Consumer Food Safety Education Problems, Perspectives ... · Consumer Food Safety Education . Problems, Perspectives & Proposed Solutions . Patricia Borrusso, Ph.D. ORISE Fellow

+ Consumer Food Safety Education

Problems,

Perspectives & Proposed Solutions

Patricia Borrusso, Ph.D. ORISE Fellow FDA Center for Food Safety and Applied Nutrition PFSE Partner Meeting May 12 2015

+ Today’s Presentation

o Background & Purpose

o Methods

o Overview of Results

o Draft* Proposed Solutions

o Conclusions & Discussion

+ Background How do we (continue to) improve behavior?

CDC 2014, https://www.healthypeople.gov/sites/default/files/Food%20and%20Medical%20Product%20Safety%20Slides%20.pdf

+ Purpose Systematic Literature Review

Review consumer food safety campaigns and research from the last 20 years

Evaluate the influence of internal and external factors on consumer behavior

Provide recommendations for future research and programs to continue to improve consumer food safety

+

Inclusion Criteria:

Published food safety research (N=243) Recent (last 15 years), from similar countries Related to one of the following topics:

Consumer knowledge, attitudes, and behavior Communication and behavior theory Design, execution & outcomes of interventions

Methods Systematic Literature Review

+

Overview of Results

+ Results: Problems & Perspectives Consumer Food Safety Interventions (n=51)

Audience 33% Children

33% General

4% Pregnant women

Behavior Measurement 20% Observed

69% Self-Reported

Length of Intervention 30% One time only

Follow Up Period 41% Immediately 26% < 1 month

4% > 6 months

Design & Evaluation 49% Single group, Pre/Post test

28% Multi group, Non-randomized

14% Non-equivalent controls

16% Randomized, controlled trials

+ Results: Summary Impact & Limitations

Interventions can impact consumer knowledge and behavior + Almost all report some positive outcomes (pub. bias…)

But… + Exact relationships between these factors are not clear

Limitations Lack Randomization Inadequate Controls Short Interventions & Follow-up Few Direct Observations

+ Results: Summary Key (?) Behavioral Influences

Knowledge How? When? Why?

Risk Perceptions Will it make me sick? How sick?

Environment/Access Is it easy? Are there environmental cues? How much does it

cost? Is everyone I know doing it?

The Message Is it from a credible source? Does it apply to me? Does it

contradict other things I’ve heard?

+ Draft* Proposed Solutions

+

Utilize Trusted Sources

Ability to persuade an audience is directly related to how credible the audience thinks the source is

Where do consumers go for food safety information?

*Does not represent official FDA position

Draft* Proposed Solutions

+ Draft* Proposed Solutions Utilize Trusted Sources

Suggested Approach*: Utilize Trusted Sources

Ability to persuade an audience is directly related to how credible the audience thinks the source is

Who do people trust?


TRUST

Low Med. High

USE

Low Food industry

(not labels) Government

School teachers Health care

professionals

Med Culinary sources Print media Food industry

(labels only)

High Friends & Family Television

+

Develop Positive Food Safety Culture

Environment (usually workplace) with social norms centered on food safety

Respect for food-related risks Motivation to handle food safely Interest and Involvement Safe food-handling behavior

How to translate for the consumer?



+






http://ruhlman.com/2013/08/bacteria-run-away-run-away/ http://boston.eater.com/2014/7/11/6193831/boston-chefs-on-customers-who-order-steak-well-done https://twitter.com/altonbrown

"I feel bad for them... They'll never be able to appreciate the true flavor..." "Sorry mate, we're out of steak." "WHY! Why don't you just eat a burger!" "Sorry.“

+








“Why are so many people so … afraid of their food? Wash your chicken or don’t wash it. I don’t care. … If you’re too busy to wash your own lettuce and buy the “pre-washed” packaged stuff, that’s probably more of a risk than rinsing a chicken in your sink.”

