title: Understanding and acceptability by Hispanic consumers of four front-of-pack food labels.
abstract: Front-of-pack food labels (FOPL) can help consumers make healthy and informed food choices. FOPL are used in the food market but evaluations of their understanding and acceptability are scanty. This study aimed to explore the subjective understanding and acceptability of four FOPL among Hispanic consumers.
  
  
  
  A qualitative study was conducted in six States of Mexico, in 18 urban elementary schools. A purposive sample of 135 parents of fifth-grade children was selected. Four FOPL were assessed: Logos, Rating Stars, Guideline Daily Allowances (GDA's), and Multiple Traffic Lights (MTL). Trained interviewers performed 18 focus groups with the participants, using an interview guide. Participants were asked about their subjective understanding and acceptability of the FOPL, displaying 16 generic breakfast cereal boxes designed for this study (four for each FOPL), varying in their nutritional value. Afterwards, participants were asked to choose among the four cereal boxes the one to best communicate the product healthiness and their reasons for choice, proposals for improving the FOPL, and desirable characteristics for new FOPL. Finally, a socio-demographic questionnaire was applied. Thematic analysis of the transcriptions of the focus groups was performed, using Altlas.tiV5 software.
  
  
  
  Logos were perceived as easy to understand, highly acceptable, and useful for decision-making; institutional endorsement of Logos was related to greater confidence in the label. The GDA's were hard to understand considering the nutritional knowledge and time needed for interpretation. The Rating Stars were related to the quality in businesses rather than foods. The MTL were viewed as indicating the high/low content of specific nutrients, but the meaning of the amber color was not fully understood. Participants highlighted the need for a simple FOPL that allows easily identification of healthy products while considering food purchasing time limitations and interpretation of food portions.
  
  
  
  Logos with an institutional endorsement was the best understood and accepted FOPL, and the GDA's and Rating Stars were the least. Our findings provide valuable insights about Hispanic consumers´ perceptions regarding FOPL and to guide public health policy. Further studies are needed in populations with chronic diseases and diverse social contexts.
authors.affiliation: Centre for Nutrition and Health Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico.
authors.forename: Vanessa
authors.initials: V
authors.lastname: De la Cruz-Góngora
authors.affiliation: Centre for Health Systems Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico. pilar.torres@insp.mx.
authors.forename: Pilar
authors.identifier: 0000-0003-1869-2044
authors.initials: P
authors.lastname: Torres
authors.affiliation: Centre for Nutrition and Health Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Contreras-Manzano
authors.affiliation: Centre for Nutrition and Health Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Jáuregui de la Mota
authors.affiliation: Centre for Nutrition and Health Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico.
authors.forename: Verónica
authors.initials: V
authors.lastname: Mundo-Rosas
authors.affiliation: Centre for Nutrition and Health Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico.
authors.forename: Salvador
authors.initials: S
authors.lastname: Villalpando
authors.affiliation: Centre for Population Health Research, National Institute of Public Health, Av. Universidad # 655, Col. Sta. Ma. Ahuacatitlán, Cuernavaca, Morelos, C.P. 62100, Mexico.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Rodríguez-Oliveros
mesh_terms: D000328:Adult; D002648:Child; D002755:Choice Behavior; D032882:Comprehension; D003258:Consumer Behavior; D004032:Diet; D057140:Fast Foods; D005260:Female; D017144:Focus Groups; D005515:Food Labeling; D005518:Food Preferences; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008800:Mexico; D009042:Motivation; D018673:Nutrition Policy; D009753:Nutritive Value; D010290:Parents; D010465:Perception; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: FOPL acceptability; FOPL understanding; Food labeling; Front-of-pack labels; Guideline daily allowance; Hispanics; Logos; Multiple traffic lights; Packaged foods; Stars rating