Abstract
Foodborne illness has a substantial health and economic burden on society, and most cases are believed to be due to unsafe food handling practices at home. Several qualitative research studies have been conducted to investigate consumers’ perspectives, opinions, and experiences with safe food handling at home, and these studies provide insights into the underlying barriers and facilitators affecting their safe food handling behaviours. We conducted a systematic review of previously published qualitative studies in this area to synthesize the main across-study themes and to develop recommendations for future consumer interventions and research. The review was conducted using the following steps: comprehensive search strategy; relevance screening of abstracts; relevance confirmation of articles; study quality assessment; thematic synthesis of the results; and quality-of-evidence assessment. A total of 39 relevant articles reporting on 37 unique qualitative studies were identified. Twenty-one barriers and 10 facilitators to safe food handling were identified, grouped across six descriptive themes: confidence and perceived risk; knowledge-behaviour gap; habits and heuristics; practical and lifestyle constraints; food preferences; and societal and social influences. Our overall confidence that each barrier and facilitator represents the phenomenon of interest was rated as high (n = 11), moderate (11), and low (9). Overarching analytical themes included: 1) safe food handling behaviours occur as part of a complex interaction of everyday consumer practices and habituation; 2) most consumers are not concerned about food safety and are generally not motivated to change their behaviours based on new knowledge about food safety risks; and 3) consumers are amenable to changing their safe food handling habits through relevant social pressures. Key implications and recommendations for research, policy and practice are discussed.
Highlights
Foodborne disease has a substantial global burden on morbidity and mortality [1]
Previous research suggests that most sporadic cases of enteric illness are associated with exposure at home vs. other settings [7,8,9], and most foodborne disease outbreaks in Europe are associated with domestic household settings [10]
Research conducted in countries classified as “very high human development” by the United Nations Development Programme was considered in this review, as studies in these settings were most relevant to our end-users (Canadian food safety decision-makers and practitioners)
Summary
Foodborne disease has a substantial global burden on morbidity and mortality [1]. In the United States (US), foodborne disease agents are estimated to cause 48 million cases of illness each year, resulting in approximately 128,000 hospitalizations and 3,000 deaths [2,3]. In Canada, approximately 4 million cases of domestically-acquired foodborne illness occur each year, resulting in an estimated 11,600 hospitalizations and 238 deaths [4,5]. These illnesses have significant economic impacts on society through direct healthcare costs and indirect costs such as lost productivity [6], and they occasionally result in costly food recalls and trade disruptions. Several previous qualitative research studies have been conducted to investigate consumers’ perspectives, opinions, and experiences with safe food handling at home [11,12,13]. These studies provide insights into the underlying reasons affecting consumers’ adoption and maintenance of their behaviours, which can help to guide the development of appropriate behaviour change interventions and other policy actions [14,15]
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