Alan S. Levy

Consumer knowledge of foodborne microbial hazards and food-handling practices.

A national telephone survey was conducted of 1,620 randomly selected U.S. residents who spoke English, were at least 18 years old, and resided in households with kitchen facilities. Respondents were interviewed about their recognition of foodborne pathogens, foods at risk for transmitting infection, knowledge of safe food handling, and food-handling practices. One-third of the respondents who prepared meals reported unsafe food hygiene practices: e.g., they did not wash hands or take precautions to prevent cross-contamination from raw meat. Unsafe practices were reported more often by men, adults 18 to 29 years of age, and occasional food preparers than by women, persons 30 years old or older, and frequent food preparers. Respondents who identified a food vehicle for Salmonella spp. were more likely to report washing their hands and cleaning cutting boards after preparing raw meat and poultry. The results raise concerns about consumer food-handling practices. The influence of food safety training, food-handling experience, and age on food-handling practices should be studied further. Awareness of a food vehicle for Salmonella spp., for example, may indicate knowledge of the etiology of foodborne disease that promotes safe food handling. Understanding the factors associated with safe food handling will assist in development of effective safe-food instruction programs.

Foodborne Illness: Perceptions, Experience, and Preventive Behaviors in the United States

Data from national telephone surveys conducted in 1988 and 1993 were used to describe consumer perceptions of foodborne illness. The 1993 data were also used to assess the relationship between the perception that a foodborne illness had recently been experienced and awareness, concern, knowledge, and behavior related to food safety. Respondents described foodborne disease primarily as a minor illness without fever that occurs within a day of eating a contaminated food prepared in a restaurant. However, several common pathogens have a latency period longer than a day, and experts on foodborne disease estimate that most cases of foodborne illness originate from foods prepared at home. In both surveys, people 18 to 39 years of age were more likely than those in other age groups to believe they had experienced a foodborne illness. In 1993, people with at least some college education were more likely to believe they had experienced foodborne illness than were people with less education. People who believed they had experienced foodborne illness had greater awareness of foodborne microbes and concern about food safety issues, were more likely to eat raw protein foods from animals, and were less likely to practice safe food handling than were those who did not perceive that they had experienced such an illness.

Prevalence of Selected Food Consumption and Preparation Behaviors Associated with Increased Risks of Food-borne Disease

Although not well quantified, a portion of food-borne illnesses results from voluntary behaviors that are entirely avoidable, such as eating raw foods of animal origin or engaging in unsafe food preparation practices. A telephone survey of 1,620 respondents was conducted to assess the prevalence of selected self-reported food consumption and preparation behaviors associated with increased risks of food-borne illness and the demographic characteristics related to such behaviors. The percentages of survey respondents who reported consuming raw foods of animal origin were 53%, raw eggs; 23%, undercooked hamburgers; 17%, raw clams or oysters; and 8%, raw sushi or ceviche. A fourth of the respondents said that after cutting raw meat or chicken, they use the cutting board again without cleaning it. Safer food consumption and preparation behaviors were consistently reported by persons who were female, were at least 40 years old, and had a high-school education or less. These findings suggest that risky food consumption and preparation behaviors are common in the United States and that educational campaigns aimed at changing these behaviors may need to be targeted to specific groups of persons.

Consumers’ Ability to Perform Tasks Using Nutrition Labels

Abstract Consumers’ ability to perform common nutrition label use tasks and specific task components, which revealed the effect of prior knowledge, were analyzed for relationships with demographic characteristics, label reading, and health status. Data were from a mall intercept experimental study. Most consumers (78%) accurately compared two products, 58% accurately evaluated nutrient level claims, 45% comprehensively balanced nutrients over a daily diet, and 20% accurately calculated the contribution of a single food to a daily diet, a task that required complex math. The subjects who performed significantly poorer were over 55 years of age, nonwhite, and less educated than those who performed best. Not reading food labels and having a diet-related health condition were also related to poorer performance. Task component analysis showed that all types of subjects shared the same response tendencies when making nutrition judgments. The findings suggest that dietary guidance for consumers will be more effective if it does not require quantitative tasks but relies instead on tasks that are easier for consumers.

