Consumer Food Safety: What Have We Learned in the Last 20 Years?

Theoretical Background and research questions/hypothesis:   Over the last 20 years there have been many efforts to improve consumer food-handling, from traditional education to national ad-campaigns and innovations to kitchen appliances.  Despite these initiatives many consumers fail to adopt recommended behaviors.  The purpose of this research was threefold:   review information about consumer behavior and behavioral influences, evaluate the impact of education campaigns and interventions, and finally, develop a comprehensive, set of recommendations to guide future efforts to improve food safety education.

Methods:  A systematic review of consumer food safety literature (N=243), published in the United States or similar countries since 2000 was completed.  Peer-reviewed journals, reports and white papers were the main formats assessed, however other sources (news articles, presentations, websites) with relevant information were also included.  The following topics are the main focus areas:  consumer behavior (handling, storage, cleaning, cooking, hygiene); behavioral determinants (such as attitudes and knowledge.); microbial studies (contamination and foodborne illness in homes); education and interventions; risk communication strategies and health promotion theories; and audience characteristics. 

Results:  Consumers lack knowledge in several specific areas such as the correct temperatures to store and cook food and how to report foodborne illness.  Some mistakenly believe certain unsafe practices are correct (i.e., washing raw meat).  This is problematic, since individuals who think they handle food safely may ignore or not believe educational messages that are discordant with prior beliefs.  Even among knowledgeable consumers recommended practices are frequently neglected.  These findings suggest other factors (convenience, visual cues, social norms, perceived threat) have a stronger impact on behavior.  Several interventions addressed the influence of these factors on behavior; however overall conclusions are unclear.  Few studies measured long-term outcomes (some do not measure any outcomes); include a large, random sample; use validated research instruments; or apply adequate controls.  Despite these limitations some evidence indicates a weak association between knowledge and behavior, which is made stronger when knowledge is combined with risk information.  Most studies agree advice from a credible source, targeting a specific audience is more successful than depersonalized communication.

Conclusions:  In order to increase safe food-handling, food safety messages must promote convenient behaviors and include credible, audience-specific risk information.  Our review of the literature did not identify clear results that identify strong behavioral influences or best practices for communicating food risks.  There is a continued need for novel education approaches that are also well-designed and rigorously evaluated.

Implications for research and/or practice:  Education alone can only improve behavior to a certain extent.  After 20 years of consumer food safety education we must evaluate whether traditional approaches continue to improve behavior.  Considering the significant gaps identified by this review, there is a clear need for a new approach to address consumer food safety.  Innovative technology, creative marketing, retail-level interventions and emotional appeals are only a few strategies that successfully improved other aspects of public-health (such as nutrition or tobacco avoidance).  The recommendations and findings from this review provide detailed suggestions for educators, regulators, industry and researchers who want to improve consumer food-handling.