Explaining Consumer Safe Food Handling Through Behavior-Change Theories: A Systematic Review

Abstract

Consumers often engage in unsafe food handling behaviors at home. Previous studies have investigated the ability of behavior-change theories to explain and predict these behaviors. The purpose of this review was to determine which theories are most consistently associated with consumers' safe food handling behaviors across the published literature. A standardized systematic review methodology was used, consisting of the following steps: comprehensive search strategy; relevance screening of identified references; confirmation of relevance and characterization of relevant articles; risk-of-bias assessment; data extraction; and descriptive analysis of study results. A total of 20 relevant studies were identified; they were mostly conducted in Australia (40%) and the United States (35%) and used a cross-sectional design (65%). Most studies targeted young adults (65%), and none focused on high-risk consumer groups. The outcomes of 70% of studies received high overall risk-of-bias ratings, largely due to a lack of control for confounding variables. The most commonly applied theory was the Theory of Planned Behavior (45% of studies), which, along with other investigated theories of behavior change, was frequently associated with consumer safe food handling behavioral intentions and behaviors. However, overall, there was wide variation in the specific constructs found to be significantly associated and in the percentage of variance explained in each outcome across studies. The results suggest that multiple theories of behavior change can help to explain consumer safe food handling behaviors and could be adopted to guide the development of future behavior-change interventions. In these contexts, theories should be appropriately selected and adapted to meet the needs of the specific target population and context of interest.

Determinants of hygienic handling of food by consumers in the COVID-19 pandemic context: A cross-sectional study in Vietnam

“…The behavioral-change theories have been ubiquitously adopted as an effective way to explain and predict the (un)safefood handling behaviors at home. Among those, the Theory of Planned Behavior (TPB) is identified as the most common applied theory (Young et al, 2017a(Young et al, ,b, 2018), which appears to explain the most variance in safe food-handling behaviors (Mullan et al, 2015). The systematic reviews of Young et al (2017aYoung et al ( , 2018 show that other theories of behavior-change (e.g., Protection Motivation Theory -PMT, Health Belief Model -HBM) also explain a certain proportion of behavioral intentions and self-reported/observed behaviors.…”

“…Among those, the Theory of Planned Behavior (TPB) is identified as the most common applied theory (Young et al, 2017a(Young et al, ,b, 2018), which appears to explain the most variance in safe food-handling behaviors (Mullan et al, 2015). The systematic reviews of Young et al (2017aYoung et al ( , 2018 show that other theories of behavior-change (e.g., Protection Motivation Theory -PMT, Health Belief Model -HBM) also explain a certain proportion of behavioral intentions and self-reported/observed behaviors. Furthermore, they look into the R 2 of different significant variables and finally come to suggest that the flexible use of theories composed of appropriate significant variables would help to guide the development of a successful safe-food handling behavioral model.…”

“…The fundamental reviewed TPB model consists of five exogenous variables, including knowledge, habit, subjective norm, perceived behavioral control, and intention (Young et al, 2017a(Young et al, ,b, 2019. Researchers often employ knowledge as the most commonly studied behavioral driver (Young et al, 2017b(Young et al, , 2019.…”

“…Therefore, the importance of at-home food handling and preparing is beyond dispute. Between 1994 and 2016, related literature employed various behavioral-change theories to explain distinct safe food-handling behaviors, including the Health Action Process Approach (HAPA), the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the Theory of Reasoned Action (TRA) (Young et al, 2017a). Among those, TPB has been found to outperform other models in terms of greater variance explained to be the most commonly applied theory (Mullan et al, 2015;Young et al, 2017aYoung et al, , b, 2018, which explains why we chose TPB as the theoretical foundation of this study.…”

“…Between 1994 and 2016, related literature employed various behavioral-change theories to explain distinct safe food-handling behaviors, including the Health Action Process Approach (HAPA), the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the Theory of Reasoned Action (TRA) (Young et al, 2017a). Among those, TPB has been found to outperform other models in terms of greater variance explained to be the most commonly applied theory (Mullan et al, 2015;Young et al, 2017aYoung et al, , b, 2018, which explains why we chose TPB as the theoretical foundation of this study. From 66 pertinent studies, the meta-analysis of Young et al (2017b) further identified important determinants of safe foodhandling behaviors across studies, namely knowledge, attitudes, risk perceptions, habits, subjective norm, self-confidence and control, and intention (see also Gstraunthaler & Day, 2008;Mullan et al, 2015;Young & Waddell, 2016).…”