The Food Safety Battle

There is a battle being waged between the food industry and consumers. It’s not a new conflict, and paradoxically, a win by either side would have the same ultimate result. But the means of attaining that win is where the conflict lies—that is: Who is really responsible for the safety of the food that arrives on families’ plates?
 

A Winnable Battle

CDC Chief of Enteric Diseases Dr. Patricia Griffin freely admits there is a food safety battle. But, she said, “Food safety has been designated by CDC as a winnable battle.” Accentuating the theme of the 2014 Consumer Food Safety Education Conference at which she spoke, Griffin noted that an essential component in winning the battle is education. Not only for the consumer, but also on the farm, in the plant, and at retail: “Education is needed,” she said.

According to CDC, about 800 foodborne illness outbreaks are reported every year in the U.S. but this is believed to be only a very small portion of the number of illnesses that actually occur. In fact, an estimated 25 to 30 illnesses occur for every one that is reported, bringing the number to 48 million—one in six—people who contract a foodborne illness each year. Of these, 128,000 are hospitalized; 3,000 die. 

To bring these numbers further into perspective, the leading cause of foodborne illness is mishandling of the food, with 18% to 21% attributed to unsafe practices in the home.

However, this should not be thought to absolve the food manufacturing industry of responsibility. Rather, it should be seen as incentive to continually reduce contamination all along the food chain to bring the safest possible product to the consumer, and as a call to action for manufacturers to assist in the education of consumers on food safety practices and proper handling of products you produce.
 

Food Safety Education. It was for just that reason that the Partnership for Food Safety Education brought together leaders in food safety education at the December conference. As explained by Partnership Executive Director Shelley Feist, the primary goals of the conference were to advance the knowledge, practice, and reach of health and food safety educators in support of the U.S. Healthy People 2020 goals:

• FS-1: Reduce infections caused by key pathogens transmitted commonly through food.
• FS-5: Increase the proportion of consumers who follow key food safety practices.
   

As such, while the presentations of the conference focused primarily on areas of knowledge needed by consumers for food safety in the home, and what educators and the industry can do to further consumer knowledge and practices (FS-5), it was also made clear that multi-state foodborne illness outbreaks often reveal gaps in the food system; gaps on which the food industry needs to focus for improvement (FS-1). Thus, this article, which brings the key points of the conference to the industry, focuses primarily on consumer education—what is needed and what industry can do, but it also brings to light educational needs throughout the food supply chain … farm to fork.

Why Consumer Food Safety Education Is Needed

Consumers exhibit a number of risky behaviors that can impact the ultimate safety of the food that is placed on the family table. One reason for this is because “people don’t associate foodborne illness with home food preparation,” said Christine Bruhn, director of the Center for Consumer Research, University of California, Davis.

Although unsafe handling and preparation is the greatest issue, consumers’ perception of risk and the behaviors they exhibit in response also are significant factors. For most people, involuntary risk is more threatening than the risk that one chooses to take, said Lynn Frewer, professor and chair of Food and Safety, Newcastle University (UK). Because of such perceptions, it can be more difficult to communicate the risks of an action that a person chooses to take vs. those over which they have no control, such as the safety of food prepared in the home vs. that processed in a plant. “People perceive that they have more control of in-home risk, so it is less threatening,” Frewer said.

Additionally, she said, “People have a lot of knowledge about food safety which they simply don’t activate.” Most know (or have heard) that eating a rare/red hamburger is risky; that it should be cooked to an internal temperature of at least 160^oF. Yet, if that is their preference, many will still eat it rare.

To further the point, consumers are unlikely to even know what temperature the burger is when they take it off the grill or out of the pan or oven, as very few regularly use thermometers. This point came up time after time in sessions at the conference with observational studies showing that fewer than 5% of consumers check temperatures of meats or foods they cook, and, of those, only about 20% knew the correct temperature for the specific food. Why? Like most unsafe practices, the reasons are based on both personal choice and external influence:

• Habitual Behavior. “I’ve always done it this way/have never done that, and no one has ever gotten sick.”
• Time or availability. “I don’t have a thermometer.” “It’s too much bother to use a thermometer; I can tell without one.”
• Sensory methods are believed to be best. “I know when the meat is done by its firmness/color/shrinkage/clear juices/[or even] smell.”
• Celebrity Chefs. “Chef XYZ says to test doneness by touch.”
• Recipes. “The recipe says cook 30 minutes per pound at 325o/microwave for 13-15 minutes. It doesn’t say anything about temperature.”
• Restaurants. “How do you want your burger cooked?”
   

