Food Protection Trends - November/December 2021 - 553

an outbreak. Ultimately, consumer perception of seriousness
and personal susceptibility to a foodborne outbreak was largely
dependent on perceived proximity to the outbreak, severity of
health outcomes, frequency of message delivery, and consumption
of the identified food. These factors may serve as the
drivers for consumer behavior during a foodborne outbreak
and could help frame outbreak communications.
Health officials communicate with the public during
foodborne outbreaks so that consumers can take steps to
protect themselves. Participants identified behaviors they
would take during an outbreak that were consistent with
recommended behaviors from past foodborne outbreak
messaging, implying that outbreak communication can drive
consumer behavior. Outbreaks provide an opportunity to
influence health behaviors by delivering tailored messaging
directly to the public. Tailored health messaging has been
shown to be more effective at driving long-term behavior
change (14) when compared with general health messaging.
Although participants stated they would take or have taken
immediate actions upon seeing a foodborne outbreak message,
longer term behavior change, including general food safety
behaviors, was not explored. For example, participants
reported they would avoid recalled or outbreak-linked food,
but it is unclear for how long they would avoid it.
Participants reported perceiving an outbreak as more serious
if they saw multiple messages about it. CDC takes several
factors into account when deciding how frequently to update
the public about multistate outbreaks, including whether
advice to consumers has changed, if there is new investigational
information to report, or if the outbreak is expanding in size
or scope. Message fatigue is a related concept that focuses
on frequency of exposure to health-related messages. There
is a potential concern with how message fatigue correlates
to message avoidance, annoyance, information seeking, and
desensitization (18). Although participants expressed that
they wanted to hear about all outbreaks, including those that
are not directly relevant to them, and were open to hearing it
multiple times, message fatigue should be further explored in
the context of risk communication for foodborne outbreaks.
Consumer perception of CDC multistate outbreak
communication tools
Public communication may be needed at various points
during an outbreak investigation; however, communication
strategies can differ, depending on how each outbreak
investigation evolves. Some factors that are considered
when choosing a communication strategy include the
number and severity of illnesses (groups at elevated risk
of severe illness), how geographically widespread illnesses
are, the availability and strength of the data supporting a
particular food as the source of an outbreak, and specific
characteristics of the food, such as shelf life, how widely
consumed the food is, whether the food has been involved
in previous outbreaks, and whether the food is typically
cooked before consuming or not. As part of its multistate
foodborne outbreak communication strategy, CDC uses
food safety alerts (example at https://www.cdc.gov/
listeria/outbreaks/countryham-10-18/index.html) or
investigation notices (example at https://www.cdc.gov/
salmonella/reading-07-18/index.html) as two Web-based
communication tools to rapidly provide information to the
public and other stakeholders during multistate outbreaks.
The food safety alert and investigation notice tools used in
the CDC communication strategy are deployed on the basis
of the best available data CDC has at the given time. Focus
group participants appeared to interpret that the messaging
associated with each tool pointed to where the contamination
occurred, rather than based upon the investigation process.
As a result of this perception, CDC is strategizing about ways
to better educate the public about the investigation process
and developing a potential investigation progression bar
graphic for use in Web-based tools.
We found that participants perceived the seriousness of
recalls differently than outbreaks, particularly that recalls
that were not linked to an outbreak were merely suggestions
to avoid a food. It was also not clear whether participants
understood the relationship between a recall and an outbreak.
Food recalls happen for a variety of reasons, including reasons
not attributed to illnesses and outbreaks. More research with
a generalizable population is needed to verify the relationship
between the perceptions of recall messages generally versus
recall messages that are associated with a specific foodborne
disease outbreak.
Where consumers obtain information and what they
want to know
Consumers reported various methods of obtaining
information about foodborne outbreaks. Although
government agencies were mentioned as one source
of outbreak information, participants also stated that
information about outbreaks was obtained through the
news media and social media as opposed to directly from
CDC website. Potential challenges with dissemination of
CDC outbreak messages through both news media outlets
and through social media include retaining the accuracy
of the message, whether the most salient messages are
communicated, or whether the message is communicated
at all. Although high-profile foodborne outbreaks are
often covered by local and national news and discussed
in conversations on social media, outbreaks linked to
foods that are not consumed as widely may not be covered
or discussed. This finding reinforces the importance of
CDC proactively disseminating outbreak messages to
news media and on social media. Further evaluation is
needed against a generalizable population for a deeper
understanding of how consumers get information during
outbreaks, which will lead to more effective outbreak
communication practices.
November/December Food Protection Trends 553
https://www.cdc.gov/listeria/outbreaks/countryham-10-18/index.html https://www.cdc.gov/listeria/outbreaks/countryham-10-18/index.html https://www.cdc.gov/salmonella/reading-07-18/index.html https://www.cdc.gov/salmonella/reading-07-18/index.html
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