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Official NIH NLM MEDLINE / PubMed Citation • PMID: 42989587 • DOI: 10.1017/S1368980026103723

National support for a healthy checkout policy: a randomised message-framing experiment.

Public health nutrition • 2026 Nov • Vol. 29 : e240 • ISSN 1475-2727
Authors: Andrea M Gil, Alexandria E Reimold, Brittany Lemmon, Ethan C Wolf, Lori Dorfman, Susan D Brown, Lauren E Au, Jennifer Falbe
Graduate Group in Nutritional Biology, University of California, Davis, USA.

Verbatim Formal Study Abstract

OBJECTIVE

Healthy checkout policies set nutritional standards for store checkouts and have been implemented in three US jurisdictions. We compared four message frames, each describing a different rationale for the policy, on adults' support for a healthy checkout policy.

DESIGN

Participants were randomised to one of four message frames: (1) expanding healthy choices; (2) reducing parental stress by removing unhealthy items from child eye level; (3) improving community and child health; or (4) addressing predatory marketing. We used Poisson regression with robust standard errors to examine policy support by message frame and explore variation in support by socio-demographic characteristics.

SETTING

Online randomised experiment.

PARTICIPANTS

A convenience sample of US adults (analytic N 3978) recruited online via quota-matching to approximate national socio-demographic characteristics.

RESULTS

Overall, most participants (65 %) supported a healthy checkout policy. Support was moderately higher (68 %) when the policy was framed as reducing parental stress than addressing predatory marketing (64 %) or expanding healthy choices (61 %; all p < 0&#xb7;05). Policy support was also higher when framed as improving community and child health (67 %) than expanding healthy choices (61 %; p < 0&#xb7;01). In adjusted models, overall policy support was higher among adults with Hispanic ethnicity (68 %); incomes >$35 000 (range 66-70 %); a prediabetes or type 2 diabetes diagnosis (67 %); at least some college education (67 %) and residence in the Northeast US (70 %; all p < 0&#xb7;05).

CONCLUSIONS

Support for a healthy checkout policy was high, especially when framed around benefits to child health. Adults with certain socio-demographic and clinical characteristics may especially support healthy checkout policies.

Publication Classification: Journal Article Randomized Controlled Trial
NLM MeSH Descriptors: Humans Female Nutrition Policy Male United States Adult Middle Aged Health Promotion Choice Behavior Young Adult Marketing Adolescent