Each of these perpetuates a perception and creates a barrier to change, but it is the external influences where industry can provide the greatest benefit and help to change in-home behavior practices. For example, celebrity chefs have significant impact on cooking and handling behaviors for both novice and experienced cooks. Inexperienced cooks will often take their words and actions as infallible. If a chef is not seen washing his hands or using a clean knife after handling raw meat, the novice cook doesn’t know to do this or deem it necessary either.

On the other hand, experienced cooks may mimic the chef’s actions believing that it shows they are just as skilled; having to use a thermometer would imply that they didn’t have the experience or skill of the celebrity chef. A survey cited by Bruhn validated the extent of these perceptions, showing that 64% of home cooks would consider using a thermometer if the celebrity chef did, while 52% felt that if the chef didn’t use one, it wasn’t necessary.

This same factor can act as a social pressure—a man cooking steak or chicken on the grill may feel others would see him as inexperienced were he to have to use a thermometer to know the meat is done. Yet, Bruhn relayed results of an observational study as having shown that 40% of chicken cooked in the home kitchen was undercooked, with grilling rates even worse—undercooked 52% of the time.

One reason for this is that the sensory methods can be inaccurate, therefore unsafe. Clear juices, white chicken, or pink burger are not always indicative of a safe temperature having been reached. Ovens and microwaves can operate at different temperatures or powers. And, as the food industry has learned time after time, times change and best practices continually improve; having always done something a certain way does not make it right or safe—even if “noone got sick.”
 

Industry Impact.A question that food manufacturers should ask themselves is: When you include recipes featuring your product (on your website, ads, or in other marketing), do you include the safe internal endpoint temperature? Or do you, “as has always been done,” simply state oven temperature and time?
 

“Natural is safer.” Another risk perception of many consumers is that the more natural, environmental, or ethical a food is or is processed, the less risk it carries. Not only does this lead consumers to make sometimes unsafe choices in food handling, it can cause them to select foods that are less safe and reject foods that are potentially beneficial. A prime example of this is the perception that organic and “natural” foods are healthier, more nutritious, and safer … including such “natural” products as raw milk. Despite the risks of raw milk espoused by FDA, USDA, and CDC, a number of families are continuing to drink this “natural” product believing it to be more healthy; confirming their right to choose; and, often, exhibiting the optimistic bias of “bad things happen to other people.”

Additionally, Frewer said, “Knowledge about food safety is linked to knowledge about nutrition.” So it is difficult to isolate one set of knowledge triggers from the other—and this perception also can go the other way—with the EU’s “Horsegate” scandal as a prime example. The inclusion of horsemeat in beef often was presented as a food safety issue and resulted in some very odd communication on the Internet, she said. In reality, horsemeat is safely eaten in many parts of the world.
 

Industry Impact. Probably the greatest example of consumer fear of that which they feel they have no choice is GMOs. It is also an area in which the food industry can have significant educational impact. GMOs were a high-profile topic of news and regulation in 2014, and the expectation is that this will continue (See Legislative Update, page 8). With consumers seeking GMO labeling of foods—both for transparency and because many see GMOs as negative, and states seeking to pass individual laws on labeling, it is likely that at least some form of GMO labeling will come to pass. Thus, rather than fighting the issue, industry would be advised to educate consumers on the history and use of beneficial GMOs, particularly any that are used in your products. As the saying goes, “Knowledge conquers fear.”

Changing Consumer Behavior: Industry’s Role

Changing behavior can be a tricky endeavor, and because the food industry and the average consumer are coming from distinctly different viewpoints and experience, aligning perspectives and imparting knowledge pose particular challenges. One area of difference is the way each assesses food safety risk:

• Consumers judge risk based on perception of danger, and require risk communication and emotional response. They may have knowledge about the topic, but they don’t always choose to abide by it.
• Food safety experts conduct technical risk assessments that are based in science and balance risk against benefit—but they don’t always consider socio-economic factors or understand consumer perceptions.
   

