Abstract
BACKGROUND: Unhealthy snacking among Indonesian adolescents is common and contributes to rising rates of overweight and obesity. With the growing availability and marketing of ultraprocessed snacks, front-of-package labels (FOPLs) have emerged as a promising tool to help adolescents make healthier snack purchases. OBJECTIVES: This study aims to explore Indonesian adolescents' drivers of snack purchase, perceptions of different FOPLs, and views on design features that could influence the impact of FOPLs. METHODS: We employed a mixed-method design, incorporating both focus group discussions (FDGs) and an online survey. Eight FDGs were conducted with 46 participants aged 12-18, of different socioeconomic status from Jakarta metropolitan areas. Three FOPLs, a warning label, traffic light label (TLL), and "healthier choice" label, were tested both independently and as part of snack packages. The Pan American Health Organization nutrient profile and the UK nutrient profile were used for the warning label and TLL, respectively. Participants completed a demographics questionnaire, then an online assessment and discussion that encompassed food purchasing decisions, reactions to each of the FOPLs, comparison of FOPLs, and comparing alternative label designs for each FOPL type. Thematic analysis and the Likert scale were used for quantitative and qualitative analysis, respectively. RESULTS: Although adolescents preferred the TLL, finding them informative, attractive, and believable, the information conveyed by the TLL was not well understood, particularly by participants with low socioeconomic status. In contrast, although warning labels were less well-liked, they were better understood, grabbed their attention, and were perceived as most likely to discourage them from buying unhealthy foods. The healthier choice label was perceived as least likely to discourage purchases of unhealthy foods. CONCLUSIONS: Although TLLs are best liked among Indonesian adolescents, warning labels are perceived as most likely to help adolescents identify unhealthy foods and discourage their purchases.