- Section 2B. Comparative Rating
- Show a slide that contains both label types (Warning + GDA).
“Now please look at both labels you have seen today. Does either label stand out for you? What about that label makes it stand out the most? Why do the other labels not stand out as much to you?
Which label do you think would most help you identify that food was unhealthy? Which label would most discourage you from buying unhealthy foods?”
- Section 3. Warning label elements
“Now, we are going to talk about some of the design elements of the warning label that you saw. We’d like to consider various elements of the label design, and I’d like your views on whether changing it would improve the effectiveness of the label or not. To start off, I’d like you to consider the ICONS or the pictures we’ve used in the label. I’ll show you the label you saw earlier and some alternatives.”
“The following are the elements of the front-of-pack warning label that will be tested. Please familiarize yourself with them so that you may guide the participants effectively.”
- “Let’s start with the icon of FAT. Of the options before you:
- Is there anything inappropriate or offensive about the alternatives proposed?
- Do the alterations improve your understanding of the label? That is, does it give you a more accurate understanding of what the label intends to say? How does it do so?
- Does the presence of an icon (compared to no icon) improve your understanding of the label? How does it do so?
- Of the options before you, which one do you think is more likely to be effective in grabbing people’s attention and deterring the purchase of unhealthy food? How does it do so?“Now, I’d like us to look at the SYMBOL/HOLDING SHAPE and COLORS we’ve used for the label. [Moderator, point to the outside shape to ensure that participants have understood exactly what was meant.] At the same time, I would like us to look at the symbol/holding shape in different colors. Here’s the original label together with an alternative symbol shape”. [SHOW SLIDE] and here are both symbols in different colors. [SHOW SLIDE] [Moderator to move to the three appropriate slides, in step with the discussion and questions below.]“Now, I’d like us to look at different food products with different symbols in different colors.” [SHOW SLIDE]. Here is another product with all of the symbols in different shapes and in red and black. [SHOW SLIDE].
- Do the alterations improve your understanding of the label? That is, does it give you a more accurate understanding of what the label intends to say? How does it do so?
- Does the presence of the (alternate shape) improve your understanding of the label? How does it do so?
- Does the presence of the (alternate color) improve your understanding of the label? How does it do so?
- Of the options before you, which one do you think is more likely to be effective in grabbing people’s attention and deterring the purchase of unhealthy food?“Now, I’d like us to look at the WARNING DEVICES on the label. [Moderator, ensure that the participants understand what is being referred to.] I’ll show you the initial label again, and an alternative to the original”. [SHOW SLIDE]“Here’s the initial label with the initial warning device. And now here are three alternatives; one with an additional exclamation mark, one without the warning text, and the last one in red as well.” [Moderator to move to the appropriate slides, in step with the discussion and questions.]
- Do the alterations improve your understanding of the label? That is, does it give you a more accurate understanding of what the label intends to say? How does it do so?
- Does the presence of the (alternate warning device) improve your understanding of the label? How does it do so?
- Of the options before you, which one do you think is more likely to be effective in grabbing people’s attention and deterring the purchase of unhealthy food? [Moderator, ensure that each participant’s response is solicited and noted by the research assistant.]“Now, I’d like us to look at the HOLDING STRAP we’ve used around the label. [Moderator, ensure that the participants have understood what is referred to.] I’ll show you the initial label again, and an alternative”. [SHOW SLIDE]
- [Moderator to move to the appropriate slides, in step with the discussion and questions below.]
- Here’s the initial label (white background). And now here is an alternative (black background).
- Do the alterations improve your understanding of the label? That is, does it give you a more accurate understanding of what the label intends to say? How does it do so?
- Does the presence of the (alternate holding strap) improve your understanding of the label? How does it do so?
- Of the options before you, which one do you think is more likely to be effective in grabbing people’s attention and deterring the purchase of unhealthy food? [Moderator, ensure that each participant’s response is solicited and noted by the research assistant.]