“People have a lot of knowledge about food safety that they don’t activate,” Bruhn said. Because of this, she said, particularly in relation to thermometer use, “I don’t think we will be successful if we try to force it.”

Rather, to change behavior, the entire food system—from farmer to retailer to celebrity chef—needs to be involved in changing the culture. We need to understand why people do what they do; correct misperceptions through appropriate vehicles, messages, and messengers; and publicly exhibit the desired behavior.
 

The Message. Whether you consider the United States to be a melting pot or a salad bowl of ethnicities, the fact is, with the the highest immigrant population in the world, the U.S. is one of the most demographically diverse. Thus, consideration must be made for the cultural diversities both in understanding of the consumer and determining the most effective messaging.

This means that while public service announcements and other such media are important, communication also needs to extend beyond the Internet, TV, and radio—into schools, churches, community centers, and other places that people gather. Other effective methods of communication for these can be information sheets with graphics, videos, recipes with a food safety message, etc. The message needs to include secondary and tertiary languages as relevant to the intended audience and be focused toward the average adult American’s eighth-grade literacy level.

The most effective messages are generally short and focused with action recommendations in positive terms—Dos vs. Don’ts. Additionally, said Michael Shapiro, Cornell associate professor of media psychology, storytelling or narration is a powerful tool. While using the story and its emotion to pull people in, you push information out. “The best way to evoke emotion is through stories that demonstrate real-life situations,” he said. Not only does audience identification with the characters help to capture their attention and make the information easier to process, it makes them less likely to argue the premise.

In all cases, the message should impart an easy, affordable, doable action that the person can take to prevent a specific food safety issue. This will vary depending on whether the communication is the result of a recall (“Check the lot number on the product”; “Discard if purchased between specific dates”; etc.) or is a general food safety message (“Use a thermometer to ensure endpoint temperature has reached 165^oF;” etc.). But all messages should include specific action(s) for a specific purpose.

When developing a message the following questions can be used as a basis for its formation:

1. What is most important for the target audience to know/understand?
2. What is the most important thing they want to know?
3. What are they most likely to get wrong?
4. What must be done, should be done, could be done?
    

The best way to reach consumers is to target their needs and wants rather than your own communication needs, Frewer said. As soon as a risk is identified for any potentially contentious issue, reach out to the public by all means possible. Tell what you don’t know as well as what you do know, and explain what you are doing to identify the cause, mitigate the problem, and prevent its occurrence in the future.

Additionally, Frewer cautioned that while social media should be a part of a company’s communication efforts, it should be considered as just one tool among many. There is no single social media channel which reaches all segments of the population, and the popularity of the channels continually change. What is “in” today is likely to be yesterday’s news tomorrow. In fact, she said, as soon as a channel is institutionalized and commercially used, it begins losing its social attraction.
 

The Messenger. To help relay cultural and individual relevance and perception of objectivity, the messenger becomes as important as the message. Using cultural agents (e.g., a tribal leader for Native American communication), independent experts (e.g., academia, CDC), and accredited peers (a mom who also has academic or scientific certification) targeted toward the intended audience will increase engagement and trust in the message. Engaging stakeholders themselves in the message also increases credibility and builds trust.

An audience’s shared values with the messenger can be significantly more influential than the competence of the messenger alone. The message needs to be scientifically grounded and economical, but, said Charlie Arnot, CMA Consulting founder and president, “Facts alone don’t drive decisions. We look for and seek information from those who think like us and act like us.” In fact, people who are like us can be so influential, they can shame us into behavior that we may not otherwise have considered. The pervasiveness and influence of “Mommy Blogs” and the continued drinking of raw milk are good examples of this.
 