Nutrition knowledge levels about dietary fats and cholesterol: 1983-1988

Abstract Consumer knowledge of dietary fats and cholesterol was analyzed for trends over time and for relationships with demographic characteristics and health and dieting behaviors. The data were obtained from three approximately biennial Health and Diet Surveys conducted by the Food and Drug Administration and the National Heart, Lung and Blood Institute between 1983 and 1988. Statistical methods included regression analysis and factor analysis. The results indicate that consumer knowledge about dietary fats and cholesterol is poor. Respondents with greater knowledge in 1988 were those who were more educated, middle-aged, or white, and those who were on a cholesterol-lowering diet. The regression analysis of 1988 scores indicated that education was the most important predictor of knowledge scores. Being on a self-prescribed cholesterol-lowering diet was related to higher knowledge, but being on a physician-recommended diet was related to higher knowledge scores only for younger respondents. None of the health behaviors, except engaging in regular exercise, was associated with higher knowledge levels.

Practice-Specific Risk Perceptions and Self-Reported Food Safety Practices

The relationship between risk perception and risk avoidance is typically analyzed using self-reported measures. However, in domains such as driving or food handling, the validity of responses about usual behavior is threatened because people think about the situations in which they are self-aware, such as when they encounter a hazard. Indeed, researchers have often noted a divergence between what people say about their behavior and how they actually behave. Thus, in order to draw conclusions about risk perceptions and risk avoidance from survey data, it is important to identify particular cognitive elements, such as those measured by questions about risk and safety knowledge, risk perceptions, or information search behavior, which may be effective antecedents of self-reported safety behavior. It is also important to identify and correct for potential sources of bias that may exist in the data. The authors analyze the Food and Drug Administrations 1998 Food Safety Survey to determine whether there are consistent cognitive antecedents for three types of safe food practices: preparation, eating, and cooling of foods. An assessment of measurement biases shows that endogeneity of food choices affects reports of food preparation. In addition, response bias affects reports of cooling practices as evidenced by its relation to knowledge and information search, a pattern of cognitive effects unique to cooling practices. After correcting for these biases, results show that practice-specific risk perceptions are the primary cognitive antecedents of safe food behavior, which has implications for the design of effective education messages about food safety.

Consumers' Assessment of the Food Safety Problem for Meals Prepared at Home and Reactions to Food Safety Labeling

Abstract Public awareness and concern regarding foodborne illnesses have increased rapidly over the past decade. This increased concern may cause consumers to avoid certain stores, products or brands, particularly following a publicized incidence of foodborne illness or a large recall. Many firms have undertaken costly efforts to improve the safety of their products yet find communicating such improvements difficult because of potential alarmist responses by consumers to food safety issues. To identify if differences in food safety risks can be effectively and credibly communicated, we conducted eight focus groups. This article summarizes these focus groups and reports how consumers frame the issues surrounding the food safety problem and how consumers react to label-based communications of food safety characteristics. We find consumers have broad, moderate food safety concerns, a wide but spotty understanding of foodborne illness prevention and consequences, and a healthy skepticism concerning food safety claims. We identify two forms of labeling that show promise with regard to consumer acceptance and credibility in communicating brand-level and package-level differences in the risk of foodborne illness and discuss implications for consumer valuation of such differences.

Information sources of U.S. adults trying to lose weight

Abstract This study attempted to determine whether dieters differ from nondieters in how and where they obtain nutrition and health information and whether choice of weight-loss practices is related to use of different information sources. A national telephone survey of a probability sample of 1649 adults provided detailed information on the weight-loss practices of 1431 dieters and comparable background information on 218 nondieters. Dieters were more active readers of nutrition information than were nondieters. However, their choices about type of regimen and about specific products and services were more heavily dependent on word of mouth, commercial sources, and physicians than on written information. Dieters relying on written materials were more likely to engage in healthy weight-loss regimens and less likely to engage in questionable weight-loss practices than were those relying on other sources. The pattern of information-seeking behavior observed for dieters, which indicated greater motivation to seek out written information but reliance on oral sources to inform them of specific weight-loss practices, suggests that if authoritative written information about specific weight-loss practices was available, it would be used and would likely be effective.