+








“Why are so many people so … afraid of their food? Wash your chicken or don’t wash it. I don’t care. … If you’re too busy to wash your own lettuce and buy the “pre-washed” packaged stuff, that’s probably more of a risk than rinsing a chicken in your sink.”

+ Draft* Proposed Solutions Improve Convenience

How can we continue to make recommended behaviors easier for the consumer?

“The only way I would ever use [a food thermometer] is if it were as convenient as not using one” (FSIS Focus group, 2001)


http://www.uncommongoods.com/product/spongester

http://products.geappliances.com/appliance/gea-specs/ZISW420DR

https://mysmartappliances.com/

http://www.amazon.com/HomeWarez-Flexible-Cutting-Prevent-Contamination/dp/B00FYEWL7W

+ Draft* Proposed Solutions Appeal to Emotions

Guilt, Fear, Disgust, etc.

Strong Negative Emotions + Self-Efficacy

Behavior Change

Not for everyone… Or is it?



Successful in other areas of Public Health



Becoming more popular for food safety


“LGMA Training Video Features Foodborne Illness Victims”

+

Program Development & Evaluation

Novel approaches, settings and communication strategies

Example: Supermarkets, workplace, church group

Rigorous studies to clarify influence of internal and external factors on consumer behavior

Publicly available/easy to find information about consumer food safety interventions



+ Conclusions

Here’s the thing about consumer behavior…

It’s not simple, Or random…

But it can be improved.

+ Conclusions

Here’s the thing about consumer behavior…

It’s not simple, Or random…

But it can be improved.

How?

Cater to the needs of your audience

Make food safety easy and socially acceptable

Appeal to emotions

Share your findings & experiences (positive and negative)

+ Thank you!

To everyone who has helped with this project, especially

Sharmi Das, Amy Lando, Marjorie Davidson, Alan Levy, Howard Seltzer, Louise

Dickerson, Maria Malagon, Christine Prue, and Shelley Feist

[email protected]

+ EXTRA SLIDES AND MATERIAL

+

Be exposed to the message, Believe the message applies to them, Listen to the entire message, Understand the message, Agree with the message, and finally, Act as the message suggests.

Background Consumer Food Safety Education

Many steps between

message creation &

behavior change

“Final defense” against foodborne illness For the information to have the intended effect (improve behavior), the consumer must:

+ Background Consumer Attitudes

Don’t think about food safety regularly Believe food prepared at home is safe Low benefit perception Risk & Susceptibility

+ Results: Problems & Perspectives Hand Hygiene

Use soap

20 s or longer

Dry

Behavior

o xxx

Results

+ Results: Problems & Perspectives

Contributing Factors

Hand Hygiene

Behavior

General

Specific

Use soap

20 s or longer

Dry

Know what to do

Understand why

Risk perception

Aware when behavior is needed

Access

Convenience

Social Norms/Environment



Hand Hygiene

Behavior

General

Specific

Use soap

20 s or longer

Dry

Know what to do

Understand why

Risk perception


Access

Convenience



Keep temp. ≤ 40°

Store leftovers right away

Prevent XC in refrigerator

Refrigerator Temperature & Storage

Behavior

o xxx

Results


Keep temp. ≤ 40°

Store leftovers right away

Prevent XC in refrigerator

Refrigerator Temperature & Storage

Contributing Factors Behavior

Know what to do

Understand why

Risk perception


Access

Convenience



Behavior

Use proper sanitizers

Clean kitchen surfaces and appliances

Prevent XC from sponges and cloths

Cleaning and Sanitizing

o xxx

Results


Behavior






Know what to do

Understand why

Risk perception


Access

Convenience



Behavior






Know what to do

Understand why

Risk perception


Access

Convenience


+

46 out of 51 studies conducted by academic or community educators (Extension, WIC, EFNEP, etc.)