Industry Impact. To both influence these groups and fight miscommunications, it is important that messages are built around shared values; are transparent—acknowledging both sides of the issue; and focus on “How can we provide the best information for you to make a decision?” Thus, industry’s most effective communication will be relayed though relevant and appropriate methods from a trusted messenger and provides a unifying, transparent message giving an accurate perception of the risk and positive, actionable recommendations.

Changing Industry Behavior

While this article, like the conference, focused in on food handling in the home, it is critical that it not be thought that the responsibility for food safety is being placed wholly on or shifted to the consumer. Rather, while understanding that consumers have a role to play and can make even safe food unsafe through their handling, industry needs to provide consumers with the safest possible product and continue improving its products and practices to do so.

As noted earlier in this article, multi-state foodborne illness outbreaks often reveal gaps in the food system, and it is such gaps that the current focus on prevention in standards and regulations, such as those of GFSI and FSMA, are intended to improve. From Salmonella in chicken to Listeria in cantaloupe, improvement and education are needed at the farm and plant level, Griffin said.

The food system has changed and the industry has to change along with it. Increased foodborne illness and its surveillance, emerging pathogens, increases in immunocompromised populations, new food vehicles, and interactive social media all mean that “What got us here won’t get us there,” said Frank Yiannas, Walmart vice president of food safety. While we can’t stop using the traditional tools of training and testing, we need to change the culture in the plant and all along the food chain to enhance employee compliance with desired food safety behavior.

In a follow-up to his book, Food Safety Culture: Creating a Behavior-Based Food Safety Management System (see QA May/June 2013), Yiannas has written a second book, Food Safety = Behavior, 30 Proven Techniques to Enhance Compliance, to be published this spring.

Among the 30 techniques that can be used to change behavior in the plant are:

• “Birds of a Feather Might Influence Food Safety for Better.” This chapter is all about homophyly, Yiannas said, explaining the term to mean that people of similar character tend to befriend each other. The technique is often seen in sales: The more like you a salesperson is, the more likely you are to buy; it is why salespeople are trained in personality styles and mirroring the style of the prospect to increase the likelihood of a sale. The same thinking holds true of encouraging desired food safety behavior in employees. Walmart’s “Mr. Rollback” is Darrell, an actual, albeit extremely personable, employee. Having Darrel deliver Walmart’s Food Safety High Five messages on video to Walmart employees brings better identification and results than would having a suited executive delivering the same message.
• “Make Food Safety the Social Norm.” Showing such videos with multiple peers acting out the desired behavior multiple times—in a positive manner—helps to increase the concept of the behavior as the social norm. Take hand washing after using the restroom as an example. There is a significant difference in the messaging of:
   

“4 out of 5 men wash their hands after using the restroom.”
vs.
“20% of men don’t wash their hands after using the restroom.”
 

While the second version brings a negative reaction of “yuck,” the first carries with it a perspective of the behavior as a social norm—“Almost all men wash their hands; I am a man, I guess I should too.” In fact, Yiannas said, statistics have shown that relaying the majority-focused message increased the desired behavior by 11%.

Behavior changes are not accomplished overnight. Rather they are most likely to be retained long-term with gradual, consistent improvement and a commitment to the outcome. Yiannas depicted this with a research initiative in which homeowners were asked to display safe-driving signage. One group was asked to place a small “Be a Safe Driver” sign in their front window; the majority agreed to do so. A second group was asked to place a very large, rather ugly “Drive Carefully” sign in the middle of their lawn; only 17% agreed. However, when the members of the first group who had agreed to post the small window sign were approached a second time and asked to place the large lawn sign, 76% complied.

This research shows that people are more likely to make major changes, enact a new behavior, after having first made a small commitment to the behavior, Yiannas explained. If you are trying to improve the food safety performance of your organization, what you are really trying to do is change peoples’ behaviors, he said. “Simply put, food safety equals behavior.”
 

A Winnable Battle

At the beginning of this article, the question was asked: Who is really responsible for the safety of the food that arrives on families’ plates?

The answer is that we all are. As clichéd as the phrase has become, all of us, “from farm to fork,” are responsible for handling every aspect of all foods as safely as possible. And we all have some behaviors to change for the battle of food safety to be won.

The author is Editor of QA magazine. She can be reached at llupo@gie.net.