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N | % | |
---|---|---|
Gender | ||
Man | 46 | 60.5 |
Woman | 30 | 39.5 |
Location | ||
Urban—Dhaka | 16 | 21.1 |
Urban—Sylhet | 15 | 19.7 |
Urban—Jamalpur | 7 | 9.2 |
Rural—Dhaka | 8 | 10.5 |
Rural—Jamalpur | 9 | 11.8 |
Rural—Kishoreganj | 14 | 18.4 |
Rural—Rangpur | 7 | 9.2 |
Age group | ||
18–34 | 62 | 81.6 |
35–50 | 14 | 18.4 |
Highest level of education | ||
No formal education | 3 | 3.9 |
Completed primary school | 20 | 26.3 |
Completed secondary school | 15 | 19.7 |
Completed higher secondary | 13 | 17.1 |
Completed college/university | 25 | 32.9 |
Has children under 16 y | ||
Yes | 53 | 69.7 |
Income (taka) | ||
Urban, mean ± SD (min-max) | 31,842 ± 21,378 (9000–100,000) | |
Rural, mean ± SD (min-max) | 18,763 ± 7401 (10,000–45,000) | |
How often do you purchase packaged food and drinks? | ||
Never or rarely | 11 | 14.5 |
A few times a week | 32 | 42.1 |
Once a day | 23 | 30.3 |
More than once a day | 10 | 13.2 |
Section | Theme | Sub-Themes |
---|---|---|
Perceptions of healthfulness | Perceptions of healthy foods | Ingredients |
Nutrients | ||
Level of processing | ||
Naturalness | ||
Food safety, cleanliness, and hygiene | ||
Preparation | ||
Perceptions of unhealthy foods | Ingredients | |
Nutrients | ||
Level of processing | ||
Naturalness | ||
Food safety, cleanliness, and hygiene | ||
Preparation | ||
Addictiveness | ||
Perceptions of sugar, sodium, and saturated fat | Top sources of sugar, sodium, and saturated fat | |
Health effects of excess consumption | ||
Misconceptions | ||
FOPL reactions | Visibility and memorability | Visibility and attention-grabbing |
Memorability | ||
Comprehension | Ability to understand the purpose of the label | |
Meaning of the label | ||
Other label reactions | Believability | |
Cultural appropriateness | ||
Target population of the label | ||
Perceived effectiveness | Potential effect on product attitudes | |
Potential effect on intentions to purchase | ||
Perceived benefits and harms | ||
FOPL comparison | FOPL comparison | Selection of which FOPL was perceived as most effective |
Alternative design comparison | Label or design preference | Attractiveness and memorability |
Cultural appropriateness | ||
Informational/understandability | ||
Perceived effect | ||
Overall preference |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Taillie, L.S.; Abrar, A.K.; Afroza, U.; Akhtar, J.; Noe, V.; Ide, N.; Abdel-Gawad, N.; Choudhury, S.R. Designing Front-of-Package Labels to Inform Consumers and Encourage Healthier Food Choices in Bangladesh: A Qualitative Study. Nutrients 2024, 16, 3989. https://doi.org/10.3390/nu16233989
Taillie LS, Abrar AK, Afroza U, Akhtar J, Noe V, Ide N, Abdel-Gawad N, Choudhury SR. Designing Front-of-Package Labels to Inform Consumers and Encourage Healthier Food Choices in Bangladesh: A Qualitative Study. Nutrients. 2024; 16(23):3989. https://doi.org/10.3390/nu16233989
Chicago/Turabian StyleTaillie, Lindsey Smith, Ahmad Khairul Abrar, Ummay Afroza, Jubaida Akhtar, Violet Noe, Nicole Ide, Nora Abdel-Gawad, and Sohel Reza Choudhury. 2024. "Designing Front-of-Package Labels to Inform Consumers and Encourage Healthier Food Choices in Bangladesh: A Qualitative Study" Nutrients 16, no. 23: 3989. https://doi.org/10.3390/nu16233989
APA StyleTaillie, L. S., Abrar, A. K., Afroza, U., Akhtar, J., Noe, V., Ide, N., Abdel-Gawad, N., & Choudhury, S. R. (2024). Designing Front-of-Package Labels to Inform Consumers and Encourage Healthier Food Choices in Bangladesh: A Qualitative Study. Nutrients, 16(23), 3989. https://doi.org/10.3390/nu16233989