Assessment of Risk Communication Associated with Ordering Undercooked Hamburgers in Restaurants

Ground beef has been associated with Escherichia coli O157:H7 and other STECs. As a mitigation step, as cook time of hamburgers increases, log reduction of harmful bacteria that may be present decreases. The United States Food and Drug Administration 2013 Model Food Code states that it is the duty of the restaurant to disclose and remind consumers of risk when ordering undercooked food such as ground beef. The purpose of this study was to determine whether the process of disclosure and reminder is actually occurring in restaurants, to describe it, to illustrate server knowledge and attitudes about undercooked hamburger risk, and to determine whether consumers responded differently to various risk messages.;Secret shoppers were recruited and trained on the protocol of hamburger ordering and asking questions about burger doneness and safety. They visited restaurants in several geographic locations across the United States, ordered medium rare burgers, and collected risk information on restaurant menus and server responses to questions relating to measuring doneness and safety (n=265). Codes were developed to characterize server responses based on methods of doneness and to classify whether safety information and incorrect information were provided. The majority of servers indicated an unreliable method of doneness or other incorrect information related to burger doneness and safety; these results indicate major gaps in server knowledge and risk communication.;A survey was conducted with restaurant servers (n = 50) to learn about servers' knowledge and attitudes surrounding undercooked hamburgers and risk communication with consumers. Although 58% of servers report feeling high levels of concern about the food their restaurant serves and 68% are very concerned about restaurant reputation, 62% report rarely or never communicating risk to consumers. The survey revealed that 51% of servers believe medium rare hamburgers to be safe and that 40% of servers would use color to describe how doneness is determined to a consumer. Results from this survey and education literature were used to construct a factsheet highlighting an E. coli O157:H7 outbreak related to undercooked hamburgers served in restaurants. Servers were shown the factsheet and interviewed to learn their perceptions of the document and whether it changed their opinions about their role in risk communication (n = 30). Overall, servers liked the information and "what you can do" section of the factsheet, and also recognized E. coli as a possible hazard in hamburgers; however, consumer choice and satisfaction ultimately appear to take precedence over risk communication.;A multifactorial survey was conducted with consumers (n = 250) to determine consumer likelihood to order a medium rare hamburger or question a server about hamburger safety based on five varying risk messages. Risk messages varied on level of description of foodborne illness symptoms and indicators of doneness. There was not a difference in consumer response to risk messages; consumers reported that they were unlikely to order a hamburger medium rare after reading each message, and were neutral about their likelihood to ask a server about hamburger safety. It would be worth investigating whether consumer responses are different if risk communication is delivered in person rather than text form.;This study shows that not only are there major gaps in risk communication occurring at restaurants, but the FDA 2013 Model Food Code does not adequately communicate risk based on risk communication literature. The Conference for Food Protection (CFP), the organization which suggests amendments to the Model Food Code first needs to determine whether servers should be risk communicators. Consumer advisory messages could be improved by making them more prominent, more actively reminding consumers of risk, and being equipped to address their questions about the safety of a product.