Target Audiences: 33% Children (< 18 years old) 33% Healthy Adults (18-55 years old)

16% Vulnerable Populations * 14% Low-Income Consumers 15% Parents and Teachers 4% Racial/Ethnic Minorities

Who, What, When, Where, How? Characteristics of consumer food safety

interventions (n=51)

+

Most frequent + 41% Hand Washing + 33% Cook + 20% Chill + 18% Clean + 16% Separate

Least frequent + 8% Incidence of foodborne

illness + 6% Description of foodborne

illness + 6% Debunk myths + 2% Don’t wash raw meat



20 Different education topics covered (% studies)

+

Intervention Setting + 46% in Schools (incl. college campuses) + 22% Outreach/Passive Education + 21% Class (structured lessons) + 12% Modified environment

Length of Intervention and Follow-up Period + 30% One day 15% 2-7 days + 41% Immediate follow-up 26% Within 4 weeks + 1 study included a follow-up period longer than 6

months*



+

Sample Size 29% < 100 subjects 45% 100-500 12% 501-1000 14% > 1001

Study Design 55% Single group 6% Retrospective Pre-test/Post-

test* 28% Quasi-Experimental 14% Non-equivalent control* 16% RCTs 2% Field

82% Measure Behavior 20% Observed 69% Self-Report 12% Intentions



+

Personally relevant Lack specific knowledge vs. Lack general knowledge Audience clusters – Not homogeneous

Draft* Proposed Solutions More Specific, Targeted Information


Specific Info Here Specific Info Here

+

Personally relevant Lack specific knowledge vs. Lack general knowledge Audience clusters – Not homogeneous

“Hard-to-Reach” Groups Intentionally refuse: Raw milk “advocacy” Unable: Physical or economic barriers

Draft* Proposed Solutions More Specific, Targeted Information


Specific Info Here Specific Info Here

Design reusable grocery bags that improve consumer safety with each use

Role of the Food Industry Suggested* Environmental Interventions

Print tips and reminders on the inside to encourage safe use: Wash regularly Designate for food Store in a cool, dry place (not the car!)


Advertise food safety items with strategically placed displays and promotional themes

Food thermometers available in the meat department Refrigerator thermometers hanging on cold storage

doors “One-stop shopping for safety” display with all related

items: Thermometers Plastic wrap and storage containers Cleaning products, sponges Hand soap



Provide more visual cues to remind customers to always keep raw meat separate from other food

While shopping: Clearly designate raw food-only areas in

shopping carts (removable or fixed bin)

In the meat department: Disposable plastic bags and sanitizer + Explanation – some consumers don’t know that this is

for

At checkout: Clearly designate raw food-only bags at checkout

(different color, design, etc.)



Incorporate food safety outreach with existing nutrition programs

Many stores have an RD to plan nutrition education

activities There is a need to evaluate this same approach for retail

food safety, for example: Cooking demonstrations to teach safe food-handling Food safety tips and reminders throughout the store Develop and share recipes that include safe handling

instructions Engage with the community



PFSE Recap: • 20 stories – most success call for the blog, ever!

• WHD page #1 most visited on fightbac.org on April 7th

• 40 new social followers (big for us )

• Many stories got 100+ views each

Let’s check them out….

United States Department of Agriculture


Food Safety Research Information Office (FSRIO)

USDA/ARS National Agricultural Library


The Mission of FSRIO is to : •Support the needs of the research community

• Provide information on publicly funded, and to the extent possible, privately funded food safety research initiatives for the purpose of:

preventing unintended duplication of food safety research

assisting the executive and legislative branches of the Government and private research entities to assess food safety research needs and priorities

A Congressionally Mandated Program



FSRIO Program Staff • A team of food safety experts who support

the research community by collecting, organizing and disseminating food safety research information

• We make information available to the public through our online tools and outreach efforts


• Food Safety Research Projects Database

• Research Publication Feeds

Key Information Products

Target Audience • Food safety research community


• Extensive collection of food

safety research projects across agencies and organizations

• Showcases over 8,800 projects

funded by U.S. and international government agencies, and private organizations

Research Projects Database


Research Project Funding Agencies



Food Safety

Research Projects Database: Categories

Farm To Table

• On Farm Food

Production

• Food Processing

• Food Transport

• Retail and Food

Service

• Consumer

Food Pathogens of Public Health Concern

• Toxoplasma gondii

• Norovirus

• Listeria monocytogenes

• Escherichia coli O157:H7

• Clostridium perfringens

• Campylobacter spp.

