Research has shown that consumers, particularly those of low socio-economic status, find traditional back-of-pack panels to be complex(1, Reference Garrett2) The 2004 White Paper has identified the need for a front-of-pack system that allows for informed healthy choices and addresses inequalities in health(3). Two systems have been most prominently debated; the ‘traffic-light’ (MTL) and ‘guideline daily amount’ (GDA) systems. Research into system effectiveness is limited and inconclusive(Reference Feunekes, Gortemaker, Willems, Lion and van den4–10), but clearly establishes a need to implement a single system. The present study intended to identify (a) the most effective front-of-pack format for parents, (b) format preferences, (c) the formats' potential for future use and (d) differences across socio-economic groups.
Two groups of parents were selected; one from an area of high deprivation (n 53) and one from an area of low deprivation (n 53), recruited through two schools of a similar size (n 212 and n 194, respectively) in the south of Birmingham. Socio-economic status was determined indirectly using census data for the postcode in which the majority of parents attending the schools lived. Indicators included index of multiple deprivation, levels of unemployment, social housing, self-rating of health, educational attainment, as well as numbers accessing free school meals per school. Both quantitative and qualitative methods were utilized. A self-administered parent questionnaire measured current use of front-of-pack labels, understanding of the two systems (through a product-comparison performance test) and format preferences. Statistical analysis was performed. Focus groups were carried out to explore possible barriers to using front-of-pack labels, features leading to preference and likelihood for future use of the systems. Two groups of four to six individuals were carried out per school using a standardized semi-structured discussion guide. Discourse was audio-taped, transcribed and thematically analysed. For both methods of labelling it was requested that the primary shopper within the family should respond in order to ensure that the results held validity amongst the potential label-using population.
The results revealed no between-group differences in current use of front-of-pack labelling, although lower socio-economic groups identified more barriers to using them, indicating an ‘at-a-glance’ format might be more relevant to them. Performance tests found that the GDA format best allowed consumers to identify healthy products (mean score 3.08 out of 4 v. 2.79 out of 4; P<0.01). There was no difference in performance across socio-economic groups. It was established that the MTL system was preferred by all parents for its ease and speed of use, and was also more likely to be used in the future as it is more accessible and attention-grabbing. Although the GDA system was considered informative, it was also thought to be more difficult to use and easy to ignore.
In conclusion, the study identified a ‘trade-off’ that may occur in attempting to implement a single system of front-of-pack labelling; between a system that provokes active use but leads to less accurate distinctions between products (MTL), and a system that may be overlooked by parents, but leads to marginally healthier choices (GDA).