• Salmonella spp.

Food Commodity

• Poultry

• Eggs

• Beef

• Dairy

• Pork

• Seafood

• Produce, Grain, Bean

• Beverage

• Epidemiology

• Risk Assessment

• Pathogen Biology

• Sanitation & Pathogen

Control

• Education and Training…


Food Safety Categories

1005

1088

1100

1189

19

383

941

106

580

262

155

1779

1300

1705

381

335

1045

0 200 400 600 800 1000 1200 1400 1600 1800 2000

Contaminants and Contamination

Diseases and Allergies

Education and Training

Epidemiology

Facilities and Sites

Food and Feed Composition and Characteristics

Food and Feed Handling and Processing

Food and Food Products

Food Defense and Security

Food Quality Characteristics

Government Policy and Regulations

Methodology

On-Farm Food Safety

Pathogen Biology

Plant Science & Plant Products

Risk Assessment

Sanitation and Pathogen Control


Farm-to-Table Categories

1264

902

47

129

187

554

421

24

77

93

On Farm Food Production

Food Processing

Food Transport

Retail and Food Service

Consumer

Number of NIFA Projects Number of Projects


Research Projects Database – 2014 Users

0

5000

10000

15000

20000

25000

30000

35000

Session Users Pageviews

286 256 456

3,325 3,028 6,040

23,607 21,492

33,954

USDA Universities Overall


Provides ready access to the latest food safety research publications, including

ahead of print.

Publications generated by these feeds are grouped by:

Journal Subject

Research Publication Feeds


57 Peer Reviewed Journals 30 Subjects

Research Publication Feeds

• Journal of Agricultural and Food

Chemistry

• International Journal of Food

Microbiology

• Journal of Food Protection

• Emerging Infectious Diseases

• PLoS One

• Bacterial Pathogens

• Chemical Contaminants

• Natural Toxins

• Parasites

• Viruses


Research Publication Feeds – 2014 Users

SessionUsers

Pageviews

events(clicks/searches)

145 127

478 232

2,025 1,855 4,096

1,324

16,519 14,814

28,496

8,635

USDA Universities Overall


• Other tools developed based on stakeholder surveys: • Outbreak Surveillance Feed and Resources • Interactive Map of Global Food Safety

•Website: http://fsrio.nal.usda.gov/ • Contact: Wendy Davis, [email protected]

Subject Specific Food Safety Resources

http://fsrio.nal.usda.gov/



Appendix


Food Pathogens of Public Health Concern


1013

402

46

424

398

87

145

0 200 400 600 800 1000 1200

Salmonella spp.

Campylobacter spp.

Clostridium perfringens

Escherichia coli O157:H7

Listeria monocytogenes

Norovirus

Toxoplasma gondii

http://fsrio.nal.usda.gov/research-projects-and-publications/research-projects-pathogen-and-food-commodity/research-projects


515 87

75 193

240 121

338 26

PoultryDairyEggsBeefPork

SeafoodProduce, grain, bean

Beverage

0 100 200 300 400 500 600


Projects by Food Commodity

http://fsrio.nal.usda.gov/research-projects-and-publications/research-projects-pathogen-and-food-commodity/research-projects






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Consumer Food Safety Education Problems, Perspectives ... · Consumer Food Safety Education . Problems, Perspectives & Proposed Solutions . Patricia Borrusso, Ph.D. ORISE